Payer Juraj, Jackuliak Peter, Vaňuga Peter, Killinger Zdenko, Dubecká Soňa, Kužma Martin
5th Department of Internal Medicine, Faculty of Medicine, Comenius University, University Hospital Bratislava, Ružinovská 6, 82101, Bratislava, Slovakia.
Slovak Society for Osteoporosis and Metabolic Bone Disorders, Bratislava, Slovakia.
Arch Osteoporos. 2025 May 4;20(1):56. doi: 10.1007/s11657-025-01538-z.
Osteoporosis is a chronic, systemic skeletal disease characterized by decreased bone mass and microarchitectural deterioration, leading to increased fracture risk. In Slovakia, its prevalence is estimated at 6%, with substantial health, social, and economic burdens.
The Slovak national guideline provides an overview for the diagnosis, prevention, and treatment of osteoporosis in Slovakia, reflecting recent scientific advances and recommendations from international bodies.
The guidelines were developed by a multidisciplinary expert panel and officially adopted by the Ministry of Health of the Slovak Republic. They are based on current evidence and international standards, including FRAX, IOF, ISCD, and ESCEO recommendations.
Diagnosis involves clinical risk assessment, biochemical testing, and imaging-primarily DXA and trabecular bone score. FRAX with or without BMD enhances risk stratification. Osteoporosis is categorized as primary or secondary. Prevention strategies include lifestyle modification, calcium and vitamin D supplementation, and fall risk reduction. Pharmacologic treatment includes antiresorptive agents (bisphosphonates, denosumab, SERMs), osteoanabolic (teriparatide, romosozumab), and hormone therapy when indicated. Sequential treatment strategies are emphasized, particularly in high-risk individuals. Treatment monitoring includes bone turnover markers and periodic DXA. CONCLUSIONS: The Slovak guidelines provide a comprehensive and pragmatic approach for the management of osteoporosis across all stages, emphasizing early diagnosis, personalized treatment, and long-term fracture prevention. They align with European and global best practices and support clinical decision-making across specialties.
骨质疏松症是一种慢性全身性骨骼疾病，其特征是骨量减少和微结构恶化，导致骨折风险增加。在斯洛伐克，其患病率估计为6%，带来了巨大的健康、社会和经济负担。
斯洛伐克国家指南概述了该国骨质疏松症的诊断、预防和治疗方法，反映了最新的科学进展和国际机构的建议。
该指南由一个多学科专家小组制定，并由斯洛伐克共和国卫生部正式采用。它们基于当前证据和国际标准，包括FRAX、国际骨质疏松症基金会（IOF）、国际临床骨密度测量学会（ISCD）和欧洲骨质疏松症和骨关节炎临床与经济学会（ESCEO）的建议。
诊断包括临床风险评估、生化检测和影像学检查——主要是双能X线吸收法（DXA）和小梁骨评分。使用或不使用骨密度（BMD）的FRAX可增强风险分层。骨质疏松症分为原发性或继发性。预防策略包括改变生活方式、补充钙和维生素D以及降低跌倒风险。药物治疗包括抗吸收剂（双膦酸盐、地诺单抗、选择性雌激素受体调节剂）、骨合成代谢药物（特立帕肽、罗莫单抗）以及在有指征时的激素治疗。强调序贯治疗策略，特别是在高危个体中。治疗监测包括骨转换标志物和定期DXA。
斯洛伐克指南为骨质疏松症各阶段的管理提供了全面且务实的方法，强调早期诊断、个性化治疗和长期骨折预防。它们与欧洲和全球最佳实践一致，并支持各专科的临床决策。
