内分泌
词汇介绍
拓展阅读
解析
Osteoporosis 英/ˌɒstiəʊpəˈrəʊsɪs/ 美/ˌɑːstioʊpəˈroʊsɪs/
释 义 n. [外科] 骨质疏松症
例 句 DEXA scans help find out whether you have osteoporosis or are at risk of developing it. 地塞米松扫描有助于了解您是否有骨质疏松症或处于危险的发展。
概述
概述
骨质疏松症是一种疾病，其中骨骼弱化增加了断骨风险，这是老年人骨折的最常见原因，直到骨折发生，通常没有任何症状。骨质疏松症可能是由于最大骨量低于正常值和骨量高于正常值所致，绝经后由于雌激素水平降低，骨质流失增加。骨质疏松症也可能由于多种疾病治疗而发生，包括酒精中毒，厌食，甲状腺功能亢进，肾脏疾病和卵巢手术切除等。某些药物会增加骨质流失的速度，包括一些抗癫痫药，化学疗法，质子泵抑制剂，选择性血清素再摄取抑制剂和糖皮质激素。吸烟和太少运动也是危险因素，骨质疏松症的定义是骨密度比年轻成年人的骨密度低 2.5个标准差。
诊断方法
骨质疏松症的诊断可以使用常规放射线照相术并通过测量骨矿物质密度（BMD）来进行。测量BMD的最普遍采用的方法是双能X射线吸收法。除了检测出异常的BMD以外，骨质疏松症的诊断还需要调查潜在的病因，可以通过验血来完成。
治疗
生活方式预防骨质疏松症在许多方面与潜在可改变的危险因素相反。由于吸烟和大量饮酒与骨质疏松症有关，因此通常建议戒烟和适量饮酒是预防的方法。在患有乳糜泻的人中坚持无麸质饮食可降低发生骨质疏松症的风险，饮食必须确保最佳钙摄入量（每天至少1克）并建议测量维生素D的水平，并在必要时采取特定的补充剂。
Trabecular bone score improves fracture risk assessment in glucocorticoid-induced osteoporosis
复制标题
骨小梁评分改善糖皮质激素性骨质疏松症骨折风险评估
发表时间：2019-10-19
影响指数：5.1
作者： Helena Florez
期刊：RHEUMATOLOGY
In our series nearly 30% of patients presented fragility fractures. However, in the subgroup of VF, most were unnoticed. Thus, 71% of patients with VF in our study had not been previously diagnosed with these fractures. This finding constitutes a common problem in clinical practice, not only in subjects treated with GC, but also in the general population, in which nearly 60% of VF may be overlooked. The present results clearly reflect the need for evaluating the presence of VF in subjects treated with GC, since this type of fracture not only constitutes the most common fracture associated with GIOP but is also a recognized cause of morbidity and mortality, constituting a clear indication for antiosteoporotic treatment. It should be noted that in the present study most patients with VF did not have osteoporotic BMD. Indeed, only 38% of patients with VF had a T-score 42.5 at the lumbar spine and/or the proximal femur, reflecting the poor diagnostic accuracy of BMD values in this context. This finding has also been reported in previous studies and is related to the alteration of other aspects of bone quality produced by GC exposure, which are not well captured by BMD, but could apparently be evaluated with TBS. Accordingly, in our study TBS was highly sensitive in evaluating subjects with VF, with 76% of these subjects presenting DMA in the TBS. In addition, DMA in TBS showed the highest, albeit not significant, diagnostic discriminative value for VF when compared with BMD osteoporotic values at any location, i.e. lumbar spine, femoral neck and/or total hip, with an AUC of 0.73, 0.64 and 0.63, respectively. Conversely, the specificity of TBS (DMA) for VF was lower than that observed with osteoporotic BMD values, with values of 0.53 and 0.72, respectively. Although this resulted in a low PPV, the NPV for DMA was high at 0.92, making TBS very useful for identifying subjects on GC treatment with low risk for FV. It should be noted that although the combination of having osteogenic BMD and low TBS (DMA) in our patients significantly increased the risk of VF, the changes in the sensitivity and specificity values of this combination were low and resulted in similar PPV and NPV values to those obtained using TBS (DMA) alone.
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