Smit A E, Meijer O C, Winter E M
Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, the Netherlands.
Einthoven Laboratory for Experimental Vascular Medicine, Leiden, the Netherlands.
Bone Rep. 2024 Mar 5;20:101750. doi: 10.1016/j.bonr.2024.101750. eCollection 2024 Mar.
Age-associated osteoporosis (AAOP) poses a significant health burden, characterized by increased fracture risk due to declining bone mass and strength. Effective prevention and early treatment strategies are crucial to mitigate the disease burden and the associated healthcare costs. Current therapeutic approaches effectively target the individual contributing factors to AAOP. Nonetheless, the management of AAOP is complicated by the multitude of variables that affect its development. Main intrinsic and extrinsic factors contributing to AAOP risk are reviewed here, including mechanical unloading, nutrient deficiency, hormonal disbalance, disrupted metabolism, cognitive decline, inflammation and circadian disruption. Furthermore, it is discussed how these can be targeted for prevention and treatment. Although valuable as individual targets for intervention, the interconnectedness of these risk factors result in a unique etiology for every patient. Acknowledgement of the multifaceted nature of AAOP will enable the development of more effective and sustainable management strategies, based on a holistic, patient-centered approach.
年龄相关性骨质疏松症（AAOP）带来了重大的健康负担，其特征是由于骨量和骨强度下降导致骨折风险增加。有效的预防和早期治疗策略对于减轻疾病负担及相关医疗成本至关重要。当前的治疗方法有效地针对了导致AAOP的个体因素。然而，AAOP的管理因影响其发展的众多变量而变得复杂。本文综述了导致AAOP风险的主要内在和外在因素，包括机械性负荷减少、营养缺乏、激素失衡、代谢紊乱、认知能力下降、炎症和昼夜节律紊乱。此外，还讨论了如何针对这些因素进行预防和治疗。尽管这些因素作为个体干预靶点很有价值，但这些风险因素的相互关联性导致每个患者都有独特的病因。认识到AAOP的多方面性质将有助于基于整体、以患者为中心的方法制定更有效和可持续的管理策略。
