Yeungnam Univ J Med.  2008 Jun;25(1):19-30.

The Diagnosis and Treatment of Osteoporosis

Affiliations
  • 1Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu, Korea. kcwon@med.yu.ac.kr

Abstract

Osteoporosis, a disease characterized by low bone mass and microarchitectural deterioration of bone tissue leading to enhanced bone fragility and fracture risk, is a major public health problem. The diagnostic methods for osteoporosis include simple radiography, bone scan, DXA (Dual energy X-ray Absortiometry) and biochemical markers of bone turnover. Optimal treatment and prevention of osteoporosis require modification of risk factors, particularly smoking cessation, adequate physical activity, and attention to diet, in addition to pharmacologic intervention. The estrogens and raloxifene both prevent bone loss in postmenopausal women, and the estrogens probably also decrease the risk of first fracture. There is good evidence that raloxifene prevents further fractures in postmenopausal women who already have had fractures and some evidence that estrogen does as well. Bisphosphonate prevents bone loss and reduces fractures in healthy and osteoporotic postmenopausal women and in osteoporotic men as well. Risedronate is more potent and has fewer side effects than alendronate and reduces the incidence of fractures in osteoporotic women. Calcitonin increases bone mineral density in early postmenopausal women and men with idiopathic osteoporosis, and also reduces the risk of new fractures in osteoporotic women. All of the agents discussed above prevent bone resorption, whereas teriparatide and strontium increase bone formation and are effective in the treatment of osteoporotic women and men. New avenues for targeting osteoporosis will emerge as our knowledge of the regulatory mechanisms of bone remodeling increases, although issues of tissue specificity may remain to be addressed.

Keyword

Osteoporosis

MeSH Terms

Absorptiometry, Photon
Alendronate
Biomarkers
Bone and Bones
Bone Density
Bone Remodeling
Bone Resorption
Calcitonin
Diet
Estrogens
Etidronic Acid
Female
Humans
Incidence
Male
Motor Activity
Organ Specificity
Osteogenesis
Osteoporosis
Public Health
Raloxifene Hydrochloride
Risk Factors
Smoking Cessation
Strontium
Teriparatide
Risedronate Sodium
Alendronate
Calcitonin
Estrogens
Etidronic Acid
Strontium
Teriparatide
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