骨质疏松症与骨关节炎：共同机制与流行病学
Osteoporosis and osteoarthritis: shared mechanisms and epidemiology.
作者信息
Geusens Piet P, van den Bergh Joop P
机构信息
aInternal Medicine, Subdivision of Rheumatology, Maastricht UMC and CAPHRI, Maastricht, The Netherlands bRheumatology, University of Hasselt, Hasselt, Belgium cInternal Medicine, Subdivision of Rheumatology, Maastricht UMC and NUTRIM, Maastricht dInternal Medicine, VieCuri Medical Center, Venlo, The Netherlands.
出版信息
Curr Opin Rheumatol. 2016 Mar;28(2):97-103. doi: 10.1097/BOR.0000000000000256.
PURPOSE OF REVIEW
Osteoporosis and osteoarthritis are different diseases, with differences in risk factors, bone mineral density (BMD), BMI, phenotype, morbidity and mortality. We review new data on the role of bone metabolism in osteoporosis and osteoarthritis.
RECENT FINDINGS
The insights in the common convergent and divergent risk factors between osteoarthritis and osteoporosis have resulted in new findings on the role of BMD, BMI, falls, genetics and epigenetics in the pathophysiology of both diseases and on the increased fracture risk in osteoporosis and osteoarthritis. The relation between BMD, BMI and fracture risk in osteoarthritis is dependent on the stage, definition and location of the osteoarthritis and method of BMD measurement. It has been suggested that osteoarthritis should be further specified in terms of bone involvement.
SUMMARY
These new findings open the way to better understand the bone subtypes of osteoarthritis (osteoporotic, bone forming and erosive) and the common and different ways bone is involved in osteoporosis and osteoarthritis. Much can be expected from further prospective studies, when taking into account the heterogeneous nature of both osteoporosis and osteoarthritis.
综述目的
骨质疏松症和骨关节炎是不同的疾病，在风险因素、骨密度（BMD）、体重指数（BMI）、表型、发病率和死亡率方面存在差异。我们综述了关于骨代谢在骨质疏松症和骨关节炎中作用的新数据。
最新发现
对骨关节炎和骨质疏松症之间共同的趋同和不同风险因素的深入了解，带来了关于BMD、BMI、跌倒、遗传学和表观遗传学在这两种疾病病理生理学中的作用以及骨质疏松症和骨关节炎中骨折风险增加的新发现。骨关节炎中BMD、BMI与骨折风险之间的关系取决于骨关节炎的阶段、定义和部位以及BMD测量方法。有人建议，骨关节炎应在骨受累方面进一步细化。
总结
这些新发现为更好地理解骨关节炎的骨亚型（骨质疏松型、骨形成型和侵蚀型）以及骨在骨质疏松症和骨关节炎中共同和不同的参与方式开辟了道路。考虑到骨质疏松症和骨关节炎的异质性，进一步的前瞻性研究有望取得很多成果。
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