Loading and skeletal development and maintenance.
Loading and skeletal development and maintenance.
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DOI：
10.4061/2011/786752
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发表时间：
2010-12-20
影响因子：
1.9
通讯作者：
Rozenberg S
中科院分区：
文献类型：
--
作者：
Bergmann P;Body JJ;Boonen S;Boutsen Y;Devogelaer JP;Goemaere S;Kaufman J;Reginster JY;Rozenberg S
机械负荷是骨量和几何形状的主要调节因素。骨细胞网络被认为是载荷的主要传感器，通过应变诱导的流体在腔道系统中流动而产生的剪应力。细胞内转导意味着雌激素受体的几种激酶和磷酸化。几种细胞外介质，其中NO和前列腺素正在将信号传导到效应细胞。停用会导致骨细胞凋亡和迅速失衡的骨吸收，导致严重的骨质疏松。在生长过程中锻炼会增加峰值骨量，对晚年的骨质疏松症可能是有益的，但如果放弃锻炼，这种增加可能会丢失。成年人和老年人的锻炼计划对骨量和几何形状几乎没有显著影响，至少在短期内是这样。关于运动和药物在治疗骨质疏松症中可能的相加作用的数据很少，但停用可能会减少药物的作用。为骨骼健康而提出的锻炼计划冗长乏味，而且遵从性通常很低。对患者来说，最实用的建议是每天至少步行30到60分钟。游泳或骑自行车等其他运动对骨骼的影响较小，但可以通过保持肌肉质量和力量间接降低骨折风险。
Mechanical loading is a major regulator of bone mass and geometry. The osteocytes network is considered the main sensor of loads, through the shear stress generated by strain induced fluid flow in the lacuno-canalicular system. Intracellular transduction implies several kinases and phosphorylation of the estrogen receptor. Several extra-cellular mediators, among which NO and prostaglandins are transducing the signal to the effector cells. Disuse results in osteocytes apoptosis and rapid imbalanced bone resorption, leading to severe osteoporosis. Exercising during growth increases peak bone mass, and could be beneficial with regards to osteoporosis later in life, but the gain could be lost if training is abandoned. Exercise programs in adults and seniors have barely significant effects on bone mass and geometry at least at short term. There are few data on a possible additive effect of exercise and drugs in osteoporosis treatment, but disuse could decrease drugs action. Exercise programs proposed for bone health are tedious and compliance is usually low. The most practical advice for patients is to walk a minimum of 30 to 60 minutes per day. Other exercises like swimming or cycling have less effect on bone, but could reduce fracture risk indirectly by maintaining muscle mass and force.