Evidence-based management for osteoporosis

Kwan Lee

doi:10.5124/jkma.2011.54.3.294

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Lee: Evidence-based management for osteoporosis

Focused Issue of This Month

Clinical Preventive Service and Scientific Evidence

Journal of the Korean Medical Association

Journal of the Korean Medical Association 2011; 54(3): 294-302.

Published online: 16 March 2011

DOI: https://doi.org/10.5124/jkma.2011.54.3.294

Evidence-based management for osteoporosis

Kwan Lee, MD

Department of Preventive Medicine, Dongguk University College of Medicine, Gyeongju, Korea.

Corresponding author: Kwan Lee, kwaniya@dongguk.ac.kr

Received 31 January 2011 Accepted 12 February 2011

(open-access):

This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Osteoporosis is the most common bone disease in humans, and it has caused major public health problems. Though osteoporosis affects all ages, its prevalence will increase as the population ages worldwide. In recent surveys of the Korean population, the prevalence of osteoporosis was 32.6% in women aged 50 years and above. Osteoporosis can be prevented, diagnosed easily, and treated before any fracture occurs. The active involvement of medical personnel and patients is needed. The prevention and management of osteoporosis are similar to other lifestyle-related diseases. Adequate intake of calcium and vitamin D, regular weight-bearing exercise, fall prevention, and avoidance of tobacco use and excessive alcohol intake are recommended for the general population. Bone mineral density testing and drug treatment must be considered to manage the risk factors of high risk groups. In this study, we review Korean and international research trends, and attempt to present an evidence-based strategy for the management of osteoporosis.

Keywords: Osteoporosis, Risk factors, Evidence-based practice, Prevention

Figures and Tables

Table 1

The classification of osteoporosis by bone mineral density measurement

Table 2

Prevalence of osteoporosis from previous study in Korea

QUS, quantitative ultrasound densitometry; DXA, dual-energy X-ray absorptiometry.

Table 3

Conditions and diseases that cause or contribute to osteoporosis [5,26]

Table 4

Indications for bone mineral density measurement [27]

Table 5

Clinical decision tools for osteoporosis among postenopausal women

NOF, National Osteoporosis Foundation; SCORE, Simple Calculated Osteoporosis Risk Estimation; ORAI, Osteoporosis Risk Assessment Instrument; ABONE, Age, Bulk, Or Never Estrogens; OS TA, Osteoporosis Self-assessment Tool for Asians.

^a)Available among premenopausal women (≥45 yr)

^b)Points per each fracture.

Table 6

Synopsis of major recommendations to the clinician for postmenopausal women and men age 50 and older

BMD, bone mineral density; DXA, dual-energy X-ray absorptiometry; WHO, World Health Organization; FDA, U.S. Food and Drug Administration.

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