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2018, vol. 71, br. 5-6, str. 201-205
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Osteoporoza u postmenopauzi
Postmenopausal osteoporosis
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-adresa: artur.bjelica@mf.uns.ac.rs
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.
Abstract
Introduction. Postmenopausal women are at a great risk for osteoporosis and bone fractures. Pathophysiology of osteoporosis. The two main factors causing osteoporosis are aging and loss of the gonadal function. Postmenopausal osteoporosis is primarily the consequence of estrogen deficiency, whereas senile osteoporosis is related to the natural aging process. Risk factors for the onset of osteoporosis. Risk factors include: age of 50 years and over. female gender. Caucasian race, genetic predisposition, short stature, undernourishment, physical inactivity, amenorrhea, late menarche, early menopause, estrogen and androgen deficiency, alcohol consumption, cigarette smoking, calcium deficiency in the diet, use of some drugs. Osteoporosis complications. Osteoporosis is the main cause of bone fractures in older population. Biochemical indicators of bone metabolism. A great number of bone formation and resorption markers are listed. Diagnostics. Dual-energy X-ray absorptiometry measurements of the hip and spine are a worldwide standard in diagnosing osteoporosis. Dual X-ray laser heel measurement is an alternative to dual-energy X-ray absorptiometry. Quantitative computed tomography measures thin layers by cross-sectional scans. Quantitative ultrasonography is a good method, but the measurements are not as precise as by other imaging techniques. Drug treatment of osteoporosis. Modern treatment of osteoporosis includes application of bisphosphonates, selective estrogen-receptor modulators, calcium preparations, vitamin D, monoclonal antibodies, hormonal therapy, estrogens, and phytoestrogens. Prevention. Lifestyle changes and non-pharmacological measures are most important for healthy bones. Physical activity, nutrition rich in calcium and vitamin D, avoidance of smoking and alcohol consumption are of crucial importance for people of all ages especially for the older ones.
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Reference
|
|
Blake, G., Fogelman, I. (2007) The role of DXA bone density scans in the diagnosis and treatment of osteoporosis. Postgraduate Medical Journal, 83(982): 509-517
|
|
Bonjour, J. (2011) Protein Intake and Bone Health. International Journal for Vitamin and Nutrition Research, 81(23): 134-142
|
|
Boskey, A.L., Imbert, L. (2017) Bone quality changes associated with aging and disease: a review. Annals of the New York Academy of Sciences, 1410(1): 93-106
|
|
Chandran, V., Reyes, M., Zysset, P. (2017) A novel registration-based methodology for prediction of trabecular bone fabric from clinical QCT: A comprehensive analysis. PLoS one, 12(11): e0187874
|
|
Chen, H., Liu, N., Xu, X., Qu, X., Lu, E. (2013) Smoking, Radiotherapy, Diabetes and Osteoporosis as Risk Factors for Dental Implant Failure: A Meta-Analysis. PLoS one, 8(8): e71955
|
|
Comhaire, F.H., Depypere, H.T. (2015) Hormones, herbal preparations and nutriceuticals for a better life after the menopause: part I. Climacteric, 18(3): 358-363
|
|
Drake, M.T., Clarke, B.L., Lewiecki, E. (2015) The Pathophysiology and Treatment of Osteoporosis. Clinical Therapeutics, 37(8): 1837-1850
|
|
Hans, D., Baim, S. (2017) Quantitative Ultrasound (QUS) in the Management of Osteoporosis and Assessment of Fracture Risk. Journal of Clinical Densitometry, 20(3): 322-333
|
|
Hlaing, T.T., Compston, J.E. (2014) Biochemical markers of bone turnover - uses and limitations. Annals of Clinical Biochemistry, 51(2): 189-202
|
|
Jackson, R., Mysiw, W. (2014) Insights into the Epidemiology of Postmenopausal Osteoporosis: The Women's Health Initiative. Seminars in Reproductive Medicine, 32(06): 454-462
|
|
Kamel, H.K. (2006) Postmenopausal osteoporosis: etiology, current diagnostic strategies, and nonprescription interventions. Journal of Managed Care Pharmacy, 12(6 Supp A): S4-S9
|
|
Kayalar, G., Cevikol, A., Yavuzer, G., Sanisoglu, Y., Cakci, A., Arasil, T. (2009) The value of calcaneal bone mass measurement using a dual X-ray laser Calscan device in risk screening for osteoporosis. Clinics (Sao Paulo), 64(8); 757-762
|
|
Kling, J.M., Clarke, B.L., Sandhu, N.P. (2014) Osteoporosis Prevention, Screening, and Treatment: A Review. Journal of Women's Health, 23(7): 563-572
|
1
|
Lane, N.E. (2006) Epidemiology, etiology, and diagnosis of osteoporosis. American Journal of Obstetrics and Gynecology, 194(2): S3-S11
|
|
Lewiecki, E. (2010) Bisphosphonates for the treatment of osteoporosis: insights for clinicians. Therapeutic Advances in Chronic Disease, 1(3): 115-128
|
2
|
Lips, P., van Schoor, N.M. (2011) The effect of vitamin D on bone and osteoporosis. Best Practice & Research Clinical Endocrinology & Metabolism, 25(4): 585-591
|
|
Monteleone, P., Mascagni, G., Giannini, A., Genazzani, A.R., Simoncini, T. (2018) Symptoms of menopause - global prevalence, physiology and implications. Nature Reviews Endocrinology, 14(4): 199-215
|
|
Nguyen, V.H. (2017) Osteoporosis prevention and osteoporosis exercise in community-based public health programs. Osteoporosis and Sarcopenia, 3(1): 18-31
|
3
|
Nordin, B.E. (1997) Calcium and osteoporosis. Nutrition, 13(7-8): 664-86
|
|
Qureshi, S., Al-Anazi, A., Qureshi, V., Javaid, K. (2011) Preventive effects of phytoestrogens against postmenopausal osteoporosis as compared to the available therapeutic choices: An overview. Journal of Natural Science, Biology and Medicine, 2(2): 154
|
|
Riggs, B. (2000) The mechanisms of estrogen regulation of bone resorption. Journal of Clinical Investigation, 106(10): 1203-1204
|
|
Santoro, N., Epperson, C., Mathews, S.B. (2015) Menopausal Symptoms and Their Management. Endocrinology and Metabolism Clinics of North America, 44(3): 497-515
|
|
Schürer, C., Wallaschofski, H., Nauck, M., Völzke, H., Schober, H., Hannemann, A. (2015) Fracture Risk and Risk Factors for Osteoporosis. Deutsches Aerzteblatt Online, 112(21-22):365-71
|
|
Shen, Y., Gray, D.L., Martinez, D.S. (2017) Combined Pharmacologic Therapy in Postmenopausal Osteoporosis. Endocrinology and Metabolism Clinics of North America, 46(1): 193-206
|
|
Sunyecz, J. (2008) The use of calcium and vitamin D in the management of osteoporosis. Therapeutics and Clinical Risk Management, Volume 4: 827-836
|
|
Swaminathan, K., Flynn, R., Garton, M., Paterson, C., Leese, G. (2009) Search for secondary osteoporosis: are Z scores useful predictors?. Postgraduate Medical Journal, 85(999): 38-39
|
1
|
Tai, V., Leung, W., Grey, A., Reid, I.R., Bolland, M.J. (2015) Calcium intake and bone mineral density: systematic review and meta-analysis. BMJ, 351:h4183
|
|
Todd, J.A. (2003) Osteoporosis and exercise. Postgraduate Medical Journal, 79(932): 320-323
|
|
|
|