维生素D与儿童青少年创伤后骨丢失的相关性研究进展

Advances in the relationship between vitamin D and post-traumatic bone loss in children and adolescents

摘要

创伤后骨丢失是儿童青少年骨折后常见而易被忽视的并发症,可影响峰值骨量并增加远期再骨折风险。维生素D作为骨-肌健康的关键调节因子,可通过调控钙磷代谢、免疫炎症反应及肌肉骨骼力学负荷等途径参与创伤后骨丢失过程。现有临床证据提示,骨折儿童维生素D缺乏/不足普遍存在,并与骨密度下降、再骨折风险增加及骨折愈合延迟等结局相关。本文围绕炎症反应、废用性力学刺激减少以及甲状旁腺激素异常等机制,系统综述维生素D与儿童青少年创伤后骨丢失的关联及其潜在干预价值,并讨论维生素D补充在临床实践中的应用要点。未来仍需开展多中心前瞻性研究与随机对照试验,以明确创伤后维生素D补充的最佳时机、剂量及监测策略。

Abstract

Post-traumatic bone loss is an under-recognized complication following fractures in children and adolescents, which may compromise peak bone mass and increase the long-term risk of refracture.As a key regulator of bone-muscle health, vitamin D may contribute to post-traumatic bone loss through multiple pathways, including modulation of calcium-phosphate metabolism, immune and inflammatory responses, and musculoskeletal mechanical loading.Available clinical evidence suggests that vitamin D deficiency/insufficiency is prevalent among pediatric fracture patients and is associated with reduced bone mineral density, increased refracture risk, and delayed fracture healing.Focusing on mechanisms such as inflammation, reduced disuse-related mechanical stimulation, and parathyroid hormone dysregulation, this review systematically summarizes the association between vitamin D and post-traumatic bone loss in children and adolescents and its potential interventional value, and discusses practical considerations for vitamin D supplementation in clinical practice.Further multicenter prospective studies and randomized controlled trials are warranted to determine the optimal timing, dosage, and monitoring strategy for post-injury vitamin D supplementation.

关键词

维生素D / 创伤后骨丢失 / 骨密度 / 骨折风险 / 骨折愈合 / 儿童青少年

Key words

vitamin D / post-traumatic bone loss / bone mineral density / fracture risk / fracture healing / children and adolescents

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