有关骨质疏松症的预防、诊断和治疗的NIH共识发展小组表示,尚未确定人群的最佳筛查指南;并建议应根据病史危险因素决定诊断性检查。[2]NIH Consensus Development Panel on Osteoporosis Prevention, Diagnosis, and Therapy. Osteoporosis prevention, diagnosis, and therapy. JAMA. 2001;285:785-795.http://www.ncbi.nlm.nih.gov/pubmed/11176917?tool=bestpractice.com
美国预防服务工作组(USPSTF)建议,应对65岁及以上和存在患病危险因素的60-64岁女性进行筛查。USPSTF并未对不需筛查的年龄上限的提出建议。[42]U.S. Preventive Services Task Force. Screening for osteoporosis: U.S.
preventive services task force recommendation statement. Ann Intern Med. 2011;154:356-364.http://annals.org/article.aspx?articleid=746858http://www.ncbi.nlm.nih.gov/pubmed/21242341?tool=bestpractice.com
没有研究骨质疏松筛查与骨折结局相关性的随机对照试验。一项观察性研究发现,进行骨矿物质密度测定的患者骨折发病率降低。[43]Lim LS, Hoeksema LJ, Sherin K, et al. Screening for osteoporosis in the adult U.S. population: ACPM position statement on preventive practice. Am J Prev Med. 2009;36:366-375.http://www.ncbi.nlm.nih.gov/pubmed/19285200?tool=bestpractice.com联合使用WHO骨折危险因素与骨矿物质密度分析有助于评估骨折的绝对风险。建议所有成年患者(50岁及以上)都应进行骨质疏松症危险因素评估。65岁及以上女性和70岁及以上男性建议接受BMD测定。对于较年轻的绝经后女性或者50-69岁的男性,如果至少存在一项骨质疏松的主要危险因素的或者两项次要危险因素,应进行BMD测定。[43]Lim LS, Hoeksema LJ, Sherin K, et al. Screening for osteoporosis in the adult U.S. population: ACPM position statement on preventive practice. Am J Prev Med. 2009;36:366-375.http://www.ncbi.nlm.nih.gov/pubmed/19285200?tool=bestpractice.com