Current methods for monitoring the treatment of osteoporosis: increased bone mineral density or reduced fracture risk?
Bone fractures are the most serious complication of osteoporosis. Fractures occurring in vertebrae or the proximal epiphysis of the femur directly increase the risk of mortality. As a result of the aging of our society and the prolonged average life expectancy, it is becoming increasingly important to develop diagnostic methods that will enable the early and accurate diagnosis of osteoporosis, and testing methods to measure the factors that are decisive for the mechanical endurance of bones. The most important diagnostic test, despite certain defects and the danger of a false result, is still the densitometric measurement of bone tissue using the DEXA method. By contrast, the monitoring of treatment based on the testing of bone tissue density remains a dubious method. The new definition of osteoporosis introduced in 2001 has concentrated our attention on reducing the risk of fracture. Thanks to large, randomized epidemiological studies, we can identify those drugs which reduce the risk of first and subsequent osteoporotic bone fractures. Alendronian, rizedronian, and parathormon have been demonstrated to have effects that reduce the risk of fractures, both in vertebrae and in the proximal epiphysis of the femur. The overarching goal of our treatment is still avoiding osteoporotic fractures, and not merely trying to improve the results of densitometric tests.
Marek
M
Kaleta
Tadeusz Szymon
TS
Gaździk
Sławomir
S
Wroński