Sopher Aviva B, Fennoy Ilene, Oberfield Sharon E
Division of Endocrinology, Diabetes and Metabolism, Department of Pediatrics, Columbia University Medical Center, New York, New York, USA.
Curr Opin Endocrinol Diabetes Obes. 2015 Feb;22(1):35-40. doi: 10.1097/MED.0000000000000124.
To update the reader's knowledge about the factors that influence bone mineral accrual and to review the advances in the assessment of bone health and treatment of bone disorders.
Maternal vitamin D status influences neonatal calcium levels, bone mineral density (BMD) and bone size. In turn, BMD z-score tends to track in childhood. These factors highlight the importance of bone health as early as fetal life. Dual-energy x-ray absorptiometry is the mainstay of clinical bone health assessment in this population because of the availability of appropriate reference data. Recently, more information has become available about the assessment and treatment of bone disease in chronically ill pediatric patients.
Bone health must become a health focus starting prenatally in order to maximize peak bone mass and to prevent osteoporosis-related bone disease in adulthood. Vitamin D, calcium and weight-bearing activity are the factors of key importance throughout childhood in achieving optimal bone health as BMD z-score tracks through childhood and into adulthood. Recent updates of the International Society for Clinical Densitometry focus on the appropriate use of dual-energy x-ray absorptiometry in children of all ages, including children with chronic disease, and on the treatment of pediatric bone disease.
更新读者关于影响骨矿物质积累的因素的知识，并回顾骨健康评估及骨疾病治疗方面的进展。
母亲的维生素D状态会影响新生儿的钙水平、骨密度（BMD）和骨骼大小。反过来，骨密度Z值在儿童期往往具有一定的跟踪性。这些因素凸显了早在胎儿期骨健康的重要性。由于有合适的参考数据，双能X线吸收法是该人群临床骨健康评估的主要方法。最近，关于慢性病儿科患者骨疾病的评估和治疗有了更多信息。
为了使峰值骨量最大化并预防成年期骨质疏松相关骨疾病，骨健康必须从产前就成为健康关注重点。由于骨密度Z值在儿童期直至成年期都具有跟踪性，维生素D、钙和负重活动是整个儿童期实现最佳骨健康的关键因素。国际临床骨密度测量学会的最新更新重点关注双能X线吸收法在各年龄段儿童（包括慢性病儿童）中的恰当应用以及儿科骨疾病的治疗。
