Shriners Hospital for Children, 1003 Boulevard Decarie, Montreal, QC, H4A 0A9, Canada.
Curr Osteoporos Rep. 2017 Oct;15(5):425-432. doi: 10.1007/s11914-017-0396-6.
Here, we review the skeletal effects of pediatric muscle disorders as well as muscle impairment in pediatric bone disorders.
When starting in utero, muscle disorders can lead to congenital multiple contractures. Pediatric-onset muscle weakness such as cerebral palsy, Duchenne muscular dystrophy, spinal muscular atrophy, or spina bifida typically are associated with small diameter of long-bone shafts, low density of metaphyseal bone, and increased fracture incidence in the lower extremities, in particular, the distal femur. Primary bone diseases can affect muscles through generic mechanisms, such as decreased physical activity or in disease-specific ways. For example, the collagen defect underlying the bone fragility of osteogenesis imperfecta may also affect muscle force generation or transmission. Transforming growth factor beta released from bone in Camurati Engelman disease may decrease muscle function.
Considering muscle-bone interactions does not only contribute to the understanding of musculoskeletal disorders but also can identify new targets for therapeutic interventions.
本文回顾了儿科肌肉疾病的骨骼效应以及儿科骨骼疾病中的肌肉损伤。
当从子宫内开始时，肌肉疾病可能导致先天性多发性挛缩。儿科发病的肌肉无力，如脑瘫、杜氏肌营养不良症、脊髓性肌萎缩症或脊柱裂，通常与长骨干直径较小、干骺端骨密度低以及下肢，特别是股骨远端骨折发生率增加有关。原发性骨病可通过一般机制（如体力活动减少）或特定疾病机制影响肌肉。例如，成骨不全症骨脆性的胶原缺陷也可能影响肌肉力量的产生或传递。卡穆拉蒂-恩格尔曼病中从骨骼释放的转化生长因子β可能会降低肌肉功能。
考虑肌肉-骨骼相互作用不仅有助于理解肌肉骨骼疾病，还可以确定治疗干预的新靶点。
