The Dilemma of Prevention and Treatment of Secondary Osteoporosis and Its Countermeasures

doi:10.12114/j.issn.1007-9572.2024.0682

Chinese General Practice ›› 2025, Vol. 28 ›› Issue (17): 2075-2081.DOI: 10.12114/j.issn.1007-9572.2024.0682

Special Issue: 骨质疏松最新文章合辑

• Forum on Secondary Osteoporosis • Previous Articles Next Articles

The Dilemma of Prevention and Treatment of Secondary Osteoporosis and Its Countermeasures

¹Department of Endocrinology, General Hospital of Southern Theater Command of the People's Liberation Army, Guangzhou 510010, China
²The First School of Clinical Medicine, Southern Medical University, Guangzhou 510515, China
³Graduate School of Guangdong Pharmaceutical University, Guangzhou 510006, China

Received:2025-01-10 Revised:2025-03-10 Published:2025-06-15 Online:2025-04-22
Contact: LI Jia

继发性骨质疏松症防治困境与对策探究

¹510010　广东省广州市，中国人民解放军南部战区总医院内分泌科
²510515　广东省广州市，南方医科大学第一临床医学院
³510006　广东省广州市，广东药科大学研究生院

通讯作者: 李佳

作者简介:

【专家简介】　李佳，中国人民解放军南部战区总医院内分泌科主任，医学博士，副主任医师，研究生导师，军队优秀专业技术人才津贴获得者。倡导骨质疏松多学科协作模式，并牵头成立广东省老年保健协会骨质疏松预防与康复专业委员会；兼任中国医师协会内分泌代谢科医师分会全国委员，广东省医师协会内分泌代谢科医师分会常务委员，广东省老年保健协会骨质疏松预防与康复专业委员会主任委员。主持国家级、省部级课题5项，发表SCI、核心期刊论文60余篇，授权专利9项，主编、参编、参译专著5部。多年来致力于将内分泌慢病管理由院内向院外延伸，创建南部战区总医院内分泌科普平台，先后荣获全国、全军多项科普大奖，主编科普书籍获军队优秀健康教育作品；荣获个人三等功、优秀教师、优秀主委等奖项及荣誉称号10余项。

作者贡献：

李佳指导论文构思、起草、修订和质量控制，对论文整体负责；谭文彬负责论文的构思与起草。

基金资助:
国家重点研发计划(2021YFC2501701); 广东省中央引导地方科技发展专项基金(KTP20190249)

Abstract

Abstract:

At present, China is faced with high prevalence of osteoporosis, low awareness rate, low treatment rate, diagnosis and treatment and follow-up management are still lack of normative problems. Osteoporosis can be secondary to multiple systemic diseases and is a multidisciplinary disease, which requires multidisciplinary medical workers to work closely together, give full play to their respective advantages, and develop a complete disease management program. In this paper, the author analyzes the status quo, difficulties and prevention and treatment measures of secondary osteoporosis (SOP), in order to provide effective inspiration for clinical workers in the standardized diagnosis and treatment of SOP.

Key words: Secondary osteoporosis, Osteoporosis, Epidemiology, Screening, Treatment, Multi-disciplinary treatment

摘要：

目前我国面临着骨质疏松症高患病率、低知晓率、低治疗率、诊治及随访管理仍缺乏规范性的难题。骨质疏松症可继发于多个系统疾病，是一个涉及多学科的疾病，需要多学科的医务工作者紧密协作、发挥各自优势、制订完备的疾病管理方案。本文分析了继发性骨质疏松症（SOP）诊治现状、困境及防治对策，以期为临床医务工作者提供SOP规范化诊疗启示。

关键词: 继发性骨质疏松症, 骨质疏松症, 流行病学, 筛查, 治疗, 多学科诊疗

LI Jia,TAN Wenbin. The Dilemma of Prevention and Treatment of Secondary Osteoporosis and Its Countermeasures[J]. Chinese General Practice, 2025, 28(17): 2075-2081. DOI: 10.12114/j.issn.1007-9572.2024.0682.
李佳,谭文彬. 继发性骨质疏松症防治困境与对策探究[J]. 中国全科医学, 2025, 28(17): 2075-2081. DOI: 10.12114/j.issn.1007-9572.2024.0682.

Figures/Tables 1

References 48

[1]	管晶晶，陈宇，汤华冬，等. 骨质疏松的健康管理发展现状及挑战[J]. 中华全科医学，2021，19(10)：1729-1732. DOI：10.16766/j.cnki.issn.1674-4152.002153.
[2]	MIRZA F, CANALIS E. Management of endocrine disease：secondary osteoporosis：pathophysiology and management[J]. Eur J Endocrinol，2015，173(3)：R131-151. DOI：10.1530/EJE-15-0118.
[3]	Development Panel on Osteoporosis Prevention DNIHC. Osteoporosis prevention，diagnosis，and therapy[J]. JAMA，2001，285(6)：785-795. DOI：10.1001/jama.285.6.785.
[4]	COLANGELO L, BIAMONTE F, PEPE J, et al. Understanding and managing secondary osteoporosis[J]. Expert Rev Endocrinol Metab，2019，14(2)：111-122. DOI：10.1080/17446651.2019.1575727.
[5]	ROMAGNOLI E, DEL FIACCO R, RUSSO S, et al. Secondary osteoporosis in men and women：clinical challenge of an unresolved issue[J]. J Rheumatol，2011，38(8)：1671-1679. DOI：10.3899/jrheum.110030.
[6]	LAI J C, SHOBACK D M, ZIPPERSTEIN J, et al. Bone mineral density，bone turnover，and systemic inflammation in non-cirrhotics with chronic hepatitis C[J]. Dig Dis Sci，2015，60(6)：1813-1819. DOI：10.1007/s10620-014-3507-6.
[7]	PREMAOR M O, COMPSTON J E. People living with HIV and fracture risk[J]. Osteoporos Int，2020，31(9)：1633-1644. DOI：10.1007/s00198-020-05350-y.
[8]	杨丽，杨长青. 肝硬化与继发性骨质疏松症[J]. 中华肝脏病杂志，2021，29(3)：204-208. DOI：10.3760/cma.j.cn501113-20210208-00078.
[9]	谭文彬，李佳，刘明玉，等. 呼吸系统疾病与继发性骨质疏松症的研究进展[J]. 中华内分泌代谢杂志，2024，40(2)：177-182. DOI：10.3760/cma.j.cn311282-20230915-00080.
[10]	MAHITTHIHARN K, KOVINDHA A, KAEWCHUR T, et al. Prevalence and influencing factors of spinal cord injury-related osteoporosis and fragility fractures in Thai people with chronic spinal cord injury：a cross-sectional，observational study[J]. J Spinal Cord Med，2023，46(3)：458-465. DOI：10.1080/10790268.2022.2054763.
[11]	DIMITRI P, ROSEN C. The central nervous system and bone metabolism：an evolving story[J]. Calcif Tissue Int，2017，100(5)：476-485. DOI：10.1007/s00223-016-0179-6.
[12]	BELLOMO G, SANTAMBROGIO L, FIACCONI M, et al. Plasma profiles of adrenocorticotropic hormone，cortisol，growth hormone and prolactin in patients with untreated Parkinson's disease[J]. J Neurol，1991，238(1)：19-22. DOI：10.1007/BF00319704.
[13]	BOSCO F, GUARNIERI L, NUCERA S, et al. Pathophysiological aspects of muscle atrophy and osteopenia induced by chronic constriction injury（CCI）of the sciatic nerve in rats[J]. Int J Mol Sci，2023，24(4)：3765. DOI：10.3390/ijms24043765.
[14]	TZOULIS P, YAVROPOULOU M P. Association of hyponatremia with bone mineral density and fractures：a narrative review[J]. Ther Adv Endocrinol Metab，2023，14：20420188231197921. DOI：10.1177/20420188231197921.
[15]	HSU S Y, RAU C S, TSAI C H, et al. The influence of hyponatremia and hypokalemia on the risk of fractures in various anatomical regions among adult trauma patients：a propensity score-matched analysis[J]. Diagnostics，2024，14(4)：355. DOI：10.3390/diagnostics14040355.
[16]	RONDANELLI M, FALIVA M A, TARTARA A, et al. An update on magnesium and bone health[J]. Biometals，2021，34(4)：715-736. DOI：10.1007/s10534-021-00305-0.
[17]	DELITALA A P, SCUTERI A, DORIA C. Thyroid hormone diseases and osteoporosis[J]. J Clin Med，2020，9(4)：1034. DOI：10.3390/jcm9041034.
[18]	THUDIUM C S, NIELSEN S H, SARDAR S, et al. Bone phenotypes in rheumatology - there is more to bone than just bone[J]. BMC Musculoskelet Disord，2020，21(1)：789. DOI：10.1186/s12891-020-03804-2.
[19]	ELLER-VAINICHER C, CAIROLI E, GRASSI G, et al. Pathophysiology and management of type 2 diabetes mellitus bone fragility[J]. J Diabetes Res，2020，2020：7608964. DOI：10.1155/2020/7608964.
[20]	AL-HASHIMI L, KLOTSCHE J, OHRNDORF S, et al. Trabecular bone score significantly influences treatment decisions in secondary osteoporosis[J]. J Clin Med，2023，12(12)：4147. DOI：10.3390/jcm12124147.
[21]	KOROMANI F, OEI L, SHEVROJA E, et al. Vertebral fractures in individuals with type 2 diabetes：more than skeletal complications alone[J]. Diabetes Care，2020，43(1)：137-144. DOI：10.2337/dc19-0925.
[22]	董单，许超，万晴冬，等. 肌少-骨质疏松症的研究进展[J]. 中华内分泌代谢杂志，2023，39(7)：625-631. DOI：10.3760/cma.j.cn311282-20230130-00046.
[23]	DONG Y C, YUAN H Y, MA G X, et al. Bone-muscle crosstalk under physiological and pathological conditions[J]. Cell Mol Life Sci，2024，81(1)：310. DOI：10.1007/s00018-024-05331-y.
[24]	中国医师协会风湿免疫科医师分会，中华医学会风湿病学分会，中华医学会骨质疏松和骨矿盐疾病分会，等. 2020版中国糖皮质激素性骨质疏松症防治专家共识[J]. 中华内科杂志，2021，60(1)：13-21. DOI：10.3760/cma.j.cn112138-20201102-00914.
[25]	国际骨髓瘤基金会中国多发性骨髓瘤工作组外科治疗专家. 多发性骨髓瘤骨病外科治疗中国专家共识[J]. 中华骨科杂志，2016，36(4)：193-199. DOI：10.3760/cma.j.issn.0253-2352.2016.04.001.
[26]	国家肾脏疾病临床医学研究中心. 中国慢性肾脏病矿物质和骨异常诊治指南概要[J]. 肾脏病与透析肾移植杂志，2019，28(1)：52-57.
[27]	中华医学会骨质疏松和骨矿盐疾病分会. 原发性骨质疏松症诊疗指南（2022）[J]. 中华骨质疏松和骨矿盐疾病杂志，2022，15(6)：573-611. DOI：10.3969/j.issn.1674-2591.2022.06.001.
[28]	孙磊，胡静，刘家怡，等. 罕见遗传性多发性骨软骨瘤合并骨质疏松症一例研究并文献复习[J]. 中华骨质疏松和骨矿盐疾病杂志，2023，16(2)：115-122. DOI：10.3969/j.issn.1674-2591.2023.02.004.
[29]	WANG Q, YING Q L, ZHU W, et al. Vitamin D and asthma occurrence in children：a systematic review and meta-analysis[J]. J Pediatr Nurs，2022，62：e60-68. DOI：10.1016/j.pedn.2021.07.005.
[30]	KEVIN A, ANANDHI A, LAKSHMINARAYANAN S, et al. Association between serum 25-hydroxy vitamin D level and gastric adenocarcinoma - a cross sectional study[J]. Prz Gastroenterol，2021，16(2)：155-160. DOI：10.5114/pg.2020.100659.
[31]	MELO VAN LENT D, EGERT S, WOLFSGRUBER S, et al. Low serum vitamin D status is associated with incident Alzheimer's dementia in the oldest old[J]. Nutrients，2022，15(1)：61. DOI：10.3390/nu15010061.
[32]	EBADI M, IP S, LYTVYAK E, et al. Vitamin D is associated with clinical outcomes in patients with primary biliary cholangitis[J]. Nutrients，2022，14(4)：878. DOI：10.3390/nu14040878.
[33]	ELOLEMY G, HASSAN W, NASR M, et al. Hypovitaminosis D in patients with ankylosing spondylitis：frequency and consequences[J]. Curr Rheumatol Rev，2021，17(4)：365-372. DOI：10.2174/1573397117666210308122515.
[34]	李月翠，周晶，李成行，等. 肺结核患者骨代谢特点及骨质疏松发生风险分析[J]. 中国卫生检验杂志，2019，29(1)：67-69.
[35]	LIU D, XU W, TANG Y, et al. Nebulization of risedronate alleviates airway obstruction and inflammation of chronic obstructive pulmonary diseases via suppressing prenylation-dependent RAS/ERK/NF-κB and RhoA/ROCK1/MLCP signaling[J]. Respir Res，2022，23(1)：380. DOI：10.1186/s12931-022-02274-5.
[36]	ZAMEER S, ALI J, VOHORA D, et al. Development，optimisation and evaluation of chitosan nanoparticles of alendronate against Alzheimer's disease in intracerebroventricular streptozotocin model for brain delivery[J]. J Drug Target，2021，29(2)：199-216. DOI：10.1080/1061186X.2020.1817041.
[37]	BLAVNSFELDT A G, DE THURAH A, THOMSEN M D, et al. The effect of glucocorticoids on bone mineral density in patients with rheumatoid arthritis：a systematic review and meta-analysis of randomized，controlled trials[J]. Bone，2018，114：172-180. DOI：10.1016/j.bone.2018.06.008.
[38]	LESPESSAILLES E, TOUMI H. Proton pump inhibitors and bone health：an update narrative review[J]. Int J Mol Sci，2022，23(18)：10733. DOI：10.3390/ijms231810733.
[39]	PAZOS-PÉREZ A, PIÑEIRO-RAMIL M, FRANCO-TREPAT E, et al. Methylphenidate promotes premature growth plate closure：in vitro evidence[J]. Int J Mol Sci，2023，24(4)：4175. DOI：10.3390/ijms24044175.
[40]	METTA V, SANCHEZ T C, PADMAKUMAR C. Osteoporosis：a hidden nonmotor face of Parkinson's disease[J]. Int Rev Neurobiol，2017，134：877-890. DOI：10.1016/bs.irn.2017.05.034.
[41]	HERRERA I, KAM Y, WHITTAKER T J, et al. Bisphosphonate-induced orbital inflammation in a patient on chronic immunosuppressive therapy[J]. BMC Ophthalmol，2019，19(1)：51. DOI：10.1186/s12886-019-1063-8.
[42]	DESHAYES S, MARTIN SILVA N, COGEZ J, et al. Multiple cranial neuropathies following zoledronic acid infusion：a relationship? Clinical features and pathogenic discussion concerning a case[J]. Osteoporos Int，2016，27(8)：2627-2629. DOI：10.1007/s00198-016-3567-x.
[43]	KESIKBURUN S, GÜZELKÜÇÜK U, ALAY S, et al. Exacerbation of myasthenia gravis by alendronate[J]. Osteoporos Int，2014，25(9)：2319-2320. DOI：10.1007/s00198-014-2768-4.
[44]	ALNAQBI K A, AL ZEYOUDI J, ALJABERI A K. Correction：cardiac arrhythmia and heart failure shortly after starting romosozumab for osteoporosis：a case-based review[J]. Cureus，2023，15(12)：c148. DOI：10.7759/cureus.c148.
[45]	魏戌，刘宁，章轶立，等. 骨质疏松症的共病研究与早期筛查[J]. 中国全科医学，2022，25(35)：4369-4374. DOI：10.12114/j.issn.1007-9572.2022.0425.
[46]	TABERNA M, GIL MONCAYO F, JANÉ-SALAS E, et al. The multidisciplinary team（MDT）approach and quality of care[J]. Front Oncol，2020，10：85. DOI：10.3389/fonc.2020.00085.
[47]	符灵芝，刘鸿飞. 多学科协作诊疗模式在老年椎体骨质疏松性骨折患者中的应用效果观察[J]. 中国社区医师，2022，38(27)：18-20.
[48]	LI Y, TUNG K K, CHO Y C, et al. Improved outcomes and reduced medical costs through multidisciplinary co-management protocol for geriatric proximal femur fractures：a one-year retrospective study[J]. BMC Geriatr，2022，22(1)：318. DOI：10.1186/s12877-022-03014-6.

The Dilemma of Prevention and Treatment of Secondary Osteoporosis and Its Countermeasures

继发性骨质疏松症防治困境与对策探究

RichHTML

PDF

Knowledge

Abstract

Cite this article

share this article

Figures/Tables 1

References 48

Related Articles 15

Recommended Articles

Metrics

Comments

[1]	YU Wenhua, LI Jianguo, DUAN Wenyan, GAO Xuyan, LI Xiaxia, ZHANG Zilong, ZHANG Li, MA Lina. Reliability and Validity of the Function Impairment Screening Tool among Community-dwelling Older Adults [J]. Chinese General Practice, 2025, 28(24): 3000-3004.
[2]	LI Miaoxiu, ZHU Bowen, KONG Lingjun, FANG Min. Progress in Research on Clinical Assessment Tools for Conservative Treatment of Adolescent Idiopathic Scoliosis [J]. Chinese General Practice, 2025, 28(24): 3079-3088.
[3]	XIAO Yao, WAN Jun. Treatment of Venous Thromboembolism in Special Populations with Direct Oral Anticoagulants [J]. Chinese General Practice, 2025, 28(24): 3066-3071.
[4]	National Clinical Research Center for Infectious Diseases Jiangxi Branch, Jiangxi Provincial Key Laboratory of Tuberculosis. Expert Consensus on the Treatment of Pulmonary Tuberculosis Complicated with Chronic Hepatitis B Virus Infection [J]. Chinese General Practice, 2025, 28(24): 2961-2967.
[5]	SHI Jiarui, WANG Zili, ZHANG Xueqing, SONG Yulei, XU Guihua, BAI Yamei. The Current Status of Initial Cognitive Screening Services in Community-based Cognitive Services Centers in Nanjing [J]. Chinese General Practice, 2025, 28(22): 2784-2790.
[6]	MA Panpan, WANG Sijing, YOU Na, DING Dafa, LU Yibing. Efficacy and Safety of Danuglipron and Orforglipron in the Treatment of Type 2 Diabetes Mellitus: a Meta-analysis [J]. Chinese General Practice, 2025, 28(21): 2679-2685.
[7]	LIU Hongya, YU Dehua. Construction and Practice of Clinical Diagnosis and Treatment Technology Combining General Practice and Specialist in Shanghai Community [J]. Chinese General Practice, 2025, 28(19): 2390-2397.
[8]	XIONG Xin, LI Yang, SHI Feng, YANG Lian, DUAN Wei, CHEN Bei, LI Yong, ZHAO Linwei, FU Quanshui, FAN Xiaoping, YANG Guoqing. Research on the Measurement System and Calibration of Thoracolumbar Vertebral Density Based on Artificial Intelligence [J]. Chinese General Practice, 2025, 28(19): 2398-2406.
[9]	BIAN Ying, YIN Gang, ZHANG Zixun, TAO Hongbing. The Mechanism of Information Construction Enabling High-quality Development of Compact County-level Medical Consortium [J]. Chinese General Practice, 2025, 28(19): 2426-2432.
[10]	GUO Xiangyun, ZHANG Yili, LI Ting, FENG Tianxiao, LI Linghui, SUN Kai, WANG Xu, QIN Xiaokuan, TIAN Jinzhou, ZHU Liguo, WEI Xu. Analysis of Prevalence Trends and Factors Influencing Key Bone Health Conditions [J]. Chinese General Practice, 2025, 28(19): 2346-2353.
[11]	TAN Wenbin, LI Jia, LIU Mingyu, LU Yongxin, CHENG Yaxin. Research Progress on the Influence of Nervous System Diseases and Related Therapeutic Drugs on Osteoporosis [J]. Chinese General Practice, 2025, 28(17): 2092-2100.
[12]	CAO Qinhan, ZHUO Xiao, XIA Yuhan, CHE Yangxi, CHEN Min. Interpretation of Updated NCCN Clinical Guidelines for Rectal Cancer (2024.V1/V2) [J]. Chinese General Practice, 2025, 28(17): 2070-2074.
[13]	HE Ting, LI Jia, TAN Wenbin. Research Progress of Circulatory System Diseases and Secondary Osteoporosis [J]. Chinese General Practice, 2025, 28(17): 2101-2112.
[14]	CHEN Beibei, LI Jia, TAN Wenbin. Progress in the Research of Endocrine and Metabolic System Diseases and Secondary Osteoporosis [J]. Chinese General Practice, 2025, 28(17): 2082-2091.
[15]	LI Jie, DU Yue, SHAO Shen, PAN Dong, ZHANG Yaxin. The Operational Efficiency of Traditional Chinese Medicine Diagnosis and Treatment Services in Primary Medical Institutions in Tianjin Based on DEA and SFA [J]. Chinese General Practice, 2025, 28(16): 1980-1986.