Chavassieux P, Seeman E, Delmas P D
Institut National de la Santé et de la Recherche Médicale Unit 831, Pavillon F, Hopital E. Herriot, 69437 Lyon Cedex 08, France.
Endocr Rev. 2007 Apr;28(2):151-64. doi: 10.1210/er.2006-0029. Epub 2006 Dec 19.
Minimal trauma fractures in bone diseases are the result of bone fragility. Rather than considering bone fragility as being the result of a reduced amount of bone, we recognize that bone fragility is the result of changes in the material and structural properties of bone. A better understanding of the contribution of each component of the material composition and structure and how these interact to maintain whole bone strength is obtained by the study of metabolic bone diseases. Disorders of collagen (osteogenesis imperfecta and Paget's disease of bone), mineral content, composition and distribution (fluorosis and osteomalacia); diseases of high remodeling (postmenopausal osteoporosis, hyperparathyroidism, and hyperthyroidism) and low remodeling (osteopetrosis, pycnodysostosis); and other diseases (idiopathic male osteoporosis, corticosteroid-induced osteoporosis) produce abnormalities in the material composition and structure that lead to bone fragility. Observations in patients and in animal models provide insights on the biomechanical consequences of these illnesses and the nature of the qualities of bone that determine its strength.
骨病中的微创伤骨折是骨脆性的结果。我们认识到，骨脆性并非是骨量减少的结果，而是骨的材料和结构特性发生变化的结果，而非将骨脆性视为骨量减少的结果。通过对代谢性骨病的研究，可以更好地理解材料组成和结构的每个成分的作用以及它们如何相互作用以维持全骨强度。胶原蛋白紊乱（成骨不全和佩吉特骨病）、矿物质含量、组成和分布（氟中毒和骨软化症）；高重塑疾病（绝经后骨质疏松症、甲状旁腺功能亢进和甲状腺功能亢进）和低重塑疾病（骨硬化症、致密性骨发育不全）；以及其他疾病（特发性男性骨质疏松症、皮质类固醇诱导的骨质疏松症）会导致材料组成和结构异常，从而导致骨脆性。对患者和动物模型的观察为这些疾病的生物力学后果以及决定骨强度的骨质量性质提供了见解。
