Fluoride: A toxic or therapeutic agent in the treatment of osteoporosis?

Jan Aaseth, Mona Shimshi, J. Lester Gabrilove, Grethe Støa Birketvedt
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引用次数: 58

Abstract

This article summarizes recent studies and is a review of the literature on the fluoride compounds and their influence on bone mineral mass. It is well known that fluoride is an important element for mineralization of body tissues. The use of topical and systemic fluoride for oral health has resulted in major reduction in dental caries, but fluoride also plays a role in bone health. Dieticians and other health professionals are advised to recommend adequate use of systemic and topical fluorides, especially in children and adolescents. Population studies as well as earlier studies of individuals exposed to fluorides indicate that doses above 30–40 mg daily can result in fluorosis, characterized by increased fracture risk. Numerous clinical studies have demonstrated increased bone mineral density in subjects treated with appropriate doses of fluoride. However, the clinical interpretation of these studies has been a matter of debate. Therapeutically, fluoride seems to be useful when the agent is started in the early stages of osteoporosis, especially in patients with intact trabecular bone. It is well established that fluoride can act as an effective stimulator of bone formation by the osteoblasts. Bisphosphonates, which can also increase bone density, act by inhibiting bone resorption by osteoclasts. As a result of this, owing to the tight paracrine association characterizing skeletal metabolism, bone formation is slowed down by the antiresorptive agents. It is of particular interest that great benefit in the treatment of osteoporoses is seen when adequate osteoblast-stimulating doses of fluorides are given in combination with antiresorptive medication, but further research is needed to substantiate this promising concept. J. Trace Elem. Exp. Med. 17:83–92, 2004. © 2004 Wiley-Liss, Inc.
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氟化物:治疗骨质疏松症的毒性或治疗剂?
本文综述了近年来有关氟化合物及其对骨矿物质的影响的研究,并对其文献进行了综述。众所周知,氟是人体组织矿化的重要元素。局部和全身氟用于口腔健康已大大减少龋齿,但氟也在骨骼健康中发挥作用。建议营养师和其他健康专业人员建议充分使用全身和局部氟化物,尤其是在儿童和青少年中。人群研究以及早期对接触氟化物的个体的研究表明,每天30–40 mg以上的剂量会导致氟中毒,其特征是骨折风险增加。大量临床研究表明,接受适当剂量氟化物治疗的受试者骨密度增加。然而,这些研究的临床解释一直存在争议。在治疗上,当氟在骨质疏松症的早期阶段开始使用时,尤其是在骨小梁完整的患者中,氟似乎是有用的。众所周知,氟化物可以作为成骨细胞骨形成的有效刺激因子。双膦酸酯也可以增加骨密度,通过抑制破骨细胞的骨吸收发挥作用。因此,由于骨骼代谢的紧密旁分泌结合,抗再吸收剂减缓了骨形成。特别令人感兴趣的是,当给予足够的成骨细胞刺激剂量的氟化物与抗再吸收药物相结合时,在治疗骨质疏松症方面可以看到巨大的益处,但还需要进一步的研究来证实这一有前景的概念。J.Trace Elem。《实验医学》,2004年17月83日至92日。©2004 Wiley-Liss,股份有限公司。
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International Society For Trace Element Research In Humans (ISTERH) Seventh International Conference, Bangkok, Thailand, November 7–12, 2004 Response† Erratum Fluoride: A toxic or therapeutic agent in the treatment of osteoporosis? Interleukin-1α, tumor necrosis factor-α, and interleukin-12 secreted by zinc-induced murine macrophages in vivo and in vitro
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