在慢性病中治疗骨质疏松症的药物
1Department of Medicine, University of California, San Francisco, California, USA.
Current opinion in nephrology and hypertension
|May 16, 2025
概括
在慢性病 (CKD) 患者中治疗骨质疏松症需要个性化策略. 骨周转和矿物质状况指导治疗,但在这个高风险群体中,需要更多的研究才能获得最佳的骨结果.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 内分泌学 在内分泌学.
- 骨的新陈代谢 骨的新陈代谢
背景情况:
- 患有慢性病 (CKD) 的患者面临明显增加的骨折风险.
- 在CKD患者中诊断和治疗骨质疏松症具有独特的复杂性.
- 在CKD中,由于骨折风险增加,骨健康管理至关重要.
研究的目的:
- 审查CKD患者管理骨健康的当前挑战.
- 突出应对CKD相关骨质疏松症的新兴策略.
- 为了确定这个人群中骨质疏松症的诊断和治疗的差距.
主要方法:
- 关于CKD相关骨质疏松症的当前文献的综述.
- 整合诊断工具,包括成像,骨循环标志物和骨活检.
- 基于骨周转状态和矿物代谢的治疗策略的评估.
主要成果:
- 诊断涉及成像,生物标志物和潜在的活检的组合.
- 在开始骨特异性疗法之前,对矿物代谢的纠正至关重要.
- 治疗选择包括抗吸收药物 (双酸盐,代诺苏玛布) 用于高周转率和骨质类代谢剂 (特里帕拉提德,罗莫苏苏玛布) 用于低周转率.
结论:
- 基于骨循环和矿物质状况的个性化管理对于CKD骨质疏松症至关重要.
- 有限的随机试验证据存在于CKD人群中的药理选择.
- 需要进一步的研究来完善治疗选择,确定安全的目标,并提高骨健康结果.
相关概念视频
Bone Remodeling
38.0K
Bone remodeling is a continuous and balanced process of bone resorption by osteoclasts and bone formation by osteoblasts. In adults, it helps maintain bone mass and calcium homeostasis. While mechanical stress can stimulate turnover as part of the normal maintenance and reparative process, several hormones also regulate bone remodeling.
38.0K
Osteoclasts in Bone Remodeling
2.8K
Osteoclasts are cells responsible for bone resorption and remodeling. They originate from hematopoietic progenitor cells present in the bone marrow. Numerous progenitor cells fuse to form multinucleated cells, each with 10-20 nuclei. A single osteoclast has a diameter of 150 to 200 µM. These cells have ruffled borders that break down the underlying bone tissue and release minerals such as calcium into the blood in bone resorption. Osteoclasts cling to bones with their ruffled edges during...
2.8K
Role of Vitamins in Maintaining Bone Health
3.1K
The growth and maintenance of bone are regulated by a combination of nutritional factors, including vitamins, such as vitamin A, B12, C, D, and K.
Vitamin A
Vitamin A is involved in the process of bone remodeling. Retinoic acid, the active metabolite of Vitamin A, has nuclear receptors in osteoblasts and osteoclasts, which are involved in bone remodeling.
Vitamin B12
Vitamin B12 acts as a cofactor during the formation of osteoblast-related proteins, such as osteocalcin. Vitamin B12 plays a role...
Vitamin A
Vitamin A is involved in the process of bone remodeling. Retinoic acid, the active metabolite of Vitamin A, has nuclear receptors in osteoblasts and osteoclasts, which are involved in bone remodeling.
Vitamin B12
Vitamin B12 acts as a cofactor during the formation of osteoblast-related proteins, such as osteocalcin. Vitamin B12 plays a role...
3.1K
Bone Disorders
3.4K
Aging and its effect on bone remodeling is the most common cause of bone disorders. In young and healthy people, bone deposition and resorption happen at an equal rate to maintain optimal bone health.
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
3.4K
Essential Minerals for Bone Health
3.7K
The minerals contained in all of the food we consume are essential for our organ systems. However, certain essential minerals, such as calcium, phosphorus, magnesium, manganese, and fluoride, largely affect bone health.
Calcium and Phosphorus
Calcium is a critical component of bones, especially in the form of calcium phosphate and calcium carbonate. Since the body cannot make calcium, it must be obtained from the diet. However, calcium cannot be absorbed from the small intestine without...
Calcium and Phosphorus
Calcium is a critical component of bones, especially in the form of calcium phosphate and calcium carbonate. Since the body cannot make calcium, it must be obtained from the diet. However, calcium cannot be absorbed from the small intestine without...
3.7K
Hormones and Bone Tissue
2.5K
The endocrine system produces and secretes hormones, which interact with the skeletal system. These hormones control bone growth, maintain bone once it is formed, and remodel it.
Hormones That Influence Osteoblasts and/or Maintain the Matrix
Several hormones are necessary for controlling bone growth and maintaining the bone matrix. The pituitary gland secretes growth hormone (GH), which, as its name implies, controls bone growth. This happens in several ways: first, it triggers chondrocyte...
Hormones That Influence Osteoblasts and/or Maintain the Matrix
Several hormones are necessary for controlling bone growth and maintaining the bone matrix. The pituitary gland secretes growth hormone (GH), which, as its name implies, controls bone growth. This happens in several ways: first, it triggers chondrocyte...
2.5K


