{"id":10454,"date":"2008-01-14T14:31:14","date_gmt":"2008-01-14T11:31:14","guid":{"rendered":"https:\/\/www.synevo.ro\/afectiuni\/profil-osteoporoza\/"},"modified":"2022-03-28T12:14:05","modified_gmt":"2022-03-28T09:14:05","slug":"profil-osteoporoza","status":"publish","type":"synevo_diseases","link":"https:\/\/old.synevo.md\/ru\/afectiuni\/profil-osteoporoza\/","title":{"rendered":"Profil osteoporoz\u0103"},"content":{"rendered":"<p><strong><span style=\"color: #000080;\">Osteoporoza<\/span><\/strong> este definit\u0103 ca o afec\u0163iune evolutiv\u0103 a sistemului osos caracterizat\u0103 prin pierderea de mas\u0103 osoas\u0103 \u015fi prin alter\u0103ri ale microarhitecturii \u0163esutului osos, av\u00e2nd drept consecin\u0163\u0103 cre\u015fterea fragilit\u0103\u0163ii osoase \u015fi a riscului de fracturi.<br>Datorit\u0103 corela\u0163iei bine determinate dintre <strong>densitatea mineral\u0103 osoas\u0103<\/strong> \u015fi <strong>riscul de fracturi<\/strong>, pentru monitorizarea tratamentului \u00een osteoporoz\u0103 se recomand\u0103 de obicei efecturea <strong><span style=\"color: #000080;\">osteodensitometriei<\/span><\/strong>. Cu toate acestea, indiferent de tratamentul utilizat, m\u0103surarea densit\u0103\u0163ii minerale osoase nu este relevant\u0103 pentru evaluarea eficien\u0163ei terapeutice, dec\u00e2t dup\u0103 un an de la \u00eenceputul tratamentului.<\/p><!--more--><p>Exist\u0103 mai multe motive care contribuie la un r\u0103spuns inadecvat la tratament, lipsa complian\u0163ei pacien\u0163ilor situ\u00e2ndu-se probabil pe primul loc. Din acest motiv, ar fi util at\u00e2t pentru medici c\u00e2t \u015fi pentru pacien\u0163i s\u0103 se ob\u0163in\u0103 precoce informa\u0163ii privind eficien\u0163a terapiei \u015fi \u00een acest sens un rol impotant \u00eel au markerii oso\u015fi.<\/p><p>Dac\u0103 <strong>densitometria osoas\u0103 cuantific\u0103 masa osoas\u0103<\/strong> \u2013 imagine static\u0103, <strong>determinarea markerilor oso\u015fi<\/strong> (cum ar fi, osteocalcinul, beta-CrossLaps) <strong>furnizeaz\u0103 informa\u0163ii despre procesul de \u201cremodelare\u201d osoas\u0103<\/strong> \u2013 imagine dinamic\u0103<em>.<\/em><sup>1<\/sup><\/p><p>De\u015fi multe afec\u0163iuni de natur\u0103 infec\u0163ioas\u0103, inflamatorie, traumatic\u0103 \u015fi tumoral\u0103 cresc turn-over-ul osos, principala utilitate a markerilor oso\u015fi este monitorizarea tratamentului osteoporozei \u00een special la femeile la care s-a instalat menopauza. Valoarea lor pentru diagnosticul ini\u0163ial de osteoporoza este limitat\u0103, deoarece \u00een majoritatea cazurilor nu se poate face o diferen\u0163iere \u00eentre femeile aflate la menopauza cu osteoporoz\u0103 \u015fi cele s\u0103n\u0103toase.<\/p><p>\u00cen cursul tratamentului hormonal de substitu\u0163ie sau a celui cu bifosfona\u0163i, concentra\u0163ia markerilor oso\u015fi sufer\u0103 modific\u0103ri \u00een func\u0163ie de tipul lor. Pentru <em>markerii form\u0103rii osoase<\/em> (osteocalcinul) se \u00eenregistreaz\u0103 o sc\u0103dere treptat\u0103 \u00een cursul tratamentului, pe o durat\u0103 de 6 luni. \u00cen schimb, <em>markerii resorb\u0163iei osoase <\/em>(ex. beta-CrossLaps \u2013 marker specific \u015fi stabil al resorb\u0163iei osoase) tind s\u0103 scad\u0103 rapid dup\u0103 ini\u0163ierea terapiei, ulterior concentra\u0163ia lor ating\u00e2nd un platou \u00een intervalul de 6 luni.<\/p><p><strong><span style=\"color: #000080;\">Un posibil algoritm de monitorizare a terapiei \u00een osteoporoz\u0103.<\/span><em><sup>2<\/sup><\/em><\/strong><\/p><ul class=\"wp-block-list\"><li style=\"text-align: left;\">Diagnostic<\/li><li style=\"text-align: left;\">Ini\u0163ierea terapiei<\/li><li style=\"text-align: left;\">Dozarea concentra\u0163iei ini\u0163iale de beta-CrossLaps 3 luni*<\/li><li style=\"text-align: left;\">A 2-a determinare de beta-CrossLaps<\/li><li style=\"text-align: left;\">Sc\u0103derea semnificativ\u0103 a concentra\u0163iei beta-CrossLaps**<\/li><li style=\"text-align: left;\">Continuarea tratamentului stabilit ini\u0163ial<\/li><li style=\"text-align: left;\">Absen\u0163a unei sc\u0103deri semnificative a concentra\u0163iei beta-CrossLaps<\/li><li style=\"text-align: left;\">Evaluarea complian\u0163ei \u015fi a reac\u0163iilor adverse gastro-intestinale<\/li><li style=\"text-align: left;\">Eventual modificarea schemei de tratament<\/li><\/ul><p>* pentru cazurile atipice se recomand\u0103 repetarea determin\u0103rilor la 3-6 luni;<br>** tratament cu bifosfonati: sc\u0103dere 80%;<\/p><p>Tratament hormonal de substitu\u0163ie: sc\u0103dere ~40%.<br>Tratament cu modulatori selectivi ai receptorilor de estrogeni: sc\u0103dere 30-40%.<\/p><p><strong>Utilitatea markerilor oso\u015fi nu este limitat\u0103 numai la evaluarea osteoporozei<\/strong>, ace\u015ftia av\u00e2nd valoare clinic\u0103 \u015fi \u00een alte afec\u0163iuni osoase, cum ar fi: boala Paget a osului, hiperparatiroidism primar \u015fi secundar, osteomalacie \u015fi boli metabolice ale osului.<sup>3<\/sup><\/p><div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-1 wp-block-columns-is-layout-flex\"><div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\"><p><strong>Teste efectuate \u00een laboratoarele Synevo:<\/strong><\/p><\/div>\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\"><div class=\"synevo-shop-products\">\r\n    <div class=\"sysprod\">\r\n        \r\n        <div class=\"sysprod-products\">\r\n                            <div class=\"sysprod-product\">\r\n                    <a class=\"sysprod-product-title\" href=\"https:\/\/old.synevo.md\/ru\/shop\/osteocalcin\/\">Osteocalcin<\/a>\r\n                    <div class=\"sysprod-product-price\">\r\n                        <span>Pre\u021b:<\/span>\r\n                        <span>290.00 lei<\/span>\r\n                    <\/div>\r\n                                            <div class=\"sysprod-product-addcart\">\r\n                            <a\r\n                                href=\"?add-to-cart=9279\"\r\n                                data-quantity=\"1\"\r\n                                class=\"addToCart button product_type_simple add_to_cart_button ajax_add_to_cart \"\r\n                                data-product_id=\"9279\"\r\n                                data-product_sku=\"MO02\"\r\n                                rel=\"nofollow\"\r\n                            ><div><\/div><\/a>\r\n                        <\/div>\r\n                                    <\/div>\r\n                            <div class=\"sysprod-product\">\r\n                    <a class=\"sysprod-product-title\" href=\"https:\/\/old.synevo.md\/ru\/shop\/beta-crosslaps-s-ctx\/\">Beta crosslaps (\u00df\u2013CTx)<\/a>\r\n                    <div class=\"sysprod-product-price\">\r\n                        <span>Pre\u021b:<\/span>\r\n                        <span>450.00 lei<\/span>\r\n                    <\/div>\r\n                                            <div class=\"sysprod-product-addcart\">\r\n                            <a\r\n                                href=\"?add-to-cart=9173\"\r\n                                data-quantity=\"1\"\r\n                                class=\"addToCart button product_type_simple add_to_cart_button ajax_add_to_cart \"\r\n                                data-product_id=\"9173\"\r\n                                data-product_sku=\"MO01\"\r\n                                rel=\"nofollow\"\r\n                            ><div><\/div><\/a>\r\n                        <\/div>\r\n                                    <\/div>\r\n                    <\/div>\r\n        \r\n    <\/div>\r\n<\/div>\r\n\r\n<style>\r\n.synevo-shop-products {\r\n    padding: 24px 0;\r\n    margin: 24px 0;\r\n    border-radius: 10px;\r\n    background: #F6F7F9;\r\n}\r\n.synevo-shop-products .sysprod-product {\r\n    position: relative;\r\n    margin: 0 24px;\r\n    margin-bottom: 24px;\r\n    border-radius: 10px;\r\n    background: #fff;\r\n    display: flex;\r\n    flex-direction: row;\r\n    align-items: center;\r\n}\r\n.synevo-shop-products .sysprod-product:last-child {\r\n    margin-bottom: 0;\r\n}\r\n.synevo-shop-products .sysprod-product-title {\r\n    flex-grow: 1;\r\n    padding: 15px;\r\n    margin-left: 14px;\r\n    font-family: Poppins,sans-serif;\r\n    font-weight: 600;\r\n    font-size: 16px;\r\n    color: #29263F;\r\n}\r\n.synevo-shop-products .sysprod-product-price {\r\n    flex-shrink: 0;\r\n    font-family: Poppins,sans-serif;\r\n    font-weight: 600;\r\n    font-size: 18px;\r\n    color: #FDB813;\r\n}\r\n.synevo-shop-products .sysprod-product-addcart {\r\n    flex-shrink: 0;\r\n    position: relative;\r\n    width: 38px;\r\n    height: 38px;\r\n    margin-left: 24px;\r\n    margin-right: 24px;\r\n}\r\n.synevo-shop-products .sysprod-product-addcart .button {\r\n    top: unset;\r\n    right: unset;\r\n}\r\n<\/style>\n\n<p><\/p><\/div><\/div><p><small><br><strong>Bibliografie:<\/strong><\/small><\/p><p><small>1. Johnell O, Kanis JA, Od\u00e9n A, et.al. Mortality after osteoporotic fractures. \u00cen Osteoporosis Int , 15:38-42, 2004. Ref Type: Journal (Full).<br>2. Delmas PD, Eastell R, Garnero P, et.al. The use of biochemical markers of bone turnover in osteoporosis. \u00cen Osteoporosis Int. IOF Recommendations, 11 (Suppl 6):S2-S17, 2000. Ref Type: Journal (Full).<br>3. Hermien W. Goderie-Plomp, Marjolein van der Klift, Willem de Ronde, et.al. Endogenous Sex Hormones, Sex Hormone-Binding Globulin and the Risk of Incident Vertebral Fractures in Elderly Men and Women: The Rotterdam Study. In The Journal of Clinical Endocrinology &amp; Metabolism, 8:3261-3269, 2004. Ref Type: Journal (Full). <\/small><\/p><hr class=\"wp-block-separator\"\/><p>Mai multe informa\u021bii despre teste:<\/p><ul class=\"wp-block-list\"><li><a href=\"\/shop\/osteocalcin\/\" class=\"rank-math-link\">Osteocalcin<\/a><\/li><li><a href=\"\/shop\/beta-crosslaps\/\" class=\"rank-math-link\">Beta crosslaps<\/a><\/li><\/ul><p><\/p>","protected":false},"featured_media":0,"template":"","synevo_diseases_category":[894],"class_list":["post-10454","synevo_diseases","type-synevo_diseases","status-publish","hentry","synevo_diseases_category-endocrinologie"],"_links":{"self":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/synevo_diseases\/10454","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/synevo_diseases"}],"about":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/types\/synevo_diseases"}],"wp:attachment":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/media?parent=10454"}],"wp:term":[{"taxonomy":"synevo_diseases_category","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/synevo_diseases_category?post=10454"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}