Postmenopausal osteoporosis: fracture risk and prevention.
In the estrogen-regulated RANK ligand (RANKL)/RANK/osteoprotegerin (OPG) pathway, estrogen deficiency favors osteoclast maturation, leading to increased bone resorption compared with bone formation. Treatment of low bone mineral density (BMD) should be based on fracture risk, assessed using the WHO Fracture Risk Algorithm (FRAX(R)). Criteria for treatment are 10-year overall fracture risk ≥ 20% or 10-year hip fracture risk ≥ 3%. Vitamin D supplementation at levels higher than those traditionally recommended may be appropriate for healthy menopausal women. Multiple strategies are needed to effectively manage osteoporosis in postmenopausal women.
Kaunitz
Andrew M
AM
Department of Obstetrics and Gynecology, University of Florida College of Medicine, Jacksonville, FL, USA.
McClung
Michael R
MR
Feldman
Robert G
RG
Wysocki
Susan
S
D015502:Absorptiometry, Photon; D000058:Accidental Falls / Q000517:prevention & control; D000368:Aged; D000465:Algorithms; D015415:Biomarkers / Q000097:blood; D015519:Bone Density; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D002118:Calcium / Q000627:therapeutic use*; D003226:Congresses as Topic; D004164:Diphosphonates / Q000627:therapeutic use; D004347:Drug Interactions; D004359:Drug Therapy, Combination; D015914:Estrogen Replacement Therapy / Q000379:methods; D005260:Female; D018565:Food-Drug Interactions; D006620:Hip Fractures / Q000175:diagnosis / Q000503:physiopathology / Q000517:prevention & control*; D006801:Humans; D008019:Life Style; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology / Q000517:prevention & control*; D058866:Osteoporotic Fractures / Q000097:blood / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D053244:Osteoprotegerin / Q000097:blood; D017410:Practice Guidelines as Topic; D053245:RANK Ligand / Q000097:blood; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome; D014807:Vitamin D / Q000627:therapeutic use*
D015415:Biomarkers; D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D053244:Osteoprotegerin; D053245:RANK Ligand; D014807:Vitamin D; D002118:Calcium