Факторы риска остеопороза и переломов

Остеопороз является заболеванием, при котором ранняя постановка диагноза крайне затруднена. Поэтому в последние годы большое внимание уделяют выявлению факторов риска, которые позволяют заподозрить это заболевание. Был проведен поиск медицинской литературы в библиографических базах MEDLINE и Cochrane Collaboration за период с 2004 по 2008 г. Поисковый запрос формировался по ключевым словам: остеопороз и факторы риска, остеопороз и падения, переломы, кость и факторы риска. Кроме этого были использованы данные ряда национальных рекомендаций по лечению остеопороза. Всего в анализ вошло 534 статьи. Двумя экспертами после анализа их качества было отобрано 37 источников, вошедших в обзор. В настоящей статье представлены данные, касающиеся различных факторов риска остеопороза, с оценкой их влияния на возникновение переломов костей.

1. Остеопороз. Диагностика, профилактика и лечение. Клинические рекомендации Российской ассоциации по остеопорозу. / Под редакцией Л. И. Беневоленской и О. М. Лесняк. М.: «ГЕОТАР-Медиа», 2005. 171 с.

2. Бащинский С. Е. Методическое пособие по разработке клинических практических руководств. Москва, 2003.

3. Brown J. P., Josse R. G. 2002 clinical practice guidelines for the diagnosis and management of osteoporosis in Canada IICMAJ, 2002,167 (10 suppl) pp. S1-S34.

4. Scottish Intercollegiate Guidelines Network (SIGN) #71: Management of osteoporosis: a national clinical guideline, June 2003. http: //www. sign. ac. uk (дата последнего посещения 11. 10. 2004).

5. Institute for Clinical Systems Improvement (ICS!) Health Care Guideline: Diagnosis and Treatment of Osteoporosis, 3rd edition, July 2004. http: //www. icsi. org (дата последнего посещения 11. 10. 2004).

6. American association of endocrinologists (AACE) medical guidelines for the prevention and treatment of postmenopausal osteoporosis: 2001 edition, with selected updates for 2003 // Endocrine Practice. 2003. Vol. 9, No 6. P. 544-564.

7. Institute for Clinical Systems Improvement (ICSI) Health Care Guideline: Diagnosis and Treatment of Osteoporosis, 5th edition, July 2006.

8. University of Michigan Health System. Guidelines for Clinical Care: Osteoporosis: Prevention and Treatment. July, 2005.

9. Institute for Clinical Systems Improvement (ICSI) Health Care Guideline for Patients and Families. July 2006.

10. Van Geel T. A. et al. Risk factors for clinical fractures among postmenopausal women: a 10-year prospective study. Menopause Int. 2007; 13(3): 110-5.

11. Van Geel A. C. Timing and risk factors for clinical fractures among postmenopausal women: a 5-years prospective study. BMC Med. 2006; 4: 24. I0.

12. Kanis J. A. et al. A family history of fracture and fracture risk: a meta-analisys. Bone. 2004; 3 5(5): 1029-37.

13. Kanis J. A. Smoking and fracture risk: a meta-analysis. Osteoporosis Int. 2005; (16): 155-162/

14. Kanis J. A. et al. Alcohol intake as a risk factor for fractures. Osteoporosis Int. 2005; 16: 737-742.

15. Cawthon P. M. et al. Alcohol Intake and its relationship with bone mineral density, falls, and fractere risk in older men. J. Am. Geriatr Soc. 2006; 54(11): 1649-57.

16. Kanis J. A. et al. A meta-analisys of milk intake and fracture risk: low utilidy for case finding. Osteoporosis Int. 2005; 16: 799-804.

17. Omos M. et al. Systematic review and meta-analysis of observational studies on the prevalence of fractures in celiac disease. Dig. Liver Dis. 2008; 40(1): 46-53.

18. Janghorbani M. Systematic review of tyre 1 and type 2 diabetes mellitus and risk of fractures. Am. J. Epidimiol. 2007; 166(5): 495-505.

19. Vestergaard P. Discrepancies in bone mineral density and fracture risk in patients with type 1 and type 2 diabetes - a meta-analysisio Osteoporosis Int. 2007; 18: 427-444.

20. Van Staa T. P. et al. In flammatory bowel disease and the risk of fracture. Gastroenterology 2003 Dec; 125(6): 1591-7.

21. Loftus E. V. Jr. et al. Risk of fracture in ulcerative colitis: a population-based study from Olmsted County, Minnesota. Clin Gastroenterol Hepatol 2003 Nov; 1(6): 465-73.

22. Takkouche B. et al. Psychotropic medications and the risk of fractures: a meta-analysis. Drug Saf. 2007; 30(2): 171-84.

23. Vestergaard P. et al. Fracture risk associated with the use of morphine and opiates. J. of Internal Medicine. 2006; 260: 76-87.

24. Togari A., Arai M., Kondo A. The role of the sympatheti nervous system in controlling bone metabolism. Expert Opin Ther Targets. 2005; 9(5): 931-40.

25. Bauer C. et al. Use of statins and fracture. Arch. Intern. Med. 2004; 164: 146-152.

26. Toh S. et al. Statins and fractor risk. A systematic review. Pharmacoepidemiol. Drug Saf 2007; 16(6)627-40.

27. Rejnmark L. et al. Fracture risk in perimenopausal women treated with beta-blockers. Calcif. Tissue Int. 2004; 75: 365-372.

28. Barad D. et al. Prior oral contraception and postmenopausal fracture: a Women's Health Initiative observational cohort study. Fertil. Steril. 2005; 84(2): 374-83.

29. Mundy G. et al. Stimulation of bone formation in vitro and in rodents by statin. Science. 1999; 286: 1946-9.

30. Bauer D. C. HMG CoA reductase inhibitors and the skeleton: a comprehensive rewiew. Osteoporosis Int 2003; 14 (4): 273-82.

31. Jassal S. K. et al. Measures of renal function, BMD, bone loss and osteoporotic fracture in older adults: the Rancho Bernardo Study. J. Bone Miner. Res. 2007; 22(2): 203-210.

32. Dukas L. et al. In elderly men and women treated for osteoporosis a low creatinine clearance of <65 ml/min is a risk factor of falls and fractures. Osteoporosis Int 2005; 16: 1683-1690.

33. Dooley A. C. et al. Increased Risk of hip fracture among men with CKD. Am. J. Kidney Dis. 2008; 51(1): 38-44.

34. Gjesdal C. G. et al. Plasma Homocysteine, Folate, and Vitamin В12 and the Risk of Hip Fractures: the Hordaland Homocysteine Study. J. Bone Miner. Res. 2007; 22(5): 747-756.

35. Dhonukshe-RuttenR. A. M. etal. Homocysteine and Vitamine B Status Relate to Bone Turnover Markers, Broadband Ultrasound Attenuation, and Fractures in Healty Elderly People. J. Bone Miner. Res. 2005; 20: 921-929.

36. Von Muhlen D. G. et al. Vitamin D, Parathyroid hormone levels and bone mineral density in community-dwelling older women: a Rancho Bernardo study. Osteoporosis Int. 2005; 16: 1721-1726.

37. Gnudi S. et al. Differences in proximal femur geometry distinguish vertebral from femoral neck fractures in osteoporotic women. The British Journal of Radiology. 2004; 77: 219-223.

38. Lubec B. et al. Evidence of McKusick's hypethesis of deficient collagen cross-linking in patient with homocysteinuria. Biochim. Diophys. Acta. l996. 1315: 159-162.

39. Szulc P. et al. Structural determinants of hip fracture in elderly women: re-analysis of the data from EPIDOS study, Osteoporosis Int. 2006; 17: 231-236.