高龄老人慢性病与骨质疏松症的相关性研究进展

近年来研究表明,骨质疏松的发生常与一些慢性疾病相关。笔者通过分析高龄老人常见的几种慢性疾病如阿尔茨海默病、脑梗死、慢性肾脏病、2型糖尿病及动脉粥样硬化这几种疾病中骨质疏松症的研究进展,探讨骨质疏松与这几种疾病之间的关系。在以上几种疾病中引起骨质疏松症的因素包括:(1)TNF-a和IL-6等炎症因子可通过抑制疾病共有的信号通路Wnt途径;(2)由于高龄老人常见的慢性病与骨质疏松有共同的危险因素,如年龄、性别、吸烟、糖尿病、高血压等;(3)高龄老人由于器官退行性改变,导致消化道吸收和消化功能减退,造成钙、维生素D、雌激素等骨合成的原料缺乏;(4)高龄老人常合并多种基础疾病,导致自身户外活动受限,缺乏光照、缺少锻炼,体质量指数下降及营养不良等在骨质疏松的形成中扮演重要角色。综上所述,骨质疏松症的发生常与多种因素相关,对于合并有其他多种慢性疾病的高龄老人来说,发生骨质疏松的风险较高,应当加强骨密度的监测,早诊断、早治疗,避免骨折的发生。

Advances in research on the relationship between chronic diseases and osteoporosis in the elderly

In recent years, studies have shown that the occurrence of osteoporosis is often associated with some chronic diseases. This paper analyzed the recent progress on osteoporosis in several chronic diseases such as Alzheimer''s disease, cerebral infarction, chronic kidney disease, type 2 diabetes mellitus and atherosclerosis, and explored the relationship between osteoporosis and these diseases. Factors that cause osteoporosis in these diseases include: (1) Inflammatory factors such as TNF-a and IL-6 could suppress the signaling pathways common to these diseases - the Wnt pathway; (2) These common chronic diseases and osteoporosis in the elderly have common risk factors, such as age, sex, smoking, diabetes and high blood pressure, etc; (3) Older elderly due to organ degeneration, often have reduced digestion and reduced absorption ability, resulting in the deficiency of calcium, vitamin D and estrogen that are important for bone health; (4) Older elderly often have a variety of underlying diseases, such as: cerebral infarction, hemiplegia, malignant tumors, which result in reduced outdoor activities, lack of sunlight exposure, reduced exercise, decreased physical fitness and malnutrition. All of these play an important role in the development of osteoporosis. In summary, the incidence of osteoporosis is often associated with a variety of factors, and for elderly people with a variety of other chronic diseases, the risk for osteoporosis is higher. Therefore, we should strengthen bone density monitoring, early diagnosis and early treatment, to avoid the occurrence of fractures.