Tanaka Hiroyuki
Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Department of Pediatrics.
Clin Calcium. 2006 Nov;16(11):1879-86.
Bone turnover rate during growth is extremely rapid. Bone growth is under the control of various hormonal environments. Long term administration of glucocorticoid in childhood induced not only osteoporosis but also growth failure via direct action on bone and cartilage and indirectly via hormonal derangements. Sex steroid is one of the important hormones for the bone mineral accrual and for cartilage maturation. Thus glucocorticoid usage during puberty resulted in irreversible effect on bone health including bone growth and peak bone mass accrual. Recently bisphosphonates have been widely used in the treatment of these steroid induced bone disorders in adult with large amount of evidences. But in pediatrics, we are far from the firm evidences. Large scale randomized controlled study (RCT) is necessary.
生长期间的骨转换率极快。骨骼生长受多种激素环境的控制。儿童期长期使用糖皮质激素不仅会导致骨质疏松,还会通过对骨骼和软骨的直接作用以及通过激素紊乱间接导致生长发育迟缓。性类固醇是骨矿物质积累和软骨成熟的重要激素之一。因此,青春期使用糖皮质激素会对骨骼健康产生不可逆的影响,包括骨骼生长和峰值骨量积累。最近,双膦酸盐已被广泛用于治疗成人这些类固醇诱导的骨疾病,并有大量证据支持。但在儿科领域,我们还缺乏确凿的证据。大规模随机对照研究(RCT)是必要的。