了解峰值骨量的重要性。
Understanding the importance of peak bone mass.
作者信息
Hereford Timothy, Kellish Alec, Samora Julie Balch, Reid Nichols Louise
机构信息
Nemours Children's Health, Wilmington, DE, USA.
Thomas Jefferson University, Philadelphia, PA, USA.
出版信息
J Pediatr Soc North Am. 2024 Apr 5;7:100031. doi: 10.1016/j.jposna.2024.100031. eCollection 2024 May.
UNLABELLED
Bone mass attained early in life is one of the most important determinants of lifelong skeletal health. Bone mineral content increases exponentially during childhood. In fact, 40%-60% of the total adult bone mass is accrued during puberty. By the end of the first 2 decades of life, peak bone mass has been reached. Between ages 20-50, bone mass has plateaued, but it continues to remodel. This is regulated by parathyroid hormone (PTH), vitamin D3, and insulin-like growth factor 1 (IGF-1). After the age of 50, bone mass begins to decrease. The purpose of this paper is to review the importance of maximizing peak bone mass and factors that can modify and maintain peak bone mass.
KEY CONCEPTS
(1)Peak bone mass is attained by the end of the second decade of life.(2)There are more fractures during peak height velocity in adolescence as the body increases in size but bone mineralization lags behind.(3)The risk of adult osteoporosis starts in childhood.(4)There are modifiable and nonmodifiable risk factors that affect peak bone mass.
LEVEL OF EVIDENCE
IV.
未标注
生命早期获得的骨量是终生骨骼健康的最重要决定因素之一。儿童期骨矿物质含量呈指数增长。事实上，成人骨总量的40%-60%是在青春期积累的。到生命的前20年结束时，达到峰值骨量。在20-50岁之间，骨量趋于平稳，但仍继续重塑。这受甲状旁腺激素（PTH）、维生素D3和胰岛素样生长因子1（IGF-1）调节。50岁以后，骨量开始下降。本文的目的是综述最大化峰值骨量的重要性以及可改变和维持峰值骨量的因素。
关键概念
（1）峰值骨量在生命的第二个十年结束时达到。（2）青春期身高增长最快时骨折较多，因为身体在生长但骨矿化滞后。（3）成人骨质疏松症的风险始于儿童期。（4）存在影响峰值骨量的可改变和不可改变的风险因素。
证据水平
IV级。
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