Kelly P J, Eisman J A, Sambrook P N
Head, Bone and Mineral Research Division, Garvan Institute of Medical Research, St. Vincent's Hospital, Sydney, NSW, Australia.
Osteoporos Int. 1990 Oct;1(1):56-60. doi: 10.1007/BF01880417.
Risk of osteoporotic fracture in later life relates to both age and menopause-related bone loss but also to peak bone density achieved in early adulthood. Several studies have shown that genetic influences make a major contribution to variance in adult bone density, but environmental factors such as dietary calcium and physical activity also contribute a large proportion of observed variance in bone density. Previous hypotheses have suggested that the effect of certain environmental factors, such as hormonal and dietary influences, may be permissive to development of peak bone mass. Consideration of the evidence for the interaction between environmental influences, such as physical activity and nutrition, and genotype leads us to propose that environmental factors interact to allow or prevent full expression of bone density genotype. This expansion of the 'threshold' hypothesis can include the effects of sex, physical activity and dietary calcium in a model that allows more systematic study of the determinants of peak bone density and thereby more rational intervention to augment bone density in early adulthood.
晚年骨质疏松性骨折的风险既与年龄和绝经相关的骨质流失有关，也与成年早期达到的峰值骨密度有关。多项研究表明，遗传因素对成人骨密度的差异起主要作用，但饮食钙和体育活动等环境因素也在观察到的骨密度差异中占很大比例。先前的假说表明，某些环境因素的影响，如激素和饮食的影响，可能有利于峰值骨量的发展。对体育活动和营养等环境影响与基因型之间相互作用的证据进行考量后，我们提出环境因素相互作用，以允许或阻止骨密度基因型的充分表达。这种对“阈值”假说的扩展可以在一个模型中纳入性别、体育活动和饮食钙的影响，从而能够更系统地研究峰值骨密度的决定因素，进而更合理地干预以增加成年早期的骨密度。
