Ziegler R
Medizinische Universitätsklinik und Poliklinik Heidelberg.
Ther Umsch. 1998 Nov;55(11):696-701.
In women, osteoporosis with fractures can happen between 50 years, the age of the menopause, and 80 years. Over these three decades, the condition of bone metabolism is not the same. The years after menopause present with high bone turnover. During these years, the administration of antiresorptive drugs is promising: Estrogens (plus progestagens), calcitonins, bisphosphonates. About 10 years after the menopause bone turnover slows down to low turnover. Now the administration of bone-formation stimulating agents is to be preferred: fluorides in the first line, perhaps anabolics in single cases. The prominent fracture of women older than 75 years is the hip fracture (type II osteoporosis). Bone turnover mostly is accelerated again, now due to secondary hyperparathyroidism as a consequence of long-lasting calcium and vitamin D deficiency. For treatment, calcium plus vitamin D is recommended. The exact diagnosis of the metabolic status of the skeleton is a prerequisite for the choice of the optimal therapeutic principle.
在女性中，伴有骨折的骨质疏松症可发生在50岁（绝经年龄）至80岁之间。在这三十年中，骨代谢状况不尽相同。绝经后的数年呈现高骨转换状态。在这些年里，使用抗吸收药物很有前景：雌激素（加孕激素）、降钙素、双膦酸盐。绝经后约10年，骨转换减缓至低转换状态。此时，首选使用刺激骨形成的药物：一线使用氟化物，个别情况下可能使用合成代谢药物。75岁以上女性的主要骨折类型是髋部骨折（II型骨质疏松症）。骨转换大多再次加速，这是由于长期钙和维生素D缺乏导致的继发性甲状旁腺功能亢进。治疗方面，建议补充钙和维生素D。准确诊断骨骼的代谢状态是选择最佳治疗原则的前提。
