Degenerative joint disease: An example of calcium paradox
Degenerative joint disease: An example of calcium paradox
复制标题
退行性关节疾病：钙悖论的一个例子
DOI：
--
复制
发表时间：
1998
影响因子：
3.3
通讯作者：
T. Fujita
中科院分区：
文献类型：
--
作者：
T. Fujita
摘要：骨质疏松症和退行性关节病（如骨关节炎和变形性椎关节强硬）代表了晚年最常见的两种疾病，具有一些共同的临床特征，如疼痛、畸形和活动受限。可能由细胞因子如白细胞介素1介导的骨吸收增加和对雌激素的有利治疗反应也是这两种疾病的特征。膝关节骨关节炎和骨质疏松症都经常发生在绝经后妇女中，而变形性椎关节炎主要影响经历了繁重劳动负荷的男性，女性不太容易受到影响，除非她们在一生中的某个时候像男性一样努力工作。软骨的退化伴随着含水量的减少、钙含量的增加、硬化以及随后的磨损和损失将导致关节间隙变窄和骨的直接接触，从而导致过度的反应性骨形成，例如骨赘。由于软骨和骨骼上的物理负荷增加会加剧这种反应，过度的体重和体育锻炼始终是退行性关节疾病的重要危险因素。然而，加速软骨退化的代谢状态作为背景可能更为重要。只要保持足够的钙摄入量和激素环境保持完整，钙就局限于骨骼。当钙缺乏和继发性甲状旁腺功能亢进发生在老年时，钙从骨中出来，并开始积聚在软组织中，如血管、脑和细胞内室，在正常生理情况下，这些组织中应该存在很少的钙。健康状况下，软骨也应该缺乏钙，但当雌激素缺乏、钙缺乏和继发性甲状旁腺功能亢进导致骨质流失时，钙可能会积聚。由缺钙引起的钙过剩被称为钙悖论。退行性关节疾病应包括在基于钙缺乏和钙矛盾的疾病组中，例如高血压、动脉硬化、阿尔茨海默病和其他神经系统退行性疾病、糖尿病和恶性肿瘤。因此，钙缺乏是导致骨质疏松症和退行性关节疾病的原因。
Abstract: Osteoporosis and degenerative arthropathy such as osteoarthritis and spondylosis deformans represent the two most common diseases seen in later life, sharing some common clinical features such as pain, deformity, and restriction of motion. Augmented bone resorption, possibly mediated by cytokines such as interleukin 1, and favorable therapeutic response to estrogen also characterize both diseases. Both osteoarthritis of the knee and osteoporosis occur frequently in postmenopausal women, whereas spondylosis deformans mainly affects men who experienced a heavy labor load, and women are less susceptible unless they worked as hard as men at some time in their lives. Degeneration of the cartilage with decrease of water content, increase of calcium content, hardening, and subsequent wear and loss would lead to narrowing of the joint space and direct contact of bones, resulting in excessive reactive bone formation such as osteophytes. Because increased physical load on the cartilage and bone would intensify such response, excessive weight and physical exercise always remain important risk factors for degenerative joint disease. The metabolic state precipitating cartilage degeneration, however, may be even more important as the background. Calcium is confined to bone so long as adequate calcium intake is maintained and the hormonal environment remains intact. When calcium deficiency and secondary hyperparathyroidism occur in old age, calcium comes out of bone and starts to accumulate in soft tissues such as blood vessels, brain, and intracellular compartments, where little calcium should be present under normal physiological circumstances. Cartilage should also be devoid of calcium in health, but calcium may accumulate when bone loss occurs in response to estrogen deficiency, calcium deficiency, and secondary hyperparathyroidism. Calcium overabundance prompted by calcium deficiency is known as the calcium paradox. Degenerative joint disease should be included in the group of diseases based on calcium deficiency and calcium paradox, such as hypertension, arteriosclerosis, Alzheimer's disease and other degenerative diseases of the nervous system, diabetes mellitus, and malignancy. Calcium deficiency is thus responsible for both osteoporosis and degenerative joint disease.
登录
查看更多内容
25 千道尔顿胰岛素样生长因子 (IGF) 结合蛋白在体外抑制鸡胚骨盆软骨的基础生长和 IGF-I 介导的生长。
DOI：
10.1210/jcem-70-1-173
发表时间：
1990
期刊：
The Journal of clinical endocrinology and metabolism
影响因子：
--
作者：
Burch,WM;Correa,J;Shively,JE;Powell,DR
通讯作者：
Powell,DR
甲状旁腺激素对肾近端肾小管原代培养物中胞质钙的影响。
DOI：
10.1152/ajprenal.1986.251.2.f188
发表时间：
1986
期刊：
The American journal of physiology
影响因子：
--
作者：
Hruska,KA;Goligorsky,M;Scoble,J;Tsutsumi,M;Westbrook,S;Moskowitz,D
通讯作者：
Moskowitz,D
胆固醇增加动脉平滑肌细胞中 L 型电压敏感钙通道电流。
影响因子：
20.1
作者：
Sen,L;Bialecki,RA;Smith,E;Smith,TW;Colucci,WS
通讯作者：
Colucci,WS
影响因子：
--
作者：
NEVITT, MC;LANE, NE;CUMMINGS, SR
通讯作者：
CUMMINGS, SR
影响因子：
--
作者：
OLIVERIA, SA;FELSON, DT;WALKER, AM
通讯作者：
WALKER, AM