THE WORLDWIDE PROBLEM OF OSTEOPOROSIS - INSIGHTS AFFORDED BY EPIDEMIOLOGY
THE WORLDWIDE PROBLEM OF OSTEOPOROSIS - INSIGHTS AFFORDED BY EPIDEMIOLOGY
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DOI：
10.1016/8756-3282(95)00258-4
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发表时间：
1995-11-01
期刊：
影响因子：
4.1
通讯作者：
MELTON, LJ
中科院分区：
文献类型：
--
作者：
RIGGS, BL;MELTON, LJ
骨质疏松症是女性和男性老年人面临的主要问题之一，骨质疏松症的病态事件是骨折，然而，骨质疏松症的定义不应要求存在骨折，而只要求骨质减少，这与不可接受的高风险有关骨折，在美国，每年约有150万起骨折可归因于骨质疏松症：其中包括70万例脊椎骨折、25万例前臂远端骨折、25万例髋部骨折和30万例其他肢体部位骨折。从50岁开始，白色女性和白色男性的（有症状的）髋部和桡骨远端骨折的发生率分别为40%和13%。髋部骨折后，在随后的6个月内死亡率为10%-20%，50%的患者在没有帮助的情况下将无法行走，并且25%将需要长期的辅助护理。与流行观点相反，与手腕和脊柱骨折相关的发病率和痛苦也是相当大的。骨质疏松症对美国医疗保健系统的年度成本至少为50 - 100亿美元，在其他发达国家具有类似的发病率和成本。这些已经很高的费用将随着人口的持续老龄化而进一步增加，此外，不发达国家的人口爆炸将改变骨质疏松症的人口统计学;例如髋骨骨折的发生率，据推测，在未来50年内，其它骨质疏松性骨折将在世界范围内增加四倍并且伴随的费用将威胁许多国家的卫生保健系统的生存能力，除非现在就采取果断的预防性干预措施，否则骨质疏松症的灾难性全球流行似乎不可避免。
Osteoporosis is one of the major problems facing women and older people of both sexes, The morbid event in osteoporosis is fracture, However, the definition of osteoporosis should not require the presence of fractures but only a decrease in bone mass that is associated with an unacceptably high risk of fracture, In the USA, approximately 1.5 million fractures annually are attributable to osteoporosis: these include 700,000 vertebral fractures, 250,000 distal forearm (Colles') fractures, 250,000 hip fractures, and 300,000 fractures of other limb sites, The lifetime risk of fractures of the spine (symptomatic), hip, and distal radius is 40% for white women and 13% for white men from 50 years of age onwards, Following a hip fracture, there is a 10%-20% mortality over the subsequent 6 months, 50% of sufferers will be unable to walk without assistance, and 25% will require long-term domiciliary care, Contrary to prevailing opinion, the morbidity and suffering associated with wrist and spine fractures are also considerable, The annual cost of osteoporosis to the US healthcare system is at least $5-$10 billion with similar incidence and cost in other developed countries, These already high costs will increase further with continued aging of the population, In addition, the population explosion in underdeveloped countries will change the demography of osteoporosis; for example, the incidence of hip fracture, and, presumably, other osteoporotic fractures will increase fourfold worldwide during the next 50 years and the attendant costs will threaten the viability of the healthcare systems of many countries, Unless decisive steps for preventive intervention are taken now, a catastrophic global epidemic of osteoporosis seems inevitable.