# 骨减少（Decreased Bone）

- 器官 / 系统：骨 / 骨骼肌肉系统（bone / musculoskeletal-system）
- NTP 数据编号：ntp-0578
- 规范 URL：https://www.labsmart.cn/ntp/bone-decreased-bone.html
- 中文图谱总页锚点：https://www.labsmart.cn/ntp-atlas.html#bone-decreased-bone
- 原始出处：https://ntp.niehs.nih.gov/atlas/nnl/musculoskeletal-system/bone/DecreasedBone
- 授权：美国联邦政府作品，公有领域；引用请标注 NTP Nonneoplastic Lesion Atlas
- 适用说明：仅供科研使用，不用于临床诊断

## 一句话结论
骨量减少可由骨形成减少或原有骨吸收增加所致。该病变的特征为骨小梁变薄或缺失和/或骨皮质变薄（Figure 1、Figure 2、Figure 3、Figure 4）。

## 病变描述（中文）
骨量减少可由骨形成减少或原有骨吸收增加所致。该病变的特征为骨小梁变薄或缺失和/或骨皮质变薄（Figure 1、Figure 2、Figure 3、Figure 4）。可见微骨折。在伴有活跃骨吸收的病变中，沿骨小梁呈扇贝状、不规则表面可见破骨细胞数量增多，这代表破骨细胞对 Howship 陷窝（吸收陷窝）的作用。弥漫性骨量减少可能由代谢紊乱所致，而局灶性骨量减少可能由骨内局灶性发生的病理过程所致，如纤维骨性病变或骨髓炎。废用（萎缩），如受伤肢体或关节的情况，可导致特定骨内弥漫性骨量减少。多种化合物的治疗与骨生长减弱相关，包括大鼠中因糖皮质激素毒性对破骨细胞活性的影响所致的干骺端骨小梁减少，以及小鼠中因对软骨形成和软骨内骨化的影响所致者。甲状腺功能亢进与因破骨细胞生成和骨吸收增加所致的皮质骨和髓质骨变薄相关。膳食因素如维生素/矿物质和蛋白质摄入可显著影响骨生长；膳食蛋白质水平低导致骨缩短，而导致因饥饿所致体重下降的毒物可引起以干骺端骨小梁丢失及骺板变窄和变形为特征的骨病变。在老龄繁殖动物中，由于妊娠对钙和蛋白质需求增加，也可观察到髓质骨小梁丢失。该病变也曾被记录为萎缩、骨质疏松、骨量减少和吸收，但更通用的术语“骨量减少”更为可取。不建议使用术语“骨质疏松”，因为其在人类医学中具有更具体的定义，即与全身性年龄相关或激素相关骨密度丢失相关的临床状况。在人类中，骨量减少被认为是骨质疏松的前驱病变/状况，其中骨内蛋白质发生改变并伴有明显的骨量减少，与骨折风险增加相关。

## 诊断与分级建议（NTP 共识，中文）
“骨 - 骨量减少”当作为原发性病变发生时应当诊断并赋予严重程度分级。病变的位置（包括特定骨及骨内位置，例如干骺端）应在病理学叙述中描述。如有可能，病变过程的特征也应在叙述中讨论。

## 英文原文 · Comment
Decreased bone can result from either decreased bone formation or increased resorption of preexisting bone. The lesion is characterized by thin or absent bony trabeculae and/or thin cortices ( Figure 1 , Figure 2 , Figure 3 , and Figure 4 ). Microfractures may be observed. In lesions with active bone resorption, there are increased numbers of osteoclasts along a scalloped, irregular surface of trabecular bone, which represent osteoclastic effects on Howship''s lacunae (resorption bays). A diffuse decrease in bone may result from metabolic disturbances, whereas a focal decrease in bone may result from a pathologic process occurring focally within a bone, such as fibro-osseous lesion or osteomyelitis. Disuse (atrophy), as in the case of injured limbs or joints, may lead to a diffuse decrease within a particular bone. Treatment with various compounds has been associated with diminished bone growth, including a decrease of metaphyseal trabeculae in corticosteroid toxicity due to effects on osteoclastic activity in rats and chondrogenesis and enchondral ossification in mice. Hyperthyroidism has been associated with thinning of cortical and medullary bone due to increased osteoclastogenesis and bone resorption. Dietary factors such as vitamin/mineral and protein intake can significantly influence bone growth; low levels of dietary protein lead to bone shortening, and toxicants that lead to decreases in body weight due to inanition can cause bone lesions characterized by loss of metaphyseal trabeculae and a narrowed and distorted physis. Loss of medullary trabeculae may also be observed in aged breeding animals due to increased calcium and protein requirements of pregnancy. This lesion has also been recorded as atrophy, osteoporosis, osteopenia, and resorption, but the more general term, "decreased bone," is preferred. The term "osteoporosis" is not recommended due to its more specific definition in human medicine as a clinical condition related to a generalized age-related or hormone-related loss of bone density. In humans, osteopenia is referred to as a precursor lesion/condition to osteoporosis, in which there is alteration of the proteins in bone and marked osteopenia, associated with increased risk of bone fracture.

## 英文原文 · Recommendation
"Bone - Decreased bone" should be diagnosed and assigned a severity grade when it occurs as a primary lesion. The location of the lesion (both the particular bone and the location within the bone, e.g., metaphysis) should be described in the pathology narrative. A characterization of the process, if possible, should also be discussed in the narrative.

## 配图
- https://www.labsmart.cn/ntp-atlas-images/ntp_0509.jpg
- https://www.labsmart.cn/ntp-atlas-images/ntp_0508.jpg

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