Osteoporosis y riesgo de fractura: estrategias actuales para la prevención, evaluación y manejo en la práctica clínica
Osteoporosis and fracture risk: current strategies for prevention, assessment and management in clinical practice
DOI:
https://doi.org/10.56712/latam.v7i2.5745Palabras clave:
remodelado óseo, densidad mineral ósea, FRAX, bisfosfonatos, riesgo de caídasResumen
La osteoporosis es una enfermedad esquelética frecuente que se asocia con disminución de la densidad mineral ósea, deterioro de la microarquitectura y aumento del riesgo de fracturas, especialmente en personas mayores y mujeres posmenopáusicas. El objetivo de este trabajo fue sintetizar la fisiopatología, los factores de riesgo, la evaluación clínica, las estrategias preventivas y las opciones terapéuticas actuales en osteoporosis. Se realizó una revisión narrativa de la literatura centrada en los mecanismos del remodelado óseo, la identificación del riesgo de fractura, los métodos diagnósticos y las intervenciones farmacológicas y no farmacológicas disponibles. La evidencia revisada mostró que la enfermedad se desarrolla por un desequilibrio entre resorción y formación ósea, influido por la interacción entre osteoblastos, osteoclastos y osteocitos, así como por mecanismos hormonales, en particular la deficiencia de estrógenos y el envejecimiento. También mostró que factores no modificables, como edad, sexo femenino y predisposición genética, y factores modificables, como baja ingesta de calcio y vitamina D, sedentarismo, tabaquismo y bajo índice de masa corporal, contribuyen de forma importante a su desarrollo. La evaluación del riesgo de fractura incluye historia clínica, valoración del riesgo de caídas, identificación de comorbilidades, medición de la densidad mineral ósea mediante absorciometría dual de rayos X y uso de herramientas como FRAX. El tratamiento se basa en medidas preventivas, educación, ejercicio, optimización nutricional y terapias farmacológicas antirresortivas o anabólicas según el riesgo. Se concluyó que el diagnóstico oportuno, la estratificación adecuada del riesgo y el seguimiento clínico permiten optimizar el tratamiento y reducir fracturas, mientras los biomarcadores y la medicina personalizada amplían las perspectivas de manejo futuro.
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Derechos de autor 2026 Stephany González Lobo, Yarizol Delgado Paniagua, Lloyd Steven Shedden Hidalgo, Joshmar Tadlaoui Gonzalez
Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
