Heaney R P
Creighton University, Omaha, NE.
Public Health Rep. 1989 Sep-Oct;104 Suppl(Suppl):36-46.
Involutional bone loss, and the fracture syndromes that are designated "osteoporosis," are multifactorial phenomena. Gonadal hormone deficiency, inadequate exercise, and a multitude of lifestyle factors are involved in their pathogenesis. Calcium is important during growth, and probably up to about age 35, when peak bone mass is finally achieved. Recent controversy concerning the role of calcium in the middle-aged and elderly, arising out of population studies showing sometimes only weak calcium effects, can be resolved by recognizing the multifactorial character of involutional bone loss, and by careful attention to such details as national differences in habitual calcium intakes. Thus interpreted, metabolic, epidemiologic, and intervention studies are internally consistent, and indicate that inadequate calcium intake also makes an important contribution to involutional bone loss.
退行性骨质流失以及被称为“骨质疏松症”的骨折综合征是多因素现象。性腺激素缺乏、运动不足以及多种生活方式因素都参与其发病机制。钙在生长期间很重要，可能一直到大约35岁达到峰值骨量时都很重要。最近，关于钙在中老年人中的作用存在争议，这源于人群研究有时仅显示钙的作用微弱，而认识到退行性骨质流失的多因素特征以及仔细关注诸如各国习惯性钙摄入量差异等细节，就可以解决这一争议。如此解读，代谢、流行病学和干预研究在内部是一致的，并表明钙摄入不足也对退行性骨质流失有重要影响。
