Osteoporosis: Modern Paradigms for Last Century's Bones.
Osteoporosis: Modern Paradigms for Last Century's Bones.
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DOI：
10.3390/nu8060376
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发表时间：
2016-06-17
期刊：
影响因子：
5.9
通讯作者：
Wolber FM
中科院分区：
文献类型：
--
作者：
Kruger MC;Wolber FM
骨骼是一个不断重塑的代谢活跃器官。随着年龄的增长和更年期的平衡转移到增加再吸收，导致骨矿物质密度的降低和骨微结构的破坏。骨量增加和骨代谢受全身激素以及遗传和生活方式因素的影响。经典范例将骨质疏松症描述为一种“脆骨”疾病，其发生在绝经后、瘦、钙摄入量低和/或维生素D不足的高加索妇女中。然而，一项针对非洲黑人妇女的研究表明，较高比例的身体脂肪并不能保护骨骼健康。异黄酮干预亚洲绝经后妇女产生不一致的骨骼健康的好处，部分原因是由于人口异质性的肠道细菌代谢的大豆苷元。对几个亚洲国家的妇女和男子进行的比较发现，各国在骨健康下降率方面存在显著差异，男女骨质疏松症的发病率都很高。这些研究揭示了遗传表型的显著差异，揭穿了长期持有的信念，并导致研究设计的新范式。目前的研究正在专门设计用于评估高加索人，亚洲人，非洲人和其他表型之间的基因型差异，并探索测量骨结构的替代方法。
The skeleton is a metabolically active organ undergoing continuously remodelling. With ageing and menopause the balance shifts to increased resorption, leading to a reduction in bone mineral density and disruption of bone microarchitecture. Bone mass accretion and bone metabolism are influenced by systemic hormones as well as genetic and lifestyle factors. The classic paradigm has described osteoporosis as being a “brittle bone” disease that occurs in post-menopausal, thin, Caucasian women with low calcium intakes and/or vitamin D insufficiency. However, a study of black women in Africa demonstrated that higher proportions of body fat did not protect bone health. Isoflavone interventions in Asian postmenopausal women have produced inconsistent bone health benefits, due in part to population heterogeneity in enteric bacterial metabolism of daidzein. A comparison of women and men in several Asian countries identified significant differences between countries in the rate of bone health decline, and a high incidence rate of osteoporosis in both sexes. These studies have revealed significant differences in genetic phenotypes, debunking long-held beliefs and leading to new paradigms in study design. Current studies are now being specifically designed to assess genotype differences between Caucasian, Asian, African, and other phenotypes, and exploring alternative methodology to measure bone architecture.