让我们谈谈骨质核心

我们甚至不会be able to sit upright without them, so it’s ironic that most of us don’t give much thought (let alone thanks!) to our bones. We tend to take our inner infrastructure for granted until we get a wake-up call. If you’ve been told you have low bone density (also known as osteopenia), you’ve gotten yours. Rather than panic, relax and read on. We explore what’s behind weakened bones and offer strategies to strengthen them.

骨质增长

我们的专业面板

We tapped some of the best bone experts in the field to bring you the most up-to-date information possible.

Kendall Moseley, M.D.

医疗主任

Johns Hopkins Metabolic Bone & Osteoporosis Center

巴尔的摩，MD

Lara比M.D.

Department of Internal Medicine and Geriatrics

克利夫兰诊所

韦斯顿，佛罗里达州

Mary Jane Minkin, M.D.

Clinical Professor of Obstetrics, Gynecology, and Reproductive Services

耶鲁医学院

New Haven, CT

无论如何，什么是骨质增长？

让我们从utero开始。当你是胎儿时，你的骨头开始形成，他们继续这样做，直到20多岁的某个时候。

What are bones made of? At first, mostly软骨(a resilient and smooth elastic tissue). When you’re a baby, your bones are soft and flexible, and even fuse together with other bones (fun fact: you’re born with almost 100 more bones than you have as an adult).

随着年龄的增长，软骨被取代磷酸钙，一个让他们努力的矿物质。你的骨头也是由collagen, a protein that gives them some flexibility, allowing them to give a little without breaking. Bones are comprised of three types of cells:

• Osteoblasts,细胞形式骨

• Osteoclasts,细胞分解骨(also known as骨resorption)

• 骨细胞，被困在骨基质中的老成骨细胞

成骨细胞正在不断制作新骨骼，而破骨细胞分解着旧骨骼，将钙释放到血液和组织中，是一种称为重塑的过程。

What’s Calcium Got to Do With Bone Density?

骨骼中的钙的量由您的骨mineral density。The higher the mineral content, the denser and stronger your bones are. The lower the mineral count, the weaker, more porous (possessing holes) and more brittle your bones are.

What do we mean by brittle? Think of glass. It’s hard, but also likely to break or shatter when you drop it. Bone that’s lacking minerals becomes delicate inside and cracks into pieces from a little pressure.

Typically, when someone is diagnosed with low bone density, or osteopenia, it means they’ve lost一些骨密度，但不像有人那么多osteoporosis骨骼疾病,发生在你的骨骼变弱,thin, and become so fragile, they’re vulnerable to fracture (the medical term for a broken bone). Experts estimate that at least one in two Americans over the age of 50 have osteopenia.

What Are the Risk Factors for Osteopenia?

So, how exactly do you wind up low bone density or osteopenia? By age 30, you’ll have reached your峰骨质量—the strongest your bones will be in your lifetime. If you had a childhood illness that affected bone formation or caused malnutrition (for example, undiagnosed celiac disease or anorexia), your peak bone mass probably isn’t as high as it could be.

Most people don’t have low bone density until mid-life, when you start naturally losing bone mass. But some factors can erode bones earlier, or accelerate loss after age 50. These include:

• 出生是一个女人：解剖学使女性造成较高的骨密度风险。女性骨骼自然较小，薄于男性，因此女性的骨质较低。所以，一旦他们开始随着年龄的年龄而失去骨骼，就会少丢失。研究表明，50岁及以上的女性是twiceas likely to have osteopenia than men.

• 身材较小：作为一个苗条，娇小的“小骨”，女性与较低的骨密度水平和骨质疏松症的风险较高有关。

• Being Caucasian or Asian:These groups tend to have far higher rates of low bone density than Latinos or African Americans. More than half of white postmenopausal women have the condition.

• Genetics:你的骨骼质量从父母身上传来。据说高达80％的峰值骨质量由您的遗传决定。

• 潜在条件：通过影响您的身体吸收钙和其他营养素的方式，许多疾病可能会干扰健康的骨骼发育。例子包括：

  • Undiagnosed celiac disease (if not treated via dietary changes)

  • 甲状腺功能亢进

  • Diabetes

  • 类风湿关节炎

  • 吃厌食症或贪食症等疾病

• Rare Bone Diseases:像下面那样的骨病肯定会影响你的骨密度。

  • Osteomalacia（由于严重的维生素D缺乏，骨骼软化）

  • Paget’s disease (which interferes with normal bone remodeling, leaving bones fragile)

  • 成骨发生不细，一种影响正常骨形成的遗传障碍

• 药物：某些药物可以加速骨质损失。Biggies是：

  • Steroids (long-term use)

  • Chemotherapy and other cancer drugs

  • Heartburn medications known as Proton pump inhibitors (Prevacid, Nexium)

  • Thyroid hormone (excessive amounts)

• 饮食：钙和维生素D中慢性低的饮食有助于您的身体吸收钙 - 可以影响骨密度。在你生命中的第一个几十年的前几十年期间略有营养素可能会导致你的峰值骨骼肿块。随着年龄的增长会导致骨骼更快地分解足够的钙和D.练习均衡，健康的进食方法最适合您的骨骼。在良好的骨骼健康所需的许多营养素和维生素中，可以让您缺乏三种情况：

  • Having an eating disorder

  • 极端节食

  • 减肥手术

  How do you know your body is low in calcium? Tell your doc if you experience any of these symptoms:

  • 刺痛（特别是在你的嘴唇，舌头，手指和脚上）

  • 肌肉痉挛和疼痛

  • Abnormal heart rhythms

• EBBIBLE激素：yup，荷尔蒙也影响骨头。患有更年期的雌激素的丧失可以加速骨质损失，并通过这种生活的变化早期（例如，在40多岁）可以提高你的骨质增长风险。在男性中，低睾酮水平也与较低的骨密度相连。

• Excess Alcohol:Chronic, heavy drinking (defined as more than two drinks a night) is linked to lower bone density.

• Not Enough Exercise (or Too Much!):Weight-bearing exercises like walking, dancing, and hiking, as well as resistance training put just enough stress on bones to stimulate bone formation. This is to build your peak bone mass and maintain healthy bone mass as you age. On the flip side,也much exercise doesn’t do a body good. Female competitive athletes are especially at risk for the female triad: interruption of their menstrual cycle, low calorie intake, and low bone mineral density.

• 社会经济状况：由于科学家们仍在调查，即使在考虑饮食，运动和其他生活方式因素时，据您介绍，社会经济地位较高的女性仍然可能发展骨质增收率的70％仍然70％。2020年期刊研究绝经。

如何诊断出骨脑病？

There aren’t obvious symptoms that bones are weakening, unless you break one. Most of the time, osteopenia is picked up during a routine骨密度扫描，或者densitometry(DXA or DEXA scan). Bone density scans are typically given to women starting at age 65 and men at age 70, but your physician or gynecologist may suggest one sooner if you have the low bone density risk factors mentioned above or ahistory of bone fractures。

骨密度扫描如何工作？

This imaging test is like an X-ray that measures the mineral content in your bones. The higher the mineral content, the stronger your bones are. The lower the mineral content, the weaker. Results are given in what’s called aT-Score.，一个告诉医生你的骨骼如何堆叠到30岁的峰骨质量。

• Above -1.0 is considered normal

• -1.0 to -2.4 means low bone density or osteopenia

• -2.5 and below indicates more severe osteoporosis, meaning your bones are brittle and at a higher risk of fracture

您的骨折风险随着您的T-Score Dips增加：一个50岁的女性，具有-1.0的T分为-1.0的足球，有16％的髋部骨折的机会，而a -2.5起高33％的风险，这是一个研究美国医学协会杂志显示。

你也可以收到一个Z-score, which compares your bone density to people your own age and gender. Think of it as an age test for your bones. Z-scores tend to be given for those under 50, for whom low bone density is not the norm. It helps doctors determine if you have an underlying condition that’s affecting your bone health.

还有一个测试你的医生可以使用，特别是如果你是一个超过50的女人：Fracture Risk Assessment Tool (FRAX)。它决定了你在未来10年内骨折的可能性。即使你没有严重的骨质疏松症，你也可以获得高的Frax得分。在确定治疗时，您的医生将使用它。

So, which type of doctor should you see for low bone density? There’s no singular specialist for osteopenia and osteoporosis. Any of the following types of docs should be able to treat you:

• 一般从业者

• Gynecologists

• Endocrinologists

• 风湿病学家

• Physiatrists

• Orthopedists

• 老年医学医生

What’s the Treatment for Osteopenia?

Most cases of osteopenia don’t require meds. Little changes to your lifestyle and diet can do a long way in beefing up your bones, as your physician will probably tell you. Start here:

• 负重练习：要求您支持自己的体重（行走，慢跑，跳舞等）和/或抵抗训练有助于刺激新的骨骼形成，这就是他们推荐骨质增长和骨质疏松症的原因。如果您的骨密度非常低，您可能需要避免高冲击练习，例如跑步或其他落下的风险。游泳和骑自行车等非重量轴承活动是一个没关系，只要您仍然在轴承锻炼中挤压。

• 饮食变化：提高您的钙和维生素D水平可以帮助缓慢骨质恶化。

  The recommendation for calcium is 1200 mg for women over 50 and 1,000 mg for men. Ideally, you should get your daily dose through your diet. Calcium-rich foods include:

  • 牛奶，酸奶和奶酪等乳制品

  • Dark leafy greens such as kale and collard greens

  • Sardines and salmon with bones

  • Fortified foods such as orange juice and cereals

  来自阳光维生素D,以及食物ke:

  • fatty fish such as salmon, tuna, and mackerel

  • fortified milk

  如果您不认为您通过饮食获得足够的D，补充可以填补差距。

  Other vitamins and nutrients that have proved helpful for bone health are:

  • 维生素C（柑橘类水果，红辣椒，草莓）

  • 维生素K（羽衣甘蓝，菠菜）

  • 钾（土豆，葡萄干，香蕉）

  • Magnesium (sweet potatoes, tomato products, artichoke hearts)

  A Mediterranean style diet—lean proteins, olive oil, foods rich in omega fatty acids—is linked to a healthier bone density, too. Some studies have linked caffeine in coffee and colas to low bone density, but the evidence hasn’t been conclusive. Experts say drink in moderation to play it safe.

对骨质增长的药物有哪些药物？

If your FRAX score puts you at a high risk for fracture, or you’ve already had a fracture, your doctor may prescribe medication to slow the bone loss. The goal is to prevent your osteopenia from progressing to osteoporosis.

What kind of med?双膦酸盐are FDA-approved for preventing osteoporosis in women with osteopenia (以及治疗骨质疏松症). These drugs slow down those osteoclasts, the cells that break down bone. Most are oral tablets taken weekly or monthly. Examples are:

• Fosamax（alendronate），口服

• 博凡纳（ibandronate），口头

• ACTONEL（Ristronate），口服

• 通过IV恢复，Zometa和Aclasta（唑酸盐酸或唑醇或唑酮）

服用Meds，如果您的DOC规定它们，可以避免进一步的骨骼损坏和倾向于带来的休息。每18个月给予唑龙酸盐六年，降低了骨瘦如柴骨折的髋部骨折的风险，与安慰剂药物相比，一项研究发表了一项研究The New England Journal of Medicine显示。与您的文档约会是开始缓慢骨丢失的治疗的第一步 - 不要等待制作一个！

遇见我们的作家

Krista Bennett DeMaio

Krista Bennett Demaio在十年的编辑经历中享有好评。前杂志编辑器转向自由职业者经常涵盖护肤，健康，美容和生活方式主题。她的工作已经出现在国家出版物和网站上，包括奥普拉,Women’s Health,红色的书,形状,奥兹博士美好的生活, bhg.com, and prevention.com. She lives in Huntington, New York with her husband and three daughters.

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