| Author/Editor | Kocjan, Tomaž; Preželj, Janez; Pfeifer, Marija; Jensterle Sever, Mojca; Čokolič, Miro; Zavratnik, Andrej | |
| Title | Smernice za odkrivanje in zdravljenje osteoporoze | |
| Translated title | Guidelines for the detection and treatment of osteoporosis | |
| Type | članek | |
| Vol. and No. | Letnik 82, št. 4 | |
| Publication year | 2013 | |
| Volume | str. 207-217 | |
| ISSN | 1581-0224 - Zdravniški vestnik | |
| Language | slv | |
| Abstract | Osteoporozni zlomi so pomemben vzrok invalidnosti in smrti. Če jih želimo učinkovito preprečiti, moramo zdraviti posameznike z visokim tveganjem za zlom. To so v prvi vrsti bolnice in bolniki po osteoporoznem zlomu vretenca ali kolka, pri katerih je pred uvedbo zdravljenja potrebno le še izključiti sekubdarne vzroke osteoporoze. Pri drugih ženskah po menopavzi in moških po petdesetem letu se odločimo za ali proti zdravljenju na podlagi njihovega tveganja za osteoporozne zlome. Tveganje za zlom v tej populaciji lahko ocenimo s pomočjo kliničnih dejavnikov, ki jih vnesemo v računalniški algoritem FRAX, ali pa na podlagi meritve mineralne kostne gostote, pri čemer moramo pri interpretaciji izvida upoštevati tudi starost in spol preiskovanca. Zdravljenje osteoporoze zahteva zdrav življenjski slog brez pretiranega vnosa alkohola in kajenja. Prehrana mora biti bogata s kalcijem in z beljakovinami. Redna telesna vadba ugodno učinkuje na kosti, pa tudi na mišice, in na preprečevanje padcev. Obvezen je dodatek vitamina D. Zdravila dokazano zmanjšajo tveganje za osteoporozne zlome. Izbiramo lahko med več zaviralci razgradnje kosti, kot so estrogeni, bisfosfonati, raloksifen in denosumab. Teriparatid je anabolno zdravilo, ki pospešuje gradnjo kosti, medtem ko stroncijev ranelat ugodno deluje na oba procesa kostne prenove.Osteoporotic fractures are major cause of disability and death. If we want to effectively prevent them, we should treat individuals at high risk of fracture. Primarily, we treat patients after osteoporotic vertebral or hip fracture, where it is required only to exclude secondary causes of osteoporosis prior to initiating treatment. For other women after menopause, the risk of fracture could be assessed using clinical factors, which are entered into the computer-driven FRAX algorithm. The measurement of bone mineral density could also be used, but we have to take into account the age and sex of subjects when interpreting the result. Treatment of osteoporosis requires a healthy lifestyle without smoking and excessive alcohol intake. The diet should be rich in calcium and protein. Regular physical exercise has positive effects on the bone as well as on the muscles and fall prevention. The addition of vitamin D is always recommended. Drugs have proven efficacy against osteoporotic fractures. We can choose between several inhibitors of bone resorption, such as estrogens, biophosphonates, raloxifene and denosumab. Teriparatide is an anabolic drug that promotes bone formation, while strontium ranelate has a beneficial effect on both processes of bone turnover. | |
| Keywords | osteoporozni zlomi bisfosfonati kalcij vitamin D osteoporotic fractures bisphosphonates calcium vitamin D |