影响城乡骨密度差异的因素分析
Analysis of the influential factors of BMD difference between rural and urban area
  
DOI:10.3969/j.issn.1006-7108.2020.07.026
中文关键词:  骨质疏松  骨密度  城乡地区  影响因素
英文关键词:osteoporosis  bone mineral density  rural and urban area  influential factors
基金项目:国家自然科学基金重点项目(81730107);国家自然科学基金面上项目(81673991); 教育部创新团队发展计划(IRT1270);科技部重点领域创新团队(2015RA4002)
作者单位
张伟强1,2,3 张浩1,2,3 沙南南1,2,3 张岩1,2,3 王晶1,2,3 李晨光1,2,3 赵永见1,2,3 王拥军2,3,4 舒冰1,2,3* 1.上海中医药大学附属龙华医院上海 200032 2.上海中医药大学脊柱病研究所上海 200032 3.上海中医药大学教育部筋骨理论与治法重点实验室上海 200032 4.上海中医药大学康复医学院上海 200032 
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中文摘要:
      城乡间骨密度(bone mass density,BMD)存在差异,但是对于差异高低的具体归属尚无定论,而且造成差异的众多因素互相交叉渗透,对于其中造成差异的生理学机制往往较少涉及,甚至有诸多矛盾之处。本综述力求归纳总结目前较成熟的研究结论,并以各自支持的观点分类列举,分为乡村BMD高于城市、城市BMD高于乡村及其他影响因素3部分,其中乡村BMD高于城市的理由包括:生活节奏、日照时间、睡眠时间、重体力活动4个方面;而城市BMD高于乡村的原因则包括:社会经济水平、教育水平、生育水平及初潮年龄及大气环境4个方面;其他不确定的影响因素主要涉及吸烟饮酒、膳食摄入和先天方面。在以城乡间各个因素具体差异数值支撑的同时,挖掘并整理了可能造成差异背后的生理病理学机制,以及相关临床试验及动物学实验的内容,综合国内外较为权威的结论进行综述。一方面在于整理目前最新的研究结果,为将来严格意义的城乡BMD水平临床研究提供一定借鉴;另一方面为深入探究导致二者差异的实验研究提供实践基础。
英文摘要:
      There is difference of the level of bone mineral density (BMD) between urban and rural areas. However, there is no conclusion where is the location of high or low BMD level. The influential factors intervene and twist with each other. The physiological mechanism has not been explored, and there have been some contrary conclusions. This review summarizes the mature research conclusion. The respective supporting points are arranged and divided into 3 parts, including higher BMD in rural over in urban, higher BMD in urban over in rural, and other factors. Among those, the reasons for higher BMD in rural than in urban include life rhythm, sunshine exposure, sleeping-time, and heavy physical activity. The reasons for higher BMD in urban than in rural include social economic level, education, disparities pregnancy time, menarche age, and environment. The uncertain reasons include smoking, drinking, dietary, and congenital factor. The summary is supported by concrete data and investigates the possible physical and pathologic mechanism causing the difference results. We aim at analyzing and concluding the latest research results to provide data for the further clinical research of BMD between urban and rural areas. On the other hand, we provide the fundamental physical mechanism for improving the relative trial research.
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