MEDIX, God. 26 Br. 141  •  Pregledni članak  •  Obiteljska medicina HR ENG

Osteoporoza i osteopenija – uloga liječnika obiteljske medicineOsteoporosis and osteopenia – the role of family medicine physician

Jasna Vučak

Osteoporoza je najčešća kronična metaboličko-koštana bolest, karakterizirana niskom koštanom masom i poremećenom mikroarhitekturom kosti, što dovodi do povećane sklonosti frakturama. Zlatnim standardom dijagnostike smatra se određivanje mineralne gustoće kostiju radiološkom metodom dualne apsorpciometrije (engl. dual energy x-ray absorptiometry – DEXA). Dijagnostički kriteriji za osteoporozu temelje se na prosječnoj mineralnoj gustoći kostiju (engl. Bone mineral density – BMD), koja se definira u g/cm2 i iskazuje kao T-score – odstupanje u broju standardnih devijacija (SD) prema mladoj zdravoj populaciji iste rase i spola. Probir se radi u svih žena >65 godina, odnosno muškaraca >70 godina. Najpoznatije sredstvo za procjenu rizika za frakturu i potrebe uvođenja terapije jest (engl. Fracture Risk Assesment Tool – FRAX). Prva linija liječenja su oralni bisfosfonati. Uloga je liječnika obiteljske medicine u probiru bolesnika za osteoporozu ili osteopeniju, provođenju savjetovanja i praćenju zdravstvenoga stanja bolesnika.

Ključne riječi:
liječenje; obiteljska medicina; osteopenija; osteoporoza; probir

Članak u cijelosti pročitajte u tiskanom izdanju MEDIX, God. 26 Br. 141

Osteoporosis is the most common chronic metabolic bone disease characterized by low bone mass and disturbed bone microarchitecture leading to an increased tendency for fractures. The aim of this paper is to provide an overview of recommendations for the diagnosis and treatment of osteoporosis and osteopenia at the level family physician health care level, with special emphasis on primary prevention and screening. The golden standard in diagnosing osteoporosis is measuring bone mineral density by the dual energy x-ray absorptiometry (DEXA). It isa radiological diagnostic criteria expressed as a T-score - a deviation in the number of standard deviations (SDs) for a young healthy population of the same race and gender. A screening is performed in all women > 65 years and men > 70 years. The best known fracture risk assessment and treatment initiation tool is the Fracture Risk Assessment Tool (FRAX). Oral bisphosphonates are first line of treatment is. The role of family medicine physicians is primarily to screen patients for osteoporosis or osteopenia, and to consult and monitor patients’ health condition.

Key words:
family medicine; osteopenia; osteoporosis; screening; treatment