B族维生素能降低骨质疏松骨折风险吗？

 

骨骼健康是人类一生中至关重要的方面，重点是要关注骨骼的质量和结构。正常的骨量和骨骼结构是通过青春期骨骼的密集形成发展而来的，并通过一生的骨骼重塑来维持。[1,2]。这两个过程分别以成骨细胞为主的骨生成和破骨细胞为主的骨吸收为中心[3]。因此，骨密度(bone mineral density, BMD)和骨转换标志物(bone turnover markers, BTMs)是反映骨骼健康的众多指标中的两个重要方面，而骨折则是严重影响生活质量的病理状况[4,5,6,7,8]。

在成人中，骨骼矿物质质量由骨骼在骨骼生长结束时积累的量决定，即峰值骨量，以及一生中丢失的骨量[7]. 据估计，峰值骨量每增加10%可将成年后发生骨质疏松性骨折的风险降低50%[9]。一生中大约在30岁时骨量达到峰值。从50岁开始，平均骨量每年损失0.5%至1%[10]。骨密度（BMD）降低到一定程度表现为骨质疏松症，即骨密度比“年轻且正常”成年人的平均值低1.0至2.5个标准差（T值介于-1.0至-2.5之间）。T值低于-2.5则定义为骨质疏松症[10]。

然而，仅凭BMD无法完全反映骨骼健康和骨质疏松性骨折的风险[11, 12]。骨形成细胞（osteoblast）和破骨细胞（osteoclast）的产物——骨代谢标志物（BTMs）与BMD一起作为衡量骨骼健康的重要指标[4]。骨折的发生意味着严重的骨骼损伤，并将严重影响患者的生活质量。到50岁时，女性患骨质疏松性骨折的风险约为50%，男性约为20%[13, 14]。例如，髋部骨折是老年人面临的主要健康问题之一，与较高的死亡率密切相关，给患者、医疗保健系统和社会带来负担[15]。因此，预防和治疗骨骼健康的丢失逐渐成为社会医疗保健的重点。

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