Rajzbaum Gérald, Bézie Yvonnick
Service de rhumatologie, fondation hôpital Saint-Joseph, 185, rue Raymond-Losserand, 75674 Paris cedex 14, France.
Joint Bone Spine. 2006 Dec;73(6):661-6. doi: 10.1016/j.jbspin.2006.02.009. Epub 2006 Sep 5.
Epidemiological studies have established a significant association between two major health problems, osteoporosis and atheroma, which is independent from age, gender, and other cardiovascular risk factors. Bone loss and the development of calcific deposits within vessel walls occur concomitantly. Proteins formerly thought to be specific of bone have been identified in atheroma lesions; and associations linking vertebral and proximal femoral fractures to aortic calcifications have been reported. Bone loss may be a marker for the risk of stroke and cardiovascular death. Bone loss may occur as a consequence of ischemia related to vascular disease. Despite numerous published studies, the mechanism underlying the osteoporosis-atheroma association remains controversial. Factors that perpetuate the debate include the often retrospective design of the studies, small sample sizes, and known limitations of absorptiometry as a tool for measuring osteoporosis severity. We reviewed the available clinical, epidemiological, and animal data on the mechanisms underlying the association between osteoporosis and atheroma. The possible effect of osteoporosis medications on the blood vessel wall is discussed. These issues remain a matter of debate, indicating a need for vast prospective studies to look for a causal link between osteoporosis and atheroma. The results of these studies may lead to new treatment strategies.
流行病学研究已证实，骨质疏松症和动脉粥样硬化这两大健康问题之间存在显著关联，且这种关联独立于年龄、性别及其他心血管危险因素。骨质流失与血管壁内钙化沉积物的形成同时发生。先前被认为是骨骼特有的蛋白质已在动脉粥样硬化病变中被鉴定出来；并且已有报道称椎骨和股骨近端骨折与主动脉钙化之间存在关联。骨质流失可能是中风和心血管死亡风险的一个指标。骨质流失可能是血管疾病相关缺血的结果。尽管已有大量研究发表，但骨质疏松症与动脉粥样硬化之间关联的潜在机制仍存在争议。使这场争论持续存在的因素包括研究往往采用回顾性设计、样本量小以及作为测量骨质疏松症严重程度工具的骨密度测定法存在已知局限性。我们回顾了关于骨质疏松症与动脉粥样硬化之间关联潜在机制的现有临床、流行病学和动物数据。讨论了骨质疏松症药物对血管壁可能产生的影响。这些问题仍存在争议，这表明需要进行大量前瞻性研究以寻找骨质疏松症与动脉粥样硬化之间的因果联系。这些研究结果可能会带来新的治疗策略。
