Present possibilities of diagnostics and therapy of osteoporosis

Authors: P. Horák;  T. Pika
Authors‘ workplace: III. interní klinika Lékařské fakulty UP a FN, Olomouc, přednosta prof. MUDr. Vlastimil Ščudla, CSc.
Published in: Vnitř Lék 2006; 52(7-8): 749-755
Category: 130th Internal Medicine Day - Rheumatology in clinical practice


The occurence of osteoporosis is not so poor in industrial countries, together with advance of socioeconomical level and spreading of human life’s lenght, increases the prevalence of osteoporosis, affect about 5-6 % of Europe population and also raises the number of the most consequential results - fractures, complications, dramatically deteriorating health state and limiting social self-realization of the pacients. Osteoporosis belongs to metabolic bone diseases with highly clarified mechanisms of bone tissue decrease and comprehensive diagnostic platform, based on combination of imaging and laboratory methods, enabling early disease detection, before occurence of fracture complications. In sequence of disorder etiology, the adequate therapy is known with continualy increasing effectivity and aplication simplicity for pacient, increasing his compliance. Increasing public knowledge and prevention put back not only occurance of complications, but also onset of the disease. Neverthless, the osteoporosis is still hidden danger with serious economic and social impact.

Key worlds:
osteoporosis - diagnostic of osteoporosis - osteoporosis therapy


1. World Health Organization. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a WHO Study Group. World Health Organ Tech Rep Ser 1994; 843: 1-129.

2. Broulík P. Osteoporóza. Praha: Maxdorf Jessenius 1999.

3. Blahoš J. Osteoporóza, Praha: Galén 1996.

4. Štěpán J. Syndrom osteoporózy. Praha: Avicenum 1990.

5. Favus MF (ed). Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism. 3rd ed. Philadelphia-New York: Lippincott 1996.

6. Cooper C, Melton LJ. 3rd ed. Epidemiology of osteoporosis. Trends Endrocrinol Metab 1992; 3: 224-229.

7. Geusens P (ed). Osteoporosis in Clinical Practice. London: Springer Verlag 1998.

8. Kocián J. Osteoporóza u mužů. Praha: Triton 2002.

9. Cooper C, O´Neill T, Silman A. The epidemiology of vertebral fracture. Bone 1993; 14: S89-S97.

10. Cauley JA, Thompson DE, Ensrud KC et al. Risk of mortality following clinical fractures. Osteoporosis Int 2000; 11: 556-561.

11. Rizzoli R. Atlas of Postmenopausal Osteoporosis. 2nd ed. London: Current Medicine Group Ltd 2005.

12. Dequeker J, Pearson J, Reeve J et al. Dual-energy X ray absorptiometry - cross-calibration and normative reference ranges for the spine; results of a European Community Concerted Action Bone 1995; 17: 247-254.

13. Pearson J, Dequeker J, Reeve J et al. Dual-energy X ray absorptiometry of the proximal femur; normal European values standardised with the European Spine Phantom. J Bone Miner Res 1995; 10: 315-324.

14. Kans JA, Borgstrom F, De Late C et al. Assessment of fracture risk. Osteoporos Int 2005; 16: 737-742.

15. Faulkner KG, Cummings SR et al. Simple measurement of femoral geometry predicts hip fracture: the study of osteoporotic fractures. J. Bone Miner Res 1993; 8: 1211-1217.

16. Bergot C, Bousson V et al. Hip fracture risk and proximal femur geometry from DXA scans. Osteoporosis Int 2002; 13: 542-550.

17. Pulkkinen P, Partanen J et al. Combination of bone mineral density and upper femur geometry improves the prediction of hip fracture. Osteoporosis Int 2002; 15: 274-280.

18. Genant HK, Guglielmi G, Jergas M (eds). Bone Densitometry and Osteoporosis. Berlin-Heidelberg: Springer-Verlag 1998.

19. Kroger H, Heikkinen J, Laitinen K et al. Dual Energy X-ray Absorptiometry in normal women: a cross-sectional study of 717 Finnish volunteers. Osteoporos Int 1992; 2: 135-140.

20. Johnell O, Oden A, De Laet C et al. Biochemical indices of bone turnover and the assessment of fracture probability. Osteoporos Int 2002; 13: 523-526.

21. Stepan JJ. Clinical utility of bone markers in the evaluation and follow-up of osteoporotic patients: Why are the markers poorly accepted by clinicians? J Endocrinol Invest 2003; 26: 458-463.

22. Eastell R, Baumann M, Hoyle NR et al. Bone Markers. London: Martin Dunitz Ltd 2001.

23. American Association of Clinical Endocrinologists. Medical guidelines for clinical practive for the prevention and treatment of postmenopausal osteoporosis: 2001 edition, with selected updates for 2003. Endocr Pract 2003; 9: 544-564.

24. Richy F, Ethgen O, Bruyere O et al. Efficacy of alphacalcidiol and calcitriol in primary and corticoid- induced osteoporosis: a metaanalysis of their effects on bone mineral density and fracture rate. Osteoporosis Int 2004; 15: 301-310.

25. Cauley JA, Robbins J, Chen Z et al. Effect of estrogen plus progestin on risk of fracutre and bone mineral density. The Women´s Health Initiavive Randomised Trial. JAMA 2003; 290: 1729-1738.

26. Ettinger B, Black DM, Mitlak BH et al. Reduction of vertebral fracture risk in postmenopausal women with osteoporosis treated with raloxifen: results form a 3-year randomised clinical trial. JAMA 1999; 292: 637-645.

27. Fleisch H Bisphosphonates in Bone Diseases. Academic Press, San Diego 2000Mc Clung M.R. Bisphsophonates. Endcrinol metab Vlin North Am 2003; 32: 253-271.

28. Reginster JY, Minne HW, Sorensesn OH et al. Randomised trial of the efects of risedronate on vertebral fractures in women with established postmenopausal osteoporosis. Osteoporos Int 2000; 11: 83-91.

29. Black DM, Cummings SR, Karpf DB et al. Randomised trial of effects of alendronate on risk of fracture in women with existinn vertebral fractures. Lancet 1996; 348: 1535-1541.

30. Chesnut III CH, Skag A, Christiansesn C et al. Oral Ibandronate Osteoporosis Vertebral Fracture Trial in North America and Europe (BONE). Effects of oral ibandronate administered daily or intermittently on fracute risk in postmenopausal osteoporosis. J Bone Miner Res 2004; 19: 1241-1249.

31. Chesnut CH, Silverman S, Adrianoi K et al. A randomised trial of nasal spray salmon calcitonin in postmenopausal women with established osteoporosis. The Prevent Recurrence of Osteoporotic Fracture Study. Am J Med 2000; 109: 267-276.

32. Payer J jr, Killinger Z, Ondrejak P. Lososí kalcitonin v liečbe osteoporózy. Vnitř Lék 1999; 45: 476-479.

33. Neer RM, Arnaud CD, Zanchetta JR et al. Effects of parathyroid hormone (1-34) on fractures and bone mineral density on postmenopausla women with osteoporosis. N Engl J Med 2001; 344: 1334-1441.

34. Meunier PJ, Roux C, Seeman E et al. The effect of Strontium Renelate on the riskm of vertebral fracture in Women with postmenopausal osteoporosis. NEJM 2004; 23: 459-468.

35. Reginster JY, Balogh A, Badurski J et al. Strontium ranelate reduces the risk of vertebral fractueres in osteoporotic postmenopausal women without prevalent fracture. Osteopor Int 2003; 14: S7–S8.

36. Reginster JY, Meunier PJ, Roux C,Compston J, Ortolani S. Strontium ranelate: An antiosteoporotic treatment demonstrated vertebral and nonvertebral anti fracture efficiacy over 5 years in post menopausal osteoporotic women. OC31. 6th European Congress on Clinical and Economic Aspects of Osteoporosis and Osteoarthritis, 15.–18. 3. 2006, Vídeň (Rakousko).

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