Zusammenfassung
Die Osteoporose ist eine systemische Skeletterkrankung, die durch eine niedrige Knochenmasse und eine mikroarchitektonische Verschlechterung des Knochengewebes charakterisiert ist. Dies resultiert in einer erhöhten Fragilität des Knochens und in einer erhöhten Frakturhäufigkeit. Sind bereits eine oder mehrere Frakturen als Folge der Osteoporose aufgetreten, liegt eine manifeste Osteoporose vor. Die klinische Bedeutung der Osteoporose liegt im Auftreten von Knochenbrüchen und deren Folgen. Die Diagnose einer Osteoporose basiert auf einer Evaluation von Risikofaktoren, wie z. B. vorbestehende Frakturen oder eine niedrige Knochendichte. Zusätzlich tragen extraossäre Faktoren, wie z. B. Stürze, oder sekundäre Ursachen wesentlich zur vermehrten Knochenbrüchigkeit bei einer Osteoporose bei. Eine adäquate Diagnostik mit der Erfassung der Risikofaktoren ist die Basis für eine korrekte, leitlinienorientierte Therapie der Patienten. Neben einem breiten Angebot an pharmakologischen Interventionen zur individuellen und evidenzbasierten Behandlung der Osteoporose haben sich in den letzten Jahren effiziente Versorgungsstrukturen, gerade für Patienten nach einer osteoporotischen Fraktur, etabliert.
Similar content being viewed by others
Literatur
Adler RA, El-Hajj Fuleihan G, Bauer DC, Camacho PM, Clarke BL, Clines GA, Compston JE, Drake MT, Edwards BJ, Favus MJ, Greenspan SL, McKinney R Jr, Pignolo RJ, Sellmeyer DE (2016) Managing osteoporosis in patients on long-term bisphosphonate treatment: report of a task force of the American Society for Bone and Mineral Research. J Bone Miner Res 31:16–35
Ahlborg HG, Johnell O, Turner CH, Rannevik G, Karlsson MK (2003) Bone loss and bone size after menopause. N Engl J Med 349:327–334
Angeli A, Guglielmi G, Dovio A, Capelli G, de Feo D, Giannini S, Giorgino R, Moro L, Giustina A (2006) High prevalence of asymptomatic vertebral fractures in post-menopausal women receiving chronic glucocorticoid therapy: a cross-sectional outpatient study. Bone 39:253–259
Black DM, Cummings SR, Karpf DB, Cauley JA, Thompson DE, Nevitt MC, Bauer DC, Genant HK, Haskell WL, Marcus R, Ott SM, Torner JC, Quandt SA, Reiss TF, Ensrud KE (1996) Randomised trial of effect of alendronate on risk of fracture in women with existing vertebral fractures. Fracture Intervention Trial Research Group. Lancet 348:1535–1541
Black DM, Reid IR, Boonen S, Bucci-Rechtweg C, Cauley JA, Cosman F, Cummings SR, Hue TF, Lippuner K, Lakatos P, Leung PC, Man Z, Martinez RL, Tan M, Ruzycky ME, Su G, Eastell R (2012) The effect of 3 versus 6 years of zoledronic acid treatment in osteoporosis: a randomized extension to the HORIZON-Pivotal Fracture Trial (PFT). J Bone Miner Res 27:243–254
Chang KP, Center JR, Nguyen TV, Eisman JA (2004) Incidenceof hip and other osteoporotic fractures in elderly men andwomen: dubbo Osteoporosis Epidemiology Study. J Bone Miner Res 19:532–536
Consensus Development Conference (1993) Diagnosis, prophylaxis and treatment of osteoporosis. Am J Med 94:646–650
Cosman F, Crittenden DB, Grauer A (2017) Romosozumab treatment in post menopausal osteoporosis. N Engl J Med 376:396–397
Delmas PD, Recker RR, Chesnut CH 3rd, Skag A, Stakkestad JA, Emkey R, Gilbride J, Schimmer RC, Christiansen C (2004) Daily and intermittent oral ibandronate normalize bone turnover and provide significant reduction in vertebral fracture risk: results from the BONE study. Osteoporos Int 15:792–798
DMAB, McCloskey EV, Johansson H, Oden A et al (2012) Denosumab reduces the risk of osteoporotic fractures in postmenopausal women, particularly in those with moderate to high fracture risk as assessed with FRAX. J Bone Miner Res 27:1480–1486
DVO Leitlinie (2017) Website: www.dv-osteologie.org/uploads/leitlinie2017
Eekman DA, van Helden SH, Huisman AM, Verhaar HJ, Bultink IE, Geusens PP, Lips P, Lems WF (2014) Optimizing fracture prevention: the fracture liaison service, an observational study. Osteoporos Int 25:701–709
Elliot-Gibson V, Bogoch ER, Jamal SA, Beaton DE (2004) Practice patterns in the diagnosis and treatment of osteoporosis after a fragility fracture: a systematic review. Osteoporos Int 15:767–778
Fitzpatrick LA (2002) Secondary causes of osteoporosis. Mayo Clin Proc 77:453–446
Franciosi LG, Page CP, Celli BR, Cazzola M, Walker MJ, Danhof M, Rabe KF, Della Pasqua OE (2006) Markers of disease severity in chronic obstructive pulmonary disease. Pulm Pharmacol Ther 19:189–199
Genant HK, Wu CY, van Kuijk C, Nevitt MC (1993) Vertebral fracture assessment using a semiquantitative technique. J Bone Miner Res 8:1137–1148
Giangregorio L, Papaioannou A, Cranney A, Zytaruk N, Adachi JD (2006) Fragility fractures and the osteoporosis care gap: an international phenomenon. Semin Arthritis Rheum 35:293–305
Hadji P, Klein S, Gothe H, Häussler B, Kless T, Schmidt T, Steinle T, Verheyen F, Linder R (2013) The epidemiology of osteoporosis – Bone Evaluation Study (BEST): an analysis of routine health insurance data. Dtsch Ärztebl Int 110(4):52–57
Haentjens P, Magaziner J, Colón-Emeric CS, Vanderschueren D, Milisen K, Velkeniers B, Boonen S (2010) Meta-analysis: excess mortality after hip fracture among older women and men. Ann Intern Med 152(6):380–390
Herrera A, Lobo-Escolar A, Mateo J, Gil J, Ibarz E, Gracia L (2012) Male osteoporosis: a review. World J Orthop 3:223–234
Hofbauer LC, Gori F, Riggs BL, Lacey DL, Dunstan CR, Spelsberg TC, Khosla S (1999) Stimulation of osteoprotegerin ligand and inhibition of osteoprotegerin production by glucocorticoids in human osteoblastic lineage cells: potential paracrine mechanisms of glucocorticoid-induced osteoporosis. Endocrinology 140:4382–4389
International Osteoporosis Foundation. Capture the fracture: fracture liason services. http://www.capturethefracture.org/fracture-liaison-services. Zugegriffen am 22.06.2016
IOF Bericht (2013) Hernlund, Kanis et al. Osteoporosis in the EU: medical management, epidemionology and economic burden. Arch Osteoporosis 8:136
Jiang HX, Majumdar SR, Dick DA, Moreau M, Raso J, Otto DD, Johnston DW (2005) Development and initial validation of a risk score for predicting in-hospital and 1-year mortality in patientswith hip fractures. J Bone Miner Res 20:494–500
Kanis JA (1994) on behalf of the World Health Organization Scientific Group. Assessment of osteoporosis at the primary health-care level. Technical Report. World Health Organization Collaborating Centre for Metabolic Bone Diseases, University of Sheffield, UK. 2007: Printed by the University of Sheffield. World Health Organization: assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Technical report series 843. WHO, Geneva
Kanis JA, Johnell O, Oden A, Dawson A, De Laet C, Jonsson B (2001) Ten year probabilities of osteoporotic fractures according to BMD and diagnostic thresholds. Osteoporos Int 12:989–995
Kendler DL, Marin F, Zerbini CAF, Russo LA, Greenspan SL, Zikan V, Bagur A, Malouf-Sierra J, Lakatos P, Fahrleitner-Pammer A, Lespessailles E, Minisola S, Body JJ, Möricke PGR, López-Romero P (2018) Effects of teriparatide and risedronate on new fractures in postmenopausal women with severe osteoporosis (VERO): a multicenter, double-blind, double-dummy, randomized controlled Trial. Lancet 391:230–240
Khosla S (2010) Update in male osteoporosis. J Clin Endocrinol Metab 95:3–10
Klotzbuecher CM, Ross PD, Landsman PB, Abbott TA 3rd, Berger M (2000) Patients with prior fractures have an increased risk of future fractures: a summary of the literature and statistical synthesis. J Bone Miner Res 15:721–739
Lambert JK, Zaidi M, Mechanick JI (2011) Male osteoporosis: epidemiology and the pathogenesis of aging bones. Curr Osteoporos Rep 9:229–236
Marshall D, Johnell O, Wedel H (1996) Meta-analysis of how well measures of bone mineral density predict occurrence of osteoporotic fractures. BMJ 312:1254–1259
Mellstrom DD, Sorensen OH, Goemaere S, Roux C, Johnson TD, Chines AA (2004) Seven years of treatment with risedronate in women with postmenopausal osteoporosis. Calcif Tissue Int 75:462–468
Mitchell PJ, Chem C (2013) Secondary prevention and estimation of fracture risk. Best Pract Res Clin Rheumatol 27:789–803
Murray AW, McQuillan C, Kennon B, Gallacher SJ (2005) Osteoporosis risk assessment and treatment intervention after hip or shoulder fracture. A comparison of two centres in the United Kingdom. Injury 36:1080–1084
Nakayama A, Major G, Holliday E, Attia J, Bogduk N (2016) Evidence of effectiveness of a fracture liaison service to reduce the re-fracture rate. Osteoporos Int 27:873–879
Painter SE, Kleerekoper M, Camacho PM (2006) Secondary osteo porosis: a review of the recent evidence. Endocr Pract 12:436–445
Pinkerton JV, Thomas S (2014) Use of SERMs for treatment in postmenopausal women. J Steroid Biochem Mol Biol 142:142–154
Resch H, Trubrich A, Kocijan R et al (2011) Denosumab – the RANKL-antibody as an example of the biotechnological development. Osteologie 20:203–210
Rizzoli R (2014) Nutritional aspects of bone health. Best Pract Res Clin Endocrinol Metab 28:795–808
Rizzoli R, Akesson K, Bouxsein M, Kanis JA, Napoli N, Papapoulos S, Reginster JY, Cooper C (2011) Subtrochanteric fractures after long-term treatment with bisphosphonates: a European Society on Clinical and Economic Aspects of Osteoporosis and Osteoarthritis, and International Osteoporosis Foundation Working Group Report. Osteoporos Int 22:373–390
Rizzoli R, Stevenson JC, Bauer JM, van Loon LJ, Walrand S, Kani JA, Cooper C, Brandi ML, Diez-Perez A, Reginster JY, Task Force ESCEO (2014) The role of dietary protein and vitamin D in maintaining musculoskeletal health in postmenopausal women: a consensus statement from the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO). Maturitas 79:122–132
Saag KG, Petersen J, Brandi ML et al (2017) Romosozumab or alendronate for fracture prevention in women withosteoporosis. N Engl J Med 377:1417–1427
Shepherd JA, Schousboe JT, Broy SB, Engelke K, Leslie WD (2015) Executive summary of the 2015 ISCD position development conference on advanced measures from DXA and QCT: fracture prediction beyond BMD. J Clin Densitom 18:274–286
Tannenbaum C, Clark J, Schwartzman K, Wallenstein S, Lapinski R, Meier D, Luckey M (2002) Yield of laboratory testing to identify secondary contributors to osteoporosis in otherwise healthy women. J Clin Endocrinol Metab 87:4431–4437
Tian X, Jee WS, Li X et al (2011) Sclerostin antibody increases bone mass by stimulating bone formation and inhibiting bone resorption in a hindlimbimmobilization rat model. Bone 48(2):197–201
Weinstein RS (2011) Clinical practice: glucocorticoid-induced bone disease. N Engl J Med 365:62–70
Zebaze RM, Ghasem-Zadeh A, Bohte A, Iuliano-Burns S, Mirams M, Price RI, Mackie EJ, Seeman E (2010) Intracortical remodelling and porosity in the distal radius and post-mortem femurs of women: a cross-sectional study. Lancet 375:1729–1736
Zhou J, Ma X, Wang T, Zhai S (2016) Comparative efficacy of bisphosphonates in short-term fracture prevention for primary osteoporosis: a systematic review with network meta-analyses. Osteoporos Int 27:3289–3300
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2020 Springer-Verlag GmbH Deutschland, ein Teil von Springer Nature
About this entry
Cite this entry
Kurth, A. (2020). Osteoporose – Prävalenz, Bedeutung und Implikationen für die Prävention und Gesundheitsförderung. In: Tiemann, M., Mohokum, M. (eds) Prävention und Gesundheitsförderung. Springer Reference Pflege – Therapie – Gesundheit . Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-55793-8_51-1
Download citation
DOI: https://doi.org/10.1007/978-3-662-55793-8_51-1
Received:
Accepted:
Published:
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-662-55793-8
Online ISBN: 978-3-662-55793-8
eBook Packages: Springer Referenz Medizin