Prestwood K M, Pilbeam C C, Raisz L G
Travelers Center on Aging, University of Connecticut Health Center, Farmington 06030, USA.
Annu Rev Med. 1995;46:249-56. doi: 10.1146/annurev.med.46.1.249.
Osteoporosis is a common disorder affecting the health of many adults. Strategies for fracture prevention include optimization of peak bone mass and prevention of bone loss at menopause and with aging. Genetic, nutritional, and life-style factors influence peak bone mass and may be used to focus preventive efforts. Once peak bone mass is reached, increased bone resorption may be the major pathogenetic factor. Calcium plus vitamin D, estrogen replacement therapy, calcitonin, and etidronate are agents currently available for treatment of osteoporosis; they act by inhibiting bone resorption. The failure of bone formation to keep pace with bone resorption also contributes to bone loss. Fluoride and intermittent parathyroid hormone therapy increase bone formation; however, more data are needed to determine efficacy. Insulin-like growth factors, transforming growth factor-beta (TGF-beta), and bone morphogenetic proteins may stimulate bone formation, but they have not yet been tested clinically. New approaches to treatment of osteoporosis will emerge as our understanding of the pathogenesis increases.
骨质疏松症是一种影响众多成年人健康的常见病症。预防骨折的策略包括优化峰值骨量以及预防绝经和衰老过程中的骨质流失。遗传、营养和生活方式因素会影响峰值骨量，可用于集中预防措施。一旦达到峰值骨量，骨吸收增加可能是主要的致病因素。钙加维生素D、雌激素替代疗法、降钙素和依替膦酸是目前可用于治疗骨质疏松症的药物；它们通过抑制骨吸收起作用。骨形成未能跟上骨吸收也会导致骨质流失。氟化物和间歇性甲状旁腺激素疗法可增加骨形成；然而，需要更多数据来确定其疗效。胰岛素样生长因子、转化生长因子-β（TGF-β）和骨形态发生蛋白可能刺激骨形成，但尚未进行临床测试。随着我们对发病机制的理解不断加深，治疗骨质疏松症的新方法将会出现。
