? Old people is the high risk crowd of fracture, the picture comes from Doctordwight.com
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Editor-in-charge | Xie Shui sends He Dongming
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A sneeze is hit in the home, cause lumbar fracture, this already was not anecdote, very big one part person is osteoporosis patient, it is especially in old people.
Osteoporosis (Osteoporosis) already became one of the commonnest chronic illnesses, most patient is in inchoate without the symptom, as human body osseous progressively prediction of a person's luck in a given year and joint of occurrence whole body is aching, final development becomes osteoporosis sex fracture, namely brittleness fracture.
As the rapid growth of senile crowd, osteoporosis and brittleness fracture patient will increase quickly, create great economic burden to the society. In recent years, the circumstance of teenage occurrence fracture is not scarce also, the relevant risk element that because this is begun,searchs brittleness fracture appears very significant.
On August 29, british medicine magazine (BMJ) online published a problem to be " the genetic risk of brittleness fracture and clinical risk factor are evaluated " research article. This research is in osteoporosis heredity research international collaboration organizes GEFOS Consortium (Http://www.gefos.org/ ) in finish, it is to reach this age bound to go up correlation of group of complete gene of fracture of the most large-scale brittleness analyses research. Communication unit is Holand Yi pulls Simusi Mai Jier university of medical center, Canada, what group of professor of thick peak of Zheng of west lake university studies for this is collective the first author.
Zheng Houfeng devotes oneself to gene of complex disease easy feeling to consider all the time, in fracture heredity risk element studies the respect obtained important research positive result, the method that Ceng Ying is analysed with Meta and correlation of complete gene group analyses, discover Caucasian first group wrist ministry the easy feeling gene of osteoporosis, fracture and bone ply, participate in England group of gene of 10 thousand people plans (UK10K Project, http://www.uk10k.org/ ) , mining affects the infrequent mutation of bone density.
Early before have research discovery, the easy feeling gene of brittleness fracture falls in the easy feeling gene of bone density for the most part, clew bone density and brittleness fracture have more genetic dependency. Then investigator alternated research train of thought, will begin from the causal analysis of bone density and brittleness fracture risk.
New research brought into a likelihood to come on as brittleness fracture the other factor of the risk, include disease of bowel of sex of rheumatism sex arthritis, inflammation, Ⅰ / level of hormone of thyroid gland of disease of Ⅱ diabetic, coronary artery, hurried, with model content of level of acid of half Guang ammonia, hollow blood sugar, sex matures the age, menopause age (female) , hand grip, , the bone density that increases on two position in all 15 risks element, the method that uses randomization of Er of heart of the first month (Mendelian Randomization) , those who analyse these risk elements and brittleness fracture is mutual causal.
? The bone capacity of human body appears to be added first as age growth, the trend that falls after
Classics research, investigator got a few about fracture risk element very meaningful new discovery. Bone density just is the influencing factor with brittleness the biggest fracture, and the critical factor that often thinks, level of low vitamin D and calcic intake of small dairy products, discover in studying this they and brittleness fracture do not have dependency of cause and effect.
So, pass interpose, promoting bone density is the important step that prevents fracture. Include to notice lifestyle among them, like right amount motion (take a walk) , bask more etc. Young needs to know the value of bone health more, in the bone density peak value that young moment reachs, can affect a person in the future bone density and fracture risk. Bone density peak value is higher, senile bone density also can be in to be worth higher relatively, reduce fracture risk thereby. Accordingly, train in young period designedly and increase bone density, be helpful for preventing senile osteoporosis and fracture.
Generally speaking, compensatory vitamin D is precaution and remedial osteoporosis and fracture the one part of clinical guideline. But it is normal that vitamin D is in or slightly low-level old people, consider this to discover, vitamin D level and fracture risk do not have dependency of cause and effect. Additional, have research discovery, higher serum calcic level is a critical factor of coronary heart disease.
By this token, the old people of opposite health is in in community, d of groovy and compensatory vitamin and calcic agent are not necessary. 2017, an article result that JAMA publishs supports this thesis likewise. But to osteoporosis and fracture patient, before undertaking bone absorbs cure inhibition, should check bone density and vitamin D level, d of compensatory vitamin and calcic agent.
Other element, if the gender is mature,hand grip is reduced, have the associated sex of certain level with brittleness fracture, but need farther test and verify. In this research, other risk factors and brittleness fracture also do not have dependency of apparent cause and effect.
"The WBBC project that west lake university is having target of first phase, build a kid to study alignment namely, aim to study the influencing factor of bone density peak value and genetic factor. " Zheng Houfeng expresses, "We the hypothesis test and verify is: Since bone density is the biggest influencing factor of fracture, and D of vitamin of senile period complement and calcic agent cannot reduce fracture risk again, so whether to mix in D of vitamin of young period interpose the complement of calcic agent (or interpose is other element) , increase the bone density after old age, prevent senile osteoporosis and fracture thereby. Prevent senile osteoporosis and fracture thereby..
Relevant bibliographical reference:
1)Trajanoska K, morris JA, oei L, zheng HF Et Al. Assessment Of The Genetic Andclinical Determinants Of Fracture Risk: Genome Wide Association And Mendelianrandomisation Study. BMJ Xxxxxx
2) Rivadeneira F Et Al. Twenty Bone-mineral-density Loci Identified Bylarge-scale Meta-analysis Of Genome-wide Association Studies. Nat Genet. 2009Nov;41(11):1199-206.
3) Estrada K Et Al. Genome-wide Meta-analysisidentifies 56 Bone Mineral Density Loci And Reveals 14 Loci Associated Withrisk Of Fracture.Nat Genet.2012 Apr 15;44(5):491-501.
4) Zheng HF Et Al. Whole-genome Sequencingidentifies EN1 As A Determinant Of Bone Density And Fracture. Nature. 2015 Oct1;526(7571):112-7.
5) Schuit SCE Et Al. Fracture Incidence Andassociation With Bone Mineral Density In Elderly Men And Women: The RotterdamStudy. Bone 2004; 34: 195 – 202.
6) Zhao JG Et Al. Association Between Calciumor Vitamin D Supplementation And Fracture Incidence In Community-Dwelling OlderAdults: A Systematic Review And Meta-analysis. JAMA, 2017. 318(24) : P.2466-2482.
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