Osteopenia was originally a qualitative term denoting bone that appeared to be less dense on radiographs. Since 1994, it has also had the quantitative meaning of a bone mineral density (BMD) T-score between –1·0 and –2·5. More than 60% of White women older than 64 years are osteopenic. Although fracture risk is often lower in osteopenic women than in those with osteoporosis, their greater number means that most fractures occur in osteopenic individuals. Fracture risk varies widely in the osteopenic range, depending on factors including BMD, age, fracture history, and nationality and ethnicity. Therefore, the diagnosis of osteopenia is not an indication for either intervention or reassurance, but BMD is a risk factor that should be incorporated into a quantitative fracture risk calculation. Evidence from trials shows that oral and intravenous bisphosphonates cost-effectively reduce fractures in older osteopenic women. Major osteoporotic fracture risks of 10–15% could be acceptable indications for treatment with generic bisphosphonates in patients older than 65 years motivated to receive treatment. This Review assesses the evidence relating to the management of older adults with osteopenic bone densities.

中文翻译：

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骨质减少：骨折预防的关键目标


骨质减少最初是一个定性术语，表示在 X 光片上似乎密度较低的骨骼。自 1994 年以来，它也具有骨密度 （BMD） T 值在 –1·0 和 –2·5 之间的定量含义。超过 60% 的 64 岁以上的白人女性患有骨质减少症。尽管骨质减少女性的骨折风险通常低于骨质疏松症患者，但骨质减少女性的骨折风险较高意味着大多数骨折发生在骨质减少个体中。骨质减少患者的骨折风险差异很大，具体取决于 BMD、年龄、骨折史以及国籍和种族等因素。因此，骨质减少的诊断不是干预或安抚的指征，但 BMD 是一个危险因素，应纳入定量骨折风险计算。试验证据表明，口服和静脉注射双膦酸盐可经济有效地减少老年骨质减少女性的骨折。对于 65 岁以上有动力接受治疗的患者，10-15% 的主要骨质疏松性骨折风险可能是使用通用双膦酸盐治疗的可接受适应症。本综述评估了与骨质减少骨密度老年人管理相关的证据。