Klemm Philipp, Schulz Nils, Lange Uwe, Bühring Björn
Abteilung für Rheumatologie, Klinische Immunologie, Osteologie und Physikalische Medizin, Campus Kerckhoff der Justus-Liebig-Universität Gießen, Kerckhoff-Klinik, Benekestraße 2-8, 61231, Bad Nauheim, Deutschland.
Bergisches Rheuma-Zentrum, Cellitinnen-Krankenhaus St. Josef, Wuppertal, Deutschland.
Inn Med (Heidelb). 2025 May 16. doi: 10.1007/s00108-025-01884-7.
Osteoporosis is a relevant public health issue characterized by reduced bone mass and impaired bone microarchitecture, leading to an increased fracture risk. Osteoporosis is diagnosed based on low bone mineral density (BMD), specific fragility fractures and/or an elevated fracture risk. The BMD is one of the most important risk factors for the increased fracture risk that defines osteoporosis, alongside age and sex. Accordingly, treatment strategies focus on reducing the fracture risk. Risk gradients and an algorithm for fracture risk assessment guide treatment decisions. A primary osteoanabolic treatment is recommended for individuals with a 3-year fracture risk of 10% or higher and antiresorptive treatment where the risk exceeds 3%. The high disease burden and gaps in care highlight the need for targeted interventions. The introduction of new guidelines in Germany and Austria provides clear and individualized recommendations for action for the diagnosis and treatment of osteoporosis.
骨质疏松症是一个相关的公共卫生问题，其特征是骨量减少和骨微结构受损，导致骨折风险增加。骨质疏松症是根据低骨矿物质密度（BMD）、特定的脆性骨折和/或骨折风险升高来诊断的。骨矿物质密度是定义骨质疏松症的骨折风险增加的最重要危险因素之一，与年龄和性别并列。因此，治疗策略侧重于降低骨折风险。风险梯度和骨折风险评估算法指导治疗决策。对于3年骨折风险为10%或更高的个体，建议进行主要的骨合成代谢治疗；对于风险超过3%的个体，建议进行抗吸收治疗。高疾病负担和护理差距凸显了有针对性干预措施的必要性。德国和奥地利新指南的出台为骨质疏松症的诊断和治疗提供了明确且个性化的行动建议。
