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Beinskjørhet, risikofaktorer: Livsstil og miljøfaktorer

Innhold i artikkelen

Røyking bidrar til utvikling av osteoporose. Det samme gjelder høyt alkoholinntak og et stillesittende liv med lite fysisk aktivitet.

Kosthold kan ha en betydning. Underernæring eller feilernæring med for lite kalsium og vitamin D gir beinskjørhet. Som regel får man tilstrekkelige mengder av disse stoffene gjennom et normalt sammensatt kosthold. De fleste ekspertene er nå enige om at store mengder melk og meieriprodukter ikke motvirker beinskjørhet hos personer med et normalt kosthold. Imidlertid har spesielt gamle mennesker ofte et dårlig kosthold. Tilskudd av kalk og vitamin D kan da være hensiktsmessig.

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Langvarig sengeleie, for eksempel i forbindelse med sykdom, øker beinnedbrytningen og øker risikoen for beinskjørhet hos gamle.

Vil du vite mer

Dette dokumentet er basert på det profesjonelle dokumentet Osteoporose . Referanselisten for dette dokumentet vises nedenfor

  1. Qaseem A, Forciea MA, McLean RM, et al. Treatment of low bone density or osteoporosis to prevent fractures in men and women: A clinical practice guideline update from the American College of Physicians. Ann Intern Med 2017. pmid:28492856 PubMed
  2. Black DM, Rosen CJ. Postmenopausal osteoporosis. N Engl J Med 2016; 374:254-262. www.nejm.org
  3. World Health Organization (WHO). WHO scientific group on the assessment of osteoporosis at primary health care level: summary meeting report. Siden besøkt 30.09.2019. www.who.int
  4. Berntsen GKR. Interpretation of forearm bone mineral density: the Tromsø study. Dr.gradsavhandling, Univ. i Tromsø. ISM skriftserie, nr 56, 2000.
  5. Norsk Endokrinologisk Forening. Osteoporose. I Nasjonal veileder i endokrinologi. Publisert 26.02.2020. Siden lest 20.10.2020. www.prosedyrer.no
  6. Syversen U, Halse JI. Medikamentell behandling av osteoporose. Tidsskr Nor Lægeforen 2003; 123: 2263-4. PubMed
  7. Lowe KE, Mansfield KE, Delmestri A, et al. Atopic eczema and fracture risk in adults: A population-based cohort study. J Allergy Clin Immunol 2019. doi:10.1016/j.jaci.2019.09.015 DOI
  8. Starup-Linde J, Rosendahl SB, Storgaard M, Langdahl B. Management of osteoporosis in patients living with HIV - a systematic review and meta-analysis. J Acquir. Immune Defic Syndr 2020; 83: 1-8. pmid:31809356 PubMed
  9. Vestergaard P, Laursen LC, Schwarz P, Brixen K. Glukokortikoidinduceret osteoporose. Ugeskr Læger 2005; 167: 898-900. PubMed
  10. Crndall CJ, Larson JCLaCroix AZ, et al. Risk of Subsequent Fractures in Postmenopausal Women After Nontraumatic vs Traumatic Fractures. JAMA Intern Med 2021. pmid:34096979 PubMed
  11. Joakimsen RM, Fønnebø V. Bør det innføres screening for osteoporose i Norge? Tidsskr Nor Lægeforen 2001; 121: 615-8. Tidsskrift for Den norske legeforening
  12. Norsk kvalitetsforbedring av laboratorieundersøkelser (Noklus). Anbefalte analyser ved ulike kliniske problemstillinger. Lipoproteinforstyrrelser. Siden besøkt 28.09.2020 www.noklus.no
  13. Nasjonal faglig retningslinje for bildediagnostikk ved ikke-traumatiske muskel- og skjelettlidelser. Anbefalinger for primærhelsetjenesten. Oslo, Helsedirektoratet 2014 www.helsebiblioteket.no
  14. Cummings SR, Lui L-Y, Eastell R, Allen IE. Association Between Drug Treatments for Patients With Osteoporosis and Overall Mortality Rates A Meta-analysis. JAMA Intern Med 2019. pmid:31424486 PubMed
  15. Hinton PS, Nigh P, Thyfault J. Effectiveness of resistance training or jumping-exercise to increase bone mineral density in men with low bone mass: a 12-month randomized, clinical trial. Bone 2015;79:203-212. PMID: 19421702 PubMed
  16. Sherrington C, Whitney JC, Lord SR, et al. Effective exercise for the prevention of falls: a systematic review and meta-analysis. J Am Geriatr Soc. 2008 Dec;56(12):2234-43. PMID: 19093923. PubMed
  17. Santesso N, Carrasco-Labra A, Brignardello-Petersen R. Hip protectors for preventing hip fractures in older people. Cochrane Database Syst Rev 2014; 3: CD001255. doi:10.1002/14651858.CD001255.pub5 DOI
  18. Koike T, Orito Y, Toyoda H, et al. External hip protectors are effective for the elderly with higher-than-average risk factors for hip fractures. Osteoporosis Int 2009; 20: 1613.20. pmid:19137351 PubMed
  19. Yao P, Bennett D, Mafham M, et al. Vitamin D and Calcium for the Prevention of Fracture: A Systematic Review and Meta-analysis. JAMA Netw Open 2019; 2: e1917789. pmid:31860103 PubMed
  20. Avenell A, Mak JC, O'Connell D. Vitamin D and vitamin D analogues for preventing fractures in post-menopausal women and older men. Cochrane Database Syst Rev. 2014 Apr 14;4:CD000227. Cochrane (DOI)
  21. Reid I, Bolland M, et.al. Effects of vitamin D supplements on bone mineral density: a systematic review and meta-analysis. Lancet 2013. doi:10.1016/S0140-6736(13)61647-5. DOI
  22. Bolland MJ, Leung W, Tai V, et al. Calcium intake and risk of fracture: systematic review. BMJ. 2015 Sep 29;351:h4580. doi: 10.1136/bmj.h4580 DOI
  23. Warensjö E, Byberg L, Melhus H, et al. Dietary calcium intake and risk of fracture and osteoporosis: prospective longitudinal cohort study. BMJ 2011; 342: d1473. BMJ (DOI)
  24. Legeforeningen. Gjør kloke valg. Anbefalinger. Siden besøkt 11.02.2021 www.legeforeningen.no
  25. Wells GA, Cranney A, Peterson J, Boucher M, Shea B, Welch V, Coyle D, Tugwell P. Alendronate for the primary and secondary prevention of osteoporotic fractures in postmenopausal women. Cochrane Database of Systematic Reviews 2008, Issue 1. Art. No.: CD001155. DOI: 10.1002/14651858.CD001155.pub2. DOI
  26. Eriksen EF, Halse J. Når seponere bisfosfonater?. Tidsskr Nor Legeforen 2012; 132: 1630-2. Tidsskrift for Den norske legeforening
  27. Park-Wyllie LY, Mamdani MM, Juurlink DN, et al. Bisphosphonate use and the risk of subtrochanteric or femoral shaft fractures in older women. JAMA 2011; 305: 783-9. Journal of the American Medical Association
  28. Sawatari Y, Marx RE. Bisphosphonates and bisphosphonate induced osteonecrosis. Oral Maxillofacial Surg Clin N Am 2007; 19: 487-98. PubMed
  29. Schilcher J, Michaëlsson K, Aspenberg P. Bisphosphonate use and atypical fractures of the femoral shaft . N Engl J Med 2011; 364: 1728-37. DOI: 10.1056/NEJMoa1010650 DOI
  30. Serrano AJ, Begona L, Anitua E, Cobos R, Orive G. Systematic review and meta-analysis of the efficacy and safety of alendronate and zoledronate for the treatment of postmenopausal osteoporosis. Gynecol Endocrinol. 2013 Dec;29(12):1005-14. PMID: 24063695 PubMed
  31. Reid DM, Devogelaer J-P, Saag K, et al. Zoledronic acid and risedronate in the prevention and treatment of glucocorticoid-induced osteoporosis (HORIZON): a multicentre, double-blind, double-dummy, randomised controlled trial. Lancet 2009; 373: 1253-63. PMID: 19362675 PubMed
  32. Faggruppe for osteoporose og benhelse, Norsk ortopedisk forening. Behandlingsveileder for menn og kvinner ≥ 50 år, med lavenergibrudd. Publisert 2015. legeforeningen.no
  33. Tanvetyanon T, Stiff PJ. Management of the adverse effects associated with intravenous bisphosphonates. Ann Oncol. 2006 Jun;17(6):897-907. PMID: 16547070 PubMed
  34. Brown JP, Roux C, Ho PR, et al. Denosumab significantly increases bone mineral density and reduces bone turnover compared with monthly oral ibandronate and risedronate in postmenopausal women who remained at higher risk for fracture despite previous suboptimal treatment with an oral bisphosphonate.. Osteoporos Int. 2014 Mar 28. pmid:24676847 PubMed
  35. Diédhiou D, Cuny T, Sarr A, et al. Efficacy and safety of denosumab for the treatment of osteoporosis: A systematic review. Ann Endocrinol (Paris). 2015 Dec;76(6):650-7. Epub 2015 Nov 27. pmid: 26639186 PubMed
  36. Eastell R, Rosen CJ, Black DM, et al. Pharmacological Management of Osteoporosis in Postmenopausal Women: An Endocrine Society* Clinical Practice Guideline. J Clin Endocrinol Metab. 2019; 104: 1595-622. pmid:30907953 PubMed
  37. Tsai JN, Uihlein AV, Lee H, et al. Teriparatide and denosumab, alone or combined, in women with postmenopausal osteoporosis: the DATA study randomised trial. Lancet 2013. doi:doi:10.1016/S0140-6736(13)60856-9 DOI
  38. Kendler DL, Marin F, Zerbini CAF, et al.: Effects of teriparatide and risedronate on new fractures in post-menopausal women with severe osteoporosis (VERO): a multicentre, double-blind, double-dummy, randomised controlled trial. Lancet 2018; 391: 230-40. pmid:29129436 PubMed
  39. Saag KG, Zanchetta JR, Devogelaer JP, et al. Effects of teriparatide versus alendronate for treating glucocorticoid-induced osteoporosis: thirty-six-month results of a randomized, double-blind, controlled trial. Arthritis Rheum 2009; 60: 3346-55. pmid:19877063 PubMed
  40. Cramer JA, Gold DT, Silverman SL, Lewiecki EM. A systematic review of persistence and compliance with bisphosphonates for osteoporosis. Osteoporos Int. 2007 Aug;18(8):1023-31. PMID: 17308956 PubMed
  41. Newman M, Minns Lowe C, Barker K. Spinal Orthoses for Vertebral Osteoporosis and Osteoporotic Vertebral Fracture: A Systematic Review. Arch Phys Med Rehabil 2015. pmid:26615791 PubMed
  42. Hagen G, Wisløff T, Falch J, et al. Efficacy and cost-effectiveness of alendronate for the prevention of fractures in postmenopausal women in Norway. Rapport fra kunnskapssenteret nr 10 - 2011.
  43. Allen CS, Yeung JH, Vandermeer B, et al. Bisphosphonates for steroid-induced osteoporosis. Cochrane Database Syst Rev. 2016 Oct 5;10:CD001347. pmid: 27706804 PubMed
  44. Zhao J-G, Zeng X-T, Wang J, et al. Association Between Calcium or Vitamin D Supplementation and Fracture Incidence in Community-Dwelling Older Adults A Systematic Review and Meta-analysis. JAMA 2017; 318: 2466-82. pmid:29279934 PubMed
  45. Burt LA, Billington EO, Rose MS, et al. Effect of High-Dose Vitamin D Supplementation on Volumetric Bone Density and Bone Strength: A Randomized Clinical Trial. JAMA. 2019 Aug 27;322(8):736-745. PMID: 31454046 PubMed
  46. Grant AM, Avenell A, Campbell MK, et al. Oral vitamin D3 and calcium for secondary prevention of low-trauma fractures in elderly people (Randomised Evaluation of Calcium Or vitamin D, RECORD): a randomised placebo-controlled trial. Lancet 2005; 365: 1621-8. PubMed
  47. Porthouse J, Cockayne S, King C, et al. Randomised controlled trial of supplementation with calcium and cholecalciferol (vitamin D3) for prevention of fractures in primary care. BMJ 2005; 330: 1003-6. British Medical Journal
  48. Gourlay ML, Fine JP, Preisser JS, et al. Bone-density testing interval and transition to osteoporosis in older women. N Engl J Med 2012; 366: 225-33. New England Journal of Medicine
  49. Chen P, Krege JH, Adachi JD, et al. Vertebral fracture status and the World Health Organization risk factors for predicting osteoporotic fracture risk. J Bone Miner Res 2009; 24: 495-502. pmid:19016585 PubMed
  50. Beaupre LA, Morrish DW, Hanley DA, et al. Oral bisphosphonates are associated with reduced mortality after hip fracture. Osteoporos Int 2011; 22: 983-91. pmid:21052642 PubMed
  51. Kanis JA, Johnell O, Oden A, et al. Long-term risk of osteoporotic fracture in Malmo. Osteoporos Int. 2000;11(8):669-74. PMID: 11095169 PubMed
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