Lindsay R
Columbia University College of Physicians and Surgeons, New York, NY.
Baillieres Clin Rheumatol. 1993 Oct;7(3):499-513. doi: 10.1016/s0950-3579(05)80075-5.
Osteoporosis is a disorder of ageing that shares with other disorders of ageing a multifactorial pathogenesis. The important factors for osteoporosis include the diet, life-style and intercurrent factors such as disease. However, it is clear that loss of ovarian function is an important determinant of bone loss, and oestrogen appears to be the key factor involved. Thus, not only does loss of ovarian function result in bone loss, it can be stopped by adequate oestrogen intervention. Numerous techniques are available to measure bone mass non-invasively and to estimate the risk of future fracture. Thus, for the postmenopausal woman who is concerned about osteoporosis, and who is willing to accept intervention to prevent the disease, bone mass measurement allows the clinician to determine the risk of future osteoporotic fracture and to provide intervention if required. Future studies may elucidate whether determination of skeletal remodelling using biochemistry adds significantly to risk determination. This may be required when considering agents other than oestrogen for intervention among asymptomatic women, as these agents primarily affect the skeleton, while the effects of oestrogen are wide ranging in the body.
骨质疏松症是一种衰老性疾病，与其他衰老性疾病一样具有多因素发病机制。骨质疏松症的重要因素包括饮食、生活方式以及诸如疾病等并发因素。然而，卵巢功能丧失显然是骨质流失的一个重要决定因素，雌激素似乎是其中的关键因素。因此，卵巢功能丧失不仅会导致骨质流失，通过适当的雌激素干预还可以阻止这种情况。有多种技术可用于非侵入性地测量骨量并估计未来骨折的风险。因此，对于担心患骨质疏松症且愿意接受干预以预防该疾病的绝经后女性，骨量测量使临床医生能够确定未来发生骨质疏松性骨折的风险，并在需要时提供干预措施。未来的研究可能会阐明，使用生物化学方法测定骨骼重塑是否能显著提高风险判定的准确性。在考虑对无症状女性使用雌激素以外的药物进行干预时，这可能是必要的，因为这些药物主要影响骨骼，而雌激素对身体的影响范围广泛。
