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Reviews in Endocrine and Metabolic Disorders
Erschienen in: Reviews in Endocrine and Metabolic Disorders 4/2010

01.12.2010

Diagnosis and treatment of osteopenia

verfasst von: Gulay Karaguzel, Michael F. Holick

Erschienen in: Reviews in Endocrine and Metabolic Disorders | Ausgabe 4/2010

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Abstract

Osteopenia is a term to define bone density that is not normal but also not as low as osteoporosis. By definition from the World Health Organization osteopenia is defined by bone densitometry as a T score −1 to −2.5. There are many causes for osteopenia including calcium and vitamin D deficiency and inactivity. Genetics plays an important role in a person’s bone mineral density and often Caucasian women with a thin body habitus who are premenopausal are found to have osteopenia. Correction of calcium and vitamin D deficiency and walking 3 to 5 miles a week can often improve bone density in the hip and spine. There are a variety of pharmaceutical agents that have been recommended for the treatment of osteopenia and osteoporosis including hormone replacement therapy, selective estrogen receptor modulator therapy, anti-resorptive therapy. In addition patients with osteoporosis who have failed anti-resorptive therapy can have a significant improvement in their bone density with anabolic therapy.
Literatur
1.
Kanis JA, Melton III LJ, Christiansen J, Johnston CC, Khaltaev N. The diagnosis of osteoporosis. J Bone Miner Res. 1994;9:1137–41.CrossRefPubMed
2.
Holick MF. Metabolic bone disease. In: Noble J, editor (Grene HL, Levinson W, Modest GA, Mulrow CD, Scherger JE, Young MJ, senior editors). Textbook of primary care medicine. St Louis: Mosby Inc; 2001. p. 387–97.
3.
Thacker HL, Richmond B. In rebuttal: osteopenia is a useful diagnosis. Clevel Clin J Med. 2006;73:34–8.CrossRef
4.
Holick MF. Optimal vitamin D status for the prevention and treatment of osteoporosis. Drugs Aging. 2007;24:1017–29.CrossRefPubMed
5.
Root AW, Diamond FB. Disorders of mineral homeostasis in newborn, infant, child, and adolescent. In: Sperling MA, editor. Pediatric endocrinology. Philadelphia: Elsevier Saunders; 2008. p. 686–769.
6.
Cummings SR, Black DM, Rubin SM. Lifetime risks of hip, Colles’, or vertebral fracture and coronary heart disease among white postmenopausal women. Arch Intern Med. 1989;149:2445–8.CrossRefPubMed
7.
8.
Report of the Expert Committee on the Diagnosis and Classification of Diabetes mellitus. Diabetes Care. 1997;20:1183–97.
9.
Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive summary of the third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA. 2001;285:2486–97.
10.
National Osteoporosis Foundation. America’s bone health: the state of osteoporosis and low bone mass in our nation. Washington: National Osteoporosis Foundation; 2002.
11.
Melton LJ 3rd. Who has osteoporosis? A conflict between clinical and public health perspectives. J Bone Miner Res. 2000;15:2309–14.CrossRefPubMed
12.
Van Staa TP, Dennisson EM, Leufkens HG, Cooper C. Epidemiology of fractures in England and Wales. Bone. 2001;29:517–22.CrossRefPubMed
13.
Wilkins CH. Osteoporosis screening and risk management. Clin Interv Aging. 2007;2:389–94.PubMed
14.
Lindsay R, Silverman SL, Cooper C, Hanley DA, Barton I, Broy SB, et al. Risk of new vertebral fracture in the year following a fracture. JAMA. 2001;285:320–3.CrossRefPubMed
15.
16.
Schousboe JT, Nyman JA, Kane RL, Ensrud KE. Cost-effectiveness of alendronate therapy for osteopenic postmenopausal women. Ann Intern Med. 2005;142:734–41.PubMed
17.
Siris ES, Chen YT, Abbott TA, Barrett-Connor E, Miller PD, Wehren LE, et al. Bone mineral density thresholds for pharmacological interventions to prevent fractures. Arch Intern Med. 2004;164:1108–12.CrossRefPubMed
18.
Kanis JA, Johnell O, Oden A, Dawson A, De Laet C, Jonsson B. Ten year probabilities of osteoporotic fractures according to BMD and diagnostic thresholds. Osteoporos Int. 2001;12:989–95.CrossRefPubMed
19.
Ocarino NM, Marubayashi U, Guimaraes CV, Silva AE, Torres RCS, Serakides R. Physical activity in osteopenia treatment improved the mass of bone directly and indirectly submitted to mechanical impact. J Musculoskelet Neuronal Interact. 2007;7:84–93.PubMed
20.
Cuneo RC, Wallace JD. Growth hormone, insulin-like factors and sport. Endocrinol Metab. 1994;1:3–13.
21.
Brahm H, Piehl-Aulin K, Saltin B, Ljunghall S. Net fluxes over working thigh of hormones, growth factors and biomarkers of bone metabolism during short lasting dynamic exercise. Calcif Tissue Int. 1997;60:175–80.CrossRefPubMed
22.
Bigbee AJ, Gosselink KL, Roy RR, Grindeland RE, Edgerton VR. Bioassayable growth hormone release in rats in response to a single bout of treadmill exercise. J Appl Physiol. 2000;89:2174–8.PubMed
23.
Lee MS, Kang CW, Shin YS, Huh HJ, Ryu H, Park JH, et al. Acute effects of chundosunbup qi-training on blood concentrations of TSH, calcitonin, PTH and thyroid hormones in elderly subjects. Am J Chin Med. 1998;26:275–81.CrossRefPubMed
24.
Asikainen TM, Kukkonen-Harjula K, Miilunpalo S. Exercise for health for early postmenopausal women: a systematic review of randomised controlled trials. Sport Med. 2004;34:753–8.CrossRef
25.
Bonaiuti D, Shea B, Iovine R, Negrini S, Robinson V, Kemper HC, et al. Exercise for preventing and treating osteoporosis in postmenopausal women. Cochrane Database Syst Rev. 2002;3:CD000333.PubMed
26.
Martyn-St James M, Carroll S. Meta-analysis of walking for preservation of bone density in postmenopausal women. Bone. 2008;43:521–31.CrossRefPubMed
27.
Martyn-St James M, Carroll S. Effects of different impact exercise modalities on bone mineral density in premenopausal women: a meta-analysis. J Bone Miner Metab. 2010;28:251–67.CrossRefPubMed
28.
National Osteoporosis Foundation. Clinician’s Guide to Prevention and Treatment Osteoporosis. Developed by the NOF 2009, updated January 2010.
29.
Wyshak G. Teeaged girls, carbonated beverage consumption, and bone fractures. Arch Pediatr Adolesc Med. 2000;154:610–3.PubMed
30.
Tucker KL, Morita K, Qiao N, Hannan MT, Cupples LA, Kiel DP. Colas, but not other carbonated beverages, are associated with lower bone mineral density in older women: The Framigham Osteoporosis Study. Am J Nutr. 2006;84:936–42.
31.
Holick MF, Garabedian M. Vitamin D: photobiology, metabolism, mechanism of action, and clinical applications. In: Favus MJ, editor. Primer on the metabolic bone diseases and disorders of mineral metabolism. American Society for Bone and Mineral Research: Washington; 2006. p. 129–37.
32.
Haddad JG, Matsuoka LY, Hollis BW, Hu YZ, Wortsman J. Human plasma transport of vitamin D after its endogenous synthesis. J Clin Invest. 1993;91:2552–5.CrossRefPubMed
33.
34.
Bouillon R. Vitamin D: from photosyntesis, metabolism, and action to clinical applications. In: DeGroot LJ, Jameson JL, editors. Endocrinology. Philadelphia: WB Saunders; 2001. p. 1009–28.
35.
36.
Holick MF. The D-lemma: to screen or not to screen for 25-hydroxyvitamin D concentrations. Clin Chem. 2010;56:1–3.CrossRef
37.
Kumar J, Muntner P, Kaskel FJ, Hailpern SM. Prevalence and associations of 25-hydroxyvitamin D deficiency in US children: NHANES 2001–2004. Pediatrics. Forthcoming 2010;125.
38.
Holick MF, Biancuzzo RM, Chen TC, Klein EK, Young A, Bibuld D, et al. Vitamin D2 is as effective as vitamin D3 in maintaining circulating concentrations of 25-hydroxyvitamin D. J Clin Endocrinol Metab. 2008;93:677–81.CrossRefPubMed
39.
Gordon CM, Williams AL, Feldman HA, May J, Sinclair L, Vasquez A, et al. Treatment of hypovitaminosis D in infants and toddlers. J Clin Endocrinol Metab. 2008;93:2716–21.CrossRefPubMed
40.
Zalloua PA, Hsu Y, Terwedow H, Zang T, Wu D, Tang G, et al. Impact of seafood and fruit consumption on bone mineral density. Maturitas. 2007;56:1–11.CrossRefPubMed
41.
Tranquilli AL, Lucino E, Garzetti GG, Romanini C. Calcium, phosphorus and magnesium intakes correlate with bone mineral content in postmenopausal women. Gynecol Endocrinol. 1994;8:55–8.CrossRefPubMed
42.
Tucker KL, Hannan MT, Chen H, Cupples LA, Wilson PWF, Kiel DP. Potassium, magnesium, and fruit and vegeteble intakes are assocated with greater bone mineral density in elderly men and women. Am J Clin Nutr. 1999;69:727–36.PubMed
43.
Lemann Jr J, Pleuss JA, Gray RW. Potassium causes calcium retention in healthy adults. J Nutr. 1993;123:1623–6.PubMed
44.
Stendig-Lindberg G, Tepper R, Leichter I. Trabecular bone density in a two year controlled trial of peroral magnesium in osteoporosis. Magnes Res. 1993;6:155–63.PubMed
45.
Darling AL, Millward DJ, Torgerson DJ, Hewitt CE, Lanham-New SA. Dietary protein and bone health: a systematic review and meta-analysis. Am J Clin Nutr. 2009;90:1674–92.CrossRefPubMed
46.
Ma DF, Qin LQ, Wang PY, Katoh R. Soy isoflavone intake inhibits bone resorption and stimulates bone formation in menopausal women: meta-analysis of randomized controlled trials. Eur J Clin Nutr. 2008;62:155–61.CrossRefPubMed
47.
Muthyala RS, Ju YH, Sheng S, Williams LD, Doerge DR, Katzenellenbogen BS, et al. Equol, a natural estrogenic metabolite from soy isoflavones: convenient preparation and resolution of R- and S-equols and their differing binding and biological activity through estrogen receptors alpha and beta. Bioorg Med Chem. 2004;12:1559–67.CrossRefPubMed
48.
Weaver CM, Legette LL. Equol, via dietary sources or intestinal production, may ameliorate estrogen deficiency-induced bone loss. J Nutr. 2010;140:1377S–9S.CrossRefPubMed
49.
Bischoff-Ferrari HA, Dawson-Hughes B, Baron JA, Burckhardt P, Li R, Spiegelman D, et al. Calcium intake and hip fracture risk in men and women: a meta-analysis of prospective cohort studies and randomized controlled trials. Am J Clin Nutr. 2007;86:1780–90.PubMed
50.
Chapuy MC, Arlot ME, Duboeuf F, Brun J, Crouzet B, Arnaud S, et al. Vitamin D3 and calcium to prevent hip fractures in elderly women. N Engl J Med. 1992;327:1637–42.CrossRefPubMed
51.
Avenell A, Gillespie W, Gillespie LD, O’Connell D. Vitamin D and vitamin D analogues for preventing fractured associated with involutional and post-menopausal osteoporosis (intervention review). Cochrane Database Syst Rev. 2009;15:CD000227.
52.
Peacock M, Liu G, Carey M, McClintock R, Ambrosius W, Hui S, et al. Effect of calcium or 25OHvitaminD3 dietary supplementation on bone loss at the hip in men and women over the age of 60. J Clin Endocrinol Metab. 2000;85:3011–9.CrossRefPubMed
53.
Porthouse J, Cockayne S, King C, et al. Randomized controlled trial of supplementation with calcium and cholecalciferol (vitamin D3) for preventation of fractures in primary care. BMJ. 2005;330:1003–6.CrossRefPubMed
54.
Grant A, Anderson F, Avenell A, Campbell MK, MCDonald AM, MacLennan GS, et al. Oral vitamin D3 and calcium for secondary prevention of low-travma fractures in the elderly people (Randomised Evaluation of Calcium or Vitamin D, RECORD). Lancet. 2005;365:1621–8.CrossRefPubMed
55.
Sanders KM, Stuart AL, Williamson EJ, Simpson JA, Kotowicz MA, Young D, et al. Annual high-dose oral vitamin D and falls and fractures in older women. A randomized controlled trial. JAMA. 2010;303:1815–22.CrossRefPubMed
56.
Bischoff-Ferrari HA, Dawson-Hughes B, Staehelin HB, Orav JE, Stuck AE, Theiler R, et al. Fall prevention with supplemental and active forms of vitamin D: a meta-analysis of randomised controlled trials. BMJ. 2009;339-b3692. doi:10.​1136/​bmj.​b3692.
57.
Richy F, Schacht E, Bruyere O, Ethgen O, Gourlay M, Reginster JY. Vitamin D analogs versus native vitamin D in preventing bone loss and osteoporosis-related fractures: a comparative meta-analysis. Calcif Tissue Int. 2005;76:176–86.CrossRefPubMed
58.
Watts NB, Diab DL. Long-term use of biphosphonates in osteoporosis. J Clin Endocrinol Metab. 2010;95:1555–65.CrossRefPubMed
59.
Ivegard M, Ström O, Borgström F, Burge RT, Tosteson ANA, Kanis J. Identifying cost-effective treatment with raloxifene in postmenopausal women using risk algoritms for fracture and invasive breast cancer. Bone. 2010 online. doi:10.​1016/​j.​bone.​2010.​07.​024
60.
Stevenson M, Jones ML, De Nigris E, Brewer N, Davis S, Oakley J. A systematic review and economic evaluation of alendronate, etidronate, risedronate, raloxifene and teriparatide for the prevention and treatment of postmenopausal osteoporosis. Health Technol Assess. 2005;9:1–160.PubMed
61.
Maricic M. The role of zolendronic acid in the management of osteoporosis. Clin Rheumatol. 2010;29:1079–84.CrossRefPubMed
62.
McClung M, Miller P, Recknor C, Mesenbrink P, Bucci-Rechtweg C, Behamou CL. Zoledronic acid for the prevention of bone loss in postmenopausal women with low bone mass. Obstet Gynecol. 2009;114:999–1007.CrossRefPubMed
63.
Abrahamsen B, Eiken P, Eastell R. Subtrochanteric and diphyseal femur fractures in patients treated with alndronate: a register based national cohort study. J Bone Miner Res. 2009;24:1095–102.CrossRefPubMed
64.
Shane E, Burr D, Ebeling PR, Adler RA, Brown TD, Cheung AM, et al. Atypical subtrochanteric and diaphyseal femoral fractures: Report of a Task of the American Society for Bone and Mineral Research. J Bone Mineral Res 2010, Sep, epub ahead of print.
65.
66.
Writing Group for the Women’s Health Initiative Investigators. Risks and benefits of estrogen plus progestin in healthy post menopausal women. JAMA. 2002;288:321–33.CrossRef
67.
Prestwood KM, Kenny AM, Kleppinger A, Kulldorff M. Ultralow-dose micronized 17β-estradiol and bone density and bone metabolism in older women: a randomized controlled trial. JAMA. 2003;290:1042–8.CrossRefPubMed
68.
McDonnell DP. Mining the complexities of the estrogen signaling pathways for novel therapeutics. Endocrinol. 2003;144:4237–40.CrossRef
69.
Nakamura T, Imai Y, Matsumoto T, Sato S, Takeuchi K, Igarashi K, et al. Estrogen prevents bone loss via estrogen receptor alpha and induction of Fas ligand in osteoclasts. Cell. 2007;130:811–23.CrossRefPubMed
70.
Ettinger B, Black DM, Mitlak BH, Knickerbocker RK, Nickelsen T, Genant HK, Christiansen C, et al. Reduction of vertebral fracture risk in postmenopausal women with osteoporosis treated with raloxifene: results from a 3-year randomized clinical trial. Multiple Outcomes of Raloxifene Evaluation (MORE) Investigators. JAMA. 1999;282:637–45.
71.
Kanis JA, Johnell O, Black DM, Downs Jr RW, Sarkar S, Fuerst T, et al. Effect of raloxifene on the risk of new vertebral fracture in postmenopausal women with osteopenia or osteoporosis: a reanalysis of the Multiple Outcomes of Raloxifene Evaluation trial. Bone. 2003;33:293–300.CrossRefPubMed
72.
Bouxsein ML, Chen P, Glass EV. Kallmes Df, Delmas PD, Mitlak BH. Teriparatide and raloxifene reduce the risk of new adjacent vertebral fractures in postmenopausal women with osteoporosis. Results from two randomized controlled trials. J Bone Joint Surg Am. 2009;91:1329–38.CrossRefPubMed
73.
Canalis A. Update in new anabolic therapies for osteoporosis. J Clin Endocrinol Metab. 2010;95:1496–504.CrossRefPubMed
74.
Pleiner-Duxneuner J, Zwetter E, Paschalis E, Roschenger P, Nell-Duxneuner V, Klaushofer K. Treatment of osteoporosis with parathyroid hormone and teriparatide. Calcif Tissue Int. 2009;84:159–70.CrossRefPubMed
75.
Misof BM, Roschger P, Cosman F, Kurland ES, Tesch W, Messmer P, et al. Effects of intermittent parathyroid hormone administration on bone mineralization density in iliac crest biopsies from patients with osteoporosis: a paired study before and after treatment. J Clin Endocrinol Metab. 2003;88:1150–6.CrossRefPubMed
76.
Body JJ, Gaich GA, Scheele WH, Kulkarni PM, Miller PD, Peretz A, et al. A randomized double-blind trial to compare efficacy of Teriparatide [recombinant human parathyroid hormone (1–34)] with alendronate in potmenopausal women with osteoporosis. J Clin Endocrinol Metab. 2002;87:4528–35.CrossRefPubMed
77.
78.
Brown JP, Prince RL, Deal C, Recker RR, Kiel DP, de Gregorio LH, et al. Comparison of the effect of denosumab and alendronate on BMDand biochemical markers of bone turnover in postmenopausal women with low bone mass: a randomized, blinded, phase 3 trial. J Bone Miner Res. 2009;24:153–61.CrossRefPubMed
79.
Cummings SR, San Martin J, McClung MR, Siris ES, Eastell R, Reid IR, et al. Denosumab for prevention of fractures in postmenopausal women with osteoporosis. N Engl J Med. 2009;361:756–65.CrossRefPubMed
80.
Ross AC, Taylor CL, Yaktine AL, Del Valle HB. Dietary reference intakes for calcium and vitamin D. Institute of Medicine of the National Academies. 2010.
Metadaten
Titel
Diagnosis and treatment of osteopenia
verfasst von
Gulay Karaguzel
Michael F. Holick
Publikationsdatum
01.12.2010
Verlag
Springer US
Erschienen in
Reviews in Endocrine and Metabolic Disorders / Ausgabe 4/2010
Print ISSN: 1389-9155
Elektronische ISSN: 1573-2606
DOI
https://doi.org/10.1007/s11154-010-9154-0

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