Skip to main content
SpringerLink
Log in

Osteoporose – Prävention: warum und wie?

Osteoporosis — prevention: why and how?

  • Leitthema
  • Published:
Der Gynäkologe Aims and scope

Zusammenfassung

Osteoporose ist eine Volkskrankheit, die zu einem Verlust an Mobilität und Lebensqualität führt. Dies sollte durch gezielte Prävention verhindert werden. Frakturen ohne adäquates Trauma sollten verstärkt beachtet werden, um Risikofaktoren, wie Ess-Störungen, längere sekundäre Amenorrhöphasen und Knochenabbau fördernde Medikamente, früh zu erkennen und soweit wie möglich zu minimieren. Auch Kontrazeption und Schwangerschaft sind für den Knochen relevant. Der Einsatz einer präventiven spezifischen Osteoporosetherapie, auch mit Hormonen, sollte individuell für jede Patientin ausgewählt werden.

Abstract

Osteoporosis is a common and debilitating disease. Targeted prevention would avoid bone fractures, and loss of mobility and quality of life. Influencing factors on bone density are already active in premenopausal women: hormonal factors, exercise, dieting, weight, and medications with negative influences on bone density are important. Minimal trauma fractures and low bone density should prompt gynecologists to consider treatments to prevent osteoporosis. Specific osteoporosis therapy, including hormone therapy if needed, should be selected individually for each patient.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1

Literatur

  1. Roux C, Wyman A, Hooven FH, Gehlbach SH, Adachi JD, Chapurlat RD, Compston JE, Cooper C, Díez-Pérez A, Greenspan SL, Lacroix AZ, Netelenbos JC, Pfeilschifter J, Rossini M, Saag KG, Sambrook PN, Silverman S, Siris ES, Watts NB, Boonen S (2012) GLOW investigators: Burden of non-hip, non-vertebral fractures on quality of life in postmenopausal women: the Global Longitudinal study of Osteoporosis in Women (GLOW. Osteoporos Int 12:2863–2871

    Article  Google Scholar 

  2. Seifert-Klauss V, Rabe T, Krämer A‑K, Schneeweise A (2015) Aromatase-Inhibitoren: Update 2015. J Reproduktionsmed Endokrinol 12(1):5–12

    Google Scholar 

  3. Berger C, Langsetmo L, Joseph L, Hanley DA, Davison KS, Josse R, Kreiger N, Tenenhouse A, Goltzman D (2008) Canadian Multicentre Osteoporosis Study Research GroupChange in bone mineral density as a function of age in women and men and association with the use of antiresorptive agents. CMAJ 178(13):1660–1668

    Article  PubMed  PubMed Central  Google Scholar 

  4. Seifert-Klauss V, Link T, Heumann C, Luppa P, Haseitl M, Laakmann J, Rattenhuber J, Kiechle M (2006) Influence of pattern of menopausal transition on the amount of trabecular bone loss. Results from a 6‑year prospective longitudinal study. Maturitas 55(4):317–324

    Article  CAS  PubMed  Google Scholar 

  5. Seifert-Klauss V, Fillenberg S, Schneider H et al (2012) Bone loss in premenopausal, perimenopausal and postmenopausal women: results of a prospective observational study over 9 years. Climacteric 15:433–440

    Article  CAS  PubMed  Google Scholar 

  6. Sowers MR, Finkelstein JS, Ettinger B, Bondarenko I, Neer RM, Cauley JA, Sherman S, Greendale GA (2003) Study of Women’s Health Across the Nation. The association of endogenous hormone concentrations and bone mineral density measures in pre- and perimenopausal women of four ethnic groups: SWAN. Osteoporos Int 14(1):44–52 (Jan)

    Article  CAS  PubMed  Google Scholar 

  7. Kleinsorge F, Seifert-Klauss V (2016) Knochenstoffwechsel in der menopausalen Transition – Einfluss von FSH, Inhibinen, Progesteron und Ovulation. Gyn Prakt Gynäkologie Vol. 21 [in press]

    Google Scholar 

  8. Niethammer B, Koerner C, Schmidmayr M, Luppa P, Seifert-Klauss V (2015) non-reproductive effects of Anovulation. bone metabolism in the luteal phase of premenopausal women differs between ovulatory and anovulatory cycles. Geburtshilfe Frauenheilkd 75:1250–1257

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Seifert-Klauss V, Prior JC (2010) Progesterone and bone: actions promoting bone health in women. J Osteoporos 2010:845180 (Open Access)

    Article  PubMed  PubMed Central  Google Scholar 

  10. Johansson H, Kanis JA, Odén A, McCloskey E, Chapurlat RD, Christiansen C, Cummings SR, Diez-Perez A, Eisman JA, Fujiwara S, Glüer CC, Goltzman D, Hans D, Khaw KT, Krieg MA, Kröger H, LaCroix AZ, Lau E, Leslie WD, Mellström D, Melton LJ 3rd, O’Neill TW, Pasco JA, Prior JC, Reid DM, Rivadeneira F, van Staa T, Yoshimura N, Zillikens MC (2014) A meta-analysis of the association of fracture risk and body mass index in women. J Bone Miner Res 1:223–233

    Article  Google Scholar 

  11. Seifert-Klauss V (2011) Osteoporose bei Patienten unter 60 Jahren: Ursachen und Therapieansätze. Gestörtes Ess-Verhalten – ein häufiger Risikofaktor. Orthop Rheum 6:46–48

    Google Scholar 

  12. Bülchmann G, Seifert-Klauss V, Backmund H, Gerlinghoff M (2001) Die Bedeutung von Ess- Störungen in der gynäkologischen Praxis. Geburtshilfe Frauenheilkd 61(8):569–577

    Article  Google Scholar 

  13. Grimes DA, Schulz KF, Curtis KM, Chen M (2014) Steroidal contraceptives: effect on bone fractures in women. Cochrane Database Syst Rev 6:CD006033 doi:10.1002/14651858.CD006033.pub5

    PubMed  Google Scholar 

  14. Schmidmayr M, Magdolen U, Tuebel J, Kiechle-Bahat M, Burgkart R, Seifert-Klauss V (2008) Progesterone enhances differentiation of primary human osteoblasts in long-term cultures. [Progesteron verstärkt die Differenzierung primärer humaner Osteoblasten in Langzeit-Kulturen]. Geburtshilfe Frauenheilkd 68:1–6

    Article  Google Scholar 

  15. Vester H, Seifert-Klauss V, van Griensven M, Neumaier M (2014) Fractures due to transient osteoporosis of pregnancy. Int J Gynaecol Obstet 124(3):259–260

    Article  PubMed  Google Scholar 

  16. Seifert-Klauss V (2012) Progesteron und Knochen. Grundlagenwissenschaftliche und klinische Erkenntnisse. Gynäkologische Endokrinologie 10:37–44

    Article  CAS  Google Scholar 

  17. Beck TJ, Petit MA, Wu G, Leboff MS, Cauley JA, Chen Z (2009) Does obesity really make the femur stronger? bone mineral density, geometry and fracture incidence in the women’s health initiative-observational study. J Bone Miner Res 8:1369–1379

    Article  Google Scholar 

  18. Gallagher JC, Yalamanchili V, Smith LM (2013) The effect of vitamin D supplementation on serum 25(OH)D in thin and obese women. J Steroid Biochem Mol Biol 136:195–200

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. DVO-Leitlinie. http://www.dv-osteologie.org/dvo_leitlinien/osteoporose-leitlinie-2014. Zugegriffen: 20.1.2016

  20. Chapuy MC, Arlot ME, Delmas PD, Meunier PJ (1994) Effect of calcium and cholecalciferol treatment for three years on hip fractures in elderly women. BMJ 23(308):1081–1082

    Article  Google Scholar 

  21. Boonen S, Lips P, Bouillon R, Bischoff-Ferrari HA, Vanderschueren D, Haentjens P (2007) Need for additional calcium to reduce the risk of hip fracture with vitamin D supplementation: evidence from a comparative metaanalysis of randomized controlled trials. J Clin Endocrinol Metab 92(4):1415–1423

    Article  CAS  PubMed  Google Scholar 

  22. Riedel J, Richter L, Wissing J, Artmann A, Kiechle M, Seifert-Klauss V (2016) Vitamin D and mammographic findings. Geburtshilfe Frauenheilkd : (eingereicht)

    Google Scholar 

  23. Michaëlsson K, Melhus H, Warensjö Lemming E, Wolk A, Byberg L (2013) Long term calcium intake and rates of all cause and cardiovascular mortality: community based prospective longitudinal cohort study. BMJ 346:f228

    Article  PubMed  PubMed Central  Google Scholar 

  24. Langsetmo L, Berger C, Kreiger N, Kovacs CS, Hanley DA, Jamal SA, Whiting SJ, Genest J, Morin SN, Hodsman A, Prior JC, Lentle B, Patel MS, Brown JP, Anastasiades T, Towheed T, Josse RG, Papaioannou A, Adachi JD, Leslie WD, Davison KS, Goltzman D, CaMos Group (2013) Calcium and vitamin D intake and mortality: results from the Canadian Multicentre Osteoporosis Study (CaMos). J Clin Endocrinol Metab 98(7):3010–3018

    Article  CAS  PubMed  Google Scholar 

  25. Nelson B (2014) Insights from the Global Longitudinal Study of Osteoporosis in Women (GLOW). Nat Rev Endocrinol 10:412–422

    Article  Google Scholar 

  26. Hadji P, Klein S, Gothe H, Häussler B, Klees T, Schmidt T, Steinle T, Verheyen F, Linder R (2013) The epidemiologiy of osteoporosis - Bone evaluation Study (BEST): an analysis of routine health insurance data. Deutsches Arztebl Int 110(4):52–57

    Google Scholar 

  27. Hosmer WD, Genant HK, Browner WS (2002) Fractures before menopause: a red flag for physicians. Osteoporos Int 13(4):337–341

    Article  CAS  PubMed  Google Scholar 

  28. Seifert-Klauss V (2011) Osteoporose-Leitlinien patientenorientiert umsetzen. CME-Beitrag zu Diagnostik und Therapie der Osteoporose. Allgemeinarzt 10:34–39

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Gynäkologische Endokrinologie und Interdisziplinäres Osteoporosezentrum (IOZ), Frauenklinik und Poliklinik der TU München, Ismaninger Str. 22, 81675, München, Deutschland

    K. Breitenbach, F. Kleinsorge &  V. Seifert-Klauss

Authors
  1. K. Breitenbach
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. F. Kleinsorge
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. V. Seifert-Klauss
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to V. Seifert-Klauss.

Ethics declarations

Interessenkonflikt

K. Breitenbach, F. Kleinsorge und V. Seifert-Klauss geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

Additional information

Redaktion

A. Schwenkhagen

K. Schaudig

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Breitenbach, K., Kleinsorge, F. & Seifert-Klauss, V. Osteoporose – Prävention: warum und wie?. Gynäkologe 49, 258–264 (2016). https://doi.org/10.1007/s00129-016-3849-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00129-016-3849-6

Schlüsselwörter

Keywords

Search

Navigation