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2018, vol. 71, br. 5-6, str. 201-205
Osteoporoza u postmenopauzi
aUniverzitet u Novom Sadu, Medicinski fakultet + Klinički centar Vojvodine, Klinika za ginekologiju i akušerstvo, Novi Sad
bUniverzitet u Novom Sadu, Medicinski fakultet + Institut za onkologiju Vojvodine, Sremska Kamenica
cUniverzitet u Novom Sadu, Medicinski fakultet + Klinički centar Vojvodine, Klinika za medicinsku rehabilitaciju, Novi Sad
dUniverzitet u Novom Sadu, Medicinski fakultet + Special Hospital for Rheumatic Diseases, Novi Sad

e-adresaartur.bjelica@mf.uns.ac.rs
Ključne reči: postmenopauzalna hemodijaliza; prelomi kosti; faktori godina; faktori rizika; estrogeni; dijagnoza; terapija; biomarkeri
Sažetak
Uvod. Žene u postmenopauzi su pod velikim rizikom za nastanak osteoporoze i preloma kostiju. Patofizologija osteoporoze. Dva glavna faktora su starenje i gubitak gonadalne funkcije. Osteoporoza u postemenopauzi je primarno posledica nedostatka estrogena a senilna osteoporoza je povezana sa prirodnim procesom starenja. Faktori rizika za osteoporozu. Kao faktori rizika navode se: 50 i više godina, ženski pol, bela rasa, genetska predispozicija, nizak rast, pothranjenost, fizička neaktivnost, amenoreja, kasna menarha, rana menopauza, stanja nedostatka estrogena i androgena, konzumiranje alkohola, pušenje cigareta, ishrana siromašna kalcijumom, upotreba nekih lekova. Komplikacije osteoporoze. Osteoporoza je glavni uzrok preloma kostiju u starijoj populaciji. Biohemijski markeri osteoporoze. Opisani su brojni markeri izgradnje i razgradnje kostiju. Dijagnostika. Dvostruka apsorpciometrija X-zraka kuka i kičme je široko rasprostranjeni standard u dijagnostici osteoporoze. Merenja dvostruke apsorpciometrije X-zraka uz primenu laserske tehnike petne kosti, alternativa je za dvostruku apsorpciometriju X-zraka. Kvantitativna kompjuterska tomografija meri tanke slojeve poprečnog skena. Kvantitativna ultrasonografija je dobra metoda, ali merenja nisu dovoljno precizna kao kod drugih imidžing tehnika. Medikamentni tretman osteoporoze. Savremeno lečenje osteoporoze uključuje primenu: bisfosfonata, selektivnih modulatora estrogenih receptora, preparata kalcijuma, vitamina D, monoklonalih antitela, hormonske terapije, primenu estrogena i fitoestrogena. Prevencija. Promena životnog stila i nefarmakološke mere su najznačajnije za postojanje zdravih kostiju. Fizička aktivnost, adekvatna ishrana bogata kalcijumom i vitaminom D, izbegavanje pušenja i konzumiranja alkohola su od neprocenjivog značaja kod osoba svih uzrasta, naročito u starijem životnom dobu.
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