Gender Differences in Osteoporosis and Fractures
Gender Differences in Osteoporosis and Fractures
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DOI：
10.1007/s11999-011-1780-7
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发表时间：
2011-07-01
影响因子：
4.2
通讯作者：
Cawthon, Peggy M.
中科院分区：
文献类型：
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作者：
Cawthon, Peggy M.
骨质疏松症通常被认为是一种“妇女病”，因为绝经后妇女的骨质疏松症患病率和骨折率远远高于老年男子。然而，受骨质疏松症和骨折影响的男性的绝对数量很大，因为在美国至少有280万男性被认为患有骨质疏松症。本综述的目的是（1）强调骨质疏松症和骨折风险的性别差异，（2）描述男性和女性之间骨折后治疗和结局的差异，（3）提出减少治疗和预防差距的解决方案。使用MEDLINE进行文献调查，使用各种检索词，并使用作者个人收集的文章中的参考文献。没有采用正式的检索策略和排除标准，因此该综述是选择性的。绝经后妇女比老年男性有更高的骨质疏松症患病率和更高的骨折发生率。尽管绝经后女性骨折风险较高，但老年男性骨折后的结局往往更差，治疗率更低，尽管对男性的病程了解较少。最近开发了多方面的干预措施，以改善骨质疏松症的筛查和治疗。无论性别如何，提高高危人群的治疗率是骨质疏松症管理的一个重要目标。需要进一步开发和评估用于筛查和治疗骨质疏松症和骨折的成本效益高的多方面干预措施;这些干预措施可能会改善骨折的一级预防。
Osteoporosis is generally thought of as a "woman's disease" because the prevalence of osteoporosis and the rate of fractures are much higher in postmenopausal women than in older men. However, the absolute number of men affected by osteoporosis and fractures is large, as at least 2.8 million men in the United States are thought to have osteoporosis.The purposes of this review are to (1) highlight gender differences in osteoporosis and fracture risk, (2) describe disparities in treatment and outcomes after fractures between men and women, and (3) propose solutions to reducing disparities in treatment and prevention.A literature survey was conducted using MEDLINE with a variety of search terms and using references from the author's personal collection of articles. A formal search strategy and exclusion criteria were not employed and the review is therefore selective.Postmenopausal women have a higher prevalence of osteoporosis and greater incidence of fracture than older men. Despite the higher fracture risk in postmenopausal women, older men tend to have worse outcomes after fracture and poorer treatment rates, although less is known about the disease course in men. Multifaceted interventions to improve the screening and treatment for osteoporosis were recently developed.Improvement in treatment rates of those at risk, regardless of gender, is an important goal in osteoporosis management.Further development and evaluation of cost-effective, multifaceted interventions for screening and treatment of osteoporosis and fractures are needed; such interventions will likely improve the primary prevention of fractures.