骨的力负荷调节理论进展

Developments of the Theory of Skeletal Adaptation to Mechanical Loading.

骨骼用尽可能少的骨量来维持肢体的运动功能，在肢体抵抗力负荷和重力时充当刚性支架。越来越多的研究表明：力负荷对骨骼的结构和骨量有着极其重要的影响。骨骼每天受到数以千计的力负荷，负荷使骨骼发生应变，但只有非常规分布的应变、强应变及高速应变才具有强成骨能力。骨骼根据所受应变的大小，调节骨塑形和骨再建的启动和关闭。骨塑形能提高骨的强度和骨量，骨再建可以保持或降低骨强度和骨量。在生长发育过程中，骨骼通过骨塑形和骨再建调节骨骼的结构和强度，使骨骼与最大主动负荷相匹配。骨骼的最大负荷来源于肌肉，而不是体重。诊断骨质疏松的新标准可能会兼顾骨质减少的病理状况和严重程度，将骨强度和肌肉力量联系起来考虑。

The primary mechanical function of bone is to provide rigid levers for limbs to act against mechanical loading and gravity, and to remain as light as possible to allow efficient locomotion. There are increasing evidence that mechanical loading is an important, if not the most important, factor influences bone mass and architecture. Many bones are exposed to thousands of repetitive loads every day, which always cause strains. Unusual strain distributions, high strains, and high strain rates seem to be particularly osteogenic. Bone modeling can increase bone strength and mass, bone remodeling can conserve or reduce them, and each can be turned ON or OFF in response to its own threshold range of bone strains. During growth and development, the skeleton optimizes its architecture and strength by (re)modeling to adapt to the largest voluntary loads on bones. The loads come from muscles, not body weight.A new standard of defining osteoporosis might relate bone strength to muscle strength that concerns the osteopenias pathogenesis and its severity, and it would be useful for prevention and cure of osteoporosis.