Prevention of Osteoporosis in Women
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Osteoporosis, the most common bone disease, is a silent condition resulting in increased fracture risk. The disorder is characterized by compromised bone strength and increased susceptibility to fractures that have important health and socioeconomic consequences. The prevention of osteoporosis should begin early and continue throughout life with measures that maintain or improve bone health. These measures include regular physical activity and a balanced diet, including adequate intake of calcium and other minerals, proteins, and foods rich in antioxidants. In older persons at increased risk of fragility fractures, the prevention of falls and the maintenance of adequate vitamin D status are essential. Assessment of fracture risk, followed by proven effective non-pharmacologic and pharmacologic management remains low, even in patients who have sustained a fragility fracture. Non-pharmacologic intervention should always be implemented, but many patients also need pharmacologic intervention to achieve adequate fracture protection. While low bone mineral density (BMD) is a factor in bone fragility, low BMD is not the only factor. Drugs for osteoporosis should not only promote changes in BMD, but should be proven to reduce the incidence of fractures. This article reviews advances in strategies to prevent osteoporosis.
Abstract
Osteoporosis, the most common bone disease, is a silent condition resulting in increased fracture risk. The disorder is characterized by compromised bone strength and increased susceptibility to fractures that have important health and socioeconomic consequences. The prevention of osteoporosis should begin early and continue throughout life with measures that maintain or improve bone health. These measures include regular physical activity and a balanced diet, including adequate intake of calcium and other minerals, proteins, and foods rich in antioxidants. In older persons at increased risk of fragility fractures, the prevention of falls and the maintenance of adequate vitamin D status are essential. Assessment of fracture risk, followed by proven effective non-pharmacologic and pharmacologic management remains low, even in patients who have sustained a fragility fracture. Non-pharmacologic intervention should always be implemented, but many patients also need pharmacologic intervention to achieve adequate fracture protection. While low bone mineral density (BMD) is a factor in bone fragility, low BMD is not the only factor. Drugs for osteoporosis should not only promote changes in BMD, but should be proven to reduce the incidence of fractures. This article reviews advances in strategies to prevent osteoporosis.
참고문헌 (38)
- Dominguez LJ, "Therapeutic options in osteoporosis", Acta Biomed, 81, pp.55~65 (2010)
- Gass M, "Preventing osteoporosis-related fractures: an overview", Am J Med, 119, pp.s3~S11 (2006)
- Papaioannou A, "2010 clinical practice guidelines for the diagnosis and management of osteoporosis in Canada: summary", CMAJ, 182, pp.1864~1873 (2010)
- National Institute of Health, "NIH Consensus Development Panel on Osteoporosis Prevention, Diagnosis, and Therapy, March 7-29, 2000", highlights of the conference. South Med J, 94, pp.569~573 (2001)
- WHO Study Group, "Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a WHO Study Group", World Health Organ Tech Rep Ser, 843, pp.1~129 (1994)
- Cummings SR, "qClinical use of bone densitometry: scientific review", JAMA, 288, pp.1889~1897 (2002)
- Hodgson SF, "American Association of Clinical Endocrinologists medical guidelines for clinical practice for the prevention and treatment of postmenopausal osteoporosis: 2001 edition, with selected updates for 2003", Endocr Pract, 9, pp.544~564 (2003)
- Wei GS, "Osteoporosis management in the new millennium", Prim Care, 30, pp.711~741 (2003)
- Siris ES, "Identification and fracture outcomes of undiagnosed low bone mineral density in postmenopausal women: results from the National Osteoporosis Risk Assessment", JAMA, 286, pp.2815~2822 (2001)
- Garnero P, "Markers of bone resorption predict hip fracture in elderly women: the EPIDOS Prospective Study", J Bone Miner Res, 11, pp.1531~1538 (1996)
- Dufresne TE, "Risedronate preserves bone architecture in early postmenopausal women in 1 year as measured by three-dimensional microcomputed tomography", Calcif Tissue Int, 73, pp.423~432 (2003)
- Boivin GY, "Alendronate increases bone strength by increasing the mean degree of mineralization of bone tissue in osteoporotic women", Bone, 27, pp.687~694 (2000)
- Freedman KB, "Treatment of osteoporosis: are physicians missing an opportunity", J Bone Joint Surg Am, 82-A, pp.1063~1070 (2000)
- U.S. Department of Health and Human Services, Office of the Surgeon General, "Bone health and osteoporosis: a report of the surgeon general" (2004), U.S. Government Printing Office
- Griffin MR, "Black-white differences in fracture rates", Am J Epidemiol, 136, pp.1378~1385 (1992)
- Melton LJ 3rd, "Epidemiology worldwide", Endocrinol Metab Clin North Am, 32, pp.1~13 (2003)
- Bettelli G, "Relationship between mortality and proximal femur fractures in the elderly", Orthopedics, 26, pp.1045~1049 (2003)
- Gao Y, "Estrogen prevents bone loss through transforming growth factor beta signaling in T cells", Proc Natl Acad Sci U S A, 101, pp.16618~16623 (2004)
- Hofbauer LC, "Clinical implications of the osteoprotegerin", RANKL, JAMA, pp.2004, 292[DOI]
- Boyle WJ, "Osteoclast differentiation and activation", Nature, 423, pp.337~342 (2003)
- Verhaar HJ, "Medical treatment of osteoporosis in the elderly", Aging Clin Exp Res, 21, pp.407~413 (2009)
- Howard E, "FPIN's clinical inquiries. Combination therapy for postmenopausal osteoporosis", Am Fam Physician, 81, pp.439~ (2010)
- Harvard Medical School, "What to do about postmenopausal fracture risk. Diet, exercise, calcium, and vitamin D are always important, but women at high risk for fractures may need drug therapy, too", Harv Womens Health Watch, 17, pp.1~3 (2009)
- Dawson-Hughes B, "A controlled trial of the effect of calcium supplementation on bone density in postmenopausal women", N Engl J Med, 323, pp.878~883 (1990)
- Bischoff-Ferrari HA, "Fracture prevention with vitamin D supplementation: a meta-analysis of randomized controlled trials", JAMA, 293, pp.2257~2264 (2005)
- Stefanick ML, "Estrogens and progestins: background and history, trends in use, and guidelines and regimens approved by the US Food and Drug Administration", Am J Med, B12, pp.64~73 (2005)
- Lindsay R, "Effect of lower doses of conjugated equine estrogens with and without medroxyprogesterone acetate on bone in early postmenopausal women", JAMA, 287, pp.2668~2676 (2002)
- polska-Orlowska K, "in bone mechanical strength in response to physical therapy", Pol Arch Med Wewn, 120, pp.368~373 (2010)
- Almstedt HC, "Changes in bone mineral density in response to 24 weeks of resistance training in college-age men and women", J Strength Cond Res, 25, pp.1098~1103 (2011)
- Englund U, "Physical activity in middle-aged women and hip fracture risk: the UFO study", Osteoporos Int, 22, pp.499~505 (2011)
- Pigozzi F, "Bone mineral density and sport: effect of physical activity", Sports Med Phys Fitness, 49, pp.177~183 (2009)
- van den Bergh JP, "Optimal use of vitamin D when treating osteoporosis", Curr Osteoporos Rep, 9, pp.36~42 (2011)
- Wasnich RD, "Changes in bone density and turnover after alendronate or estrogen withdrawal", Menopause, 11, pp.622~630 (2004)
- Cauley JA, "Effects of estrogen plus progestin on risk of fracture and bone mineral density: the Women's Health Initiative randomized trial", JAMA, 290, pp.1729~1738 (2003)
- Qaseem A, "Pharmacologic treatment of low bone density or osteoporosis to prevent fractures: a clinical practice guideline from the American College of Physicians", Ann Intern Med, 149, pp.404~415 (2008)
- Wells G, "Meta-analyses of therapies for postmenopausal osteoporosis. V. Meta-analysis of the efficacy of hormone replacement therapy in treating and preventing osteoporosis in postmenopausal women", Endocr Rev, 23, pp.529~539 (2002)
- Kawate H, "Alendronate improves QOL of postmenopausal women with osteoporosis", Clin Interv Aging, 5, pp.123~131 (2010)
- Favus MJ, "Bisphosphonates for osteoporosis", N Engl J Med, 363, pp.2027~2035 (2010)