Calcaneal bone mineral density in patients with Charcot neuropathic osteoarthropathy: differences between Type 1 and Type 2 diabetes
Calcaneal bone mineral density in patients with Charcot neuropathic osteoarthropathy: differences between Type 1 and Type 2 diabetes
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DOI：
10.1111/j.1464-5491.2005.01510.x
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发表时间：
2005-06-01
影响因子：
3.5
通讯作者：
Edmonds, ME
中科院分区：
文献类型：
--
作者：
Petrova, NL;Foster, AVM;Edmonds, ME
目的测定2型和2型单侧Charcot骨关节病患者和对照组的双足骨密度和神经病变情况。方法比较17例1型糖尿病合并骨关节病变患者与47例1型糖尿病对照组、18例2型糖尿病患者与48例2型糖尿病对照组的跟骨密度、温度和振动阈值。除了Charcot足外，我们还研究了非Charcot足，以评估骨关节病发病时的骨质减少。结果在I型糖尿病患者中，与对照组相比，非charcot足的骨密度降低[Z-score: -1.7 ((-1.9)-{-1.4)) vs. -0.2 (1-1.1)-10.51), P < 0.0001，中位数（四分位数范围）]；但不是在2型糖尿病[z分数:0.15({-0.45)-{0.85))和0.3 ({-0.5}- {0.9)),P = 0.675)。I型糖尿病患者Charcot足骨密度低于非Charcot足骨密度[Z-score: -2.0 ([-2.8)-{-1.4)) vs. -1.7 ({-1.9}-{-1.4}), P = 0.018]和2型糖尿病患者Charcot足骨密度[Z-score: -0.2 ({-1.4)-{0.11) vs. 0.3 ({-0.5)-{0.9)), P = 0.001]。与2型糖尿病患者相比，1型糖尿病患者非charcot足骨密度降低（P < 0.0001）。1型Charcot患者的体重指数低于2型Charcot患者（P = 0.007）。与2型对照组相比，2型患者的非charcot足部有较高的温度阈值（P = 0.001）和振动阈值（P < 0.0001），而与1型对照组相比，1型患者有较高的温度阈值（P = 0.01），但没有振动阈值（P = 0.077）。结论1型糖尿病非charcot足骨密度降低，2型糖尿病无骨密度降低。2型患者有高温和振动阈值，而1型患者只有高温阈值。
Aims To measure bone density and neuropathy in both feet in Type land Type 2 patients with unilateral Charcot osteoarthropathy and controls.Methods Calcaneal bone density, temperature and vibration thresholds were compared between 17 Type I diabetic patients with osteoarthropathy and 47 Type 1 controls and between 18 Type 2 diabetic patients and 48 Type 2 controls. As well as the Charcot foot, the non-Charcot foot was studied to assess osteopenia at onset of osteoarthropathy.Results In Type I diabetes, bone density was reduced in the non-Charcot foot compared with controls [Z-score: -1.7 ((-1.9)-{-1.4)) vs. -0.2 (1-1.1)-10.51), P < 0.0001, median (interquartile range)]; but not in Type 2 diabetes [Z-score: 0.15 ({-0.45)-{0.85)) vs. 0.3 ({-0.5}-{0.9)), P = 0.675]. Bone density in the Charcot foot was lower compared with the non-Charcot foot in both Type I [Z-score: -2.0 ([-2.8)-{-1.4)) vs. -1.7 ({-1.9}-{-1.4}), P = 0.018] and Type 2 diabetes [Z-score: -0.2 ({-1.4)-{0.11) vs. 0.3 ({-0.5)-{0.9)), P = 0.001]. In Type I diabetes, bone density of the non-Charcot foot was reduced compared with that in Type 2 (P < 0.0001). Body mass index was lower in Type 1 than in Type 2 Charcot patients (P = 0.007). Type 2 patients had high temperature (P = 0.001) and vibration thresholds (P < 0.0001) in the non-Charcot foot compared with Type 2 controls whereas Type 1 patients had a high temperature threshold (P = 0.01) but not vibration threshold compared with Type 1 controls (P = 0.077).Conclusion Bone density was reduced in the non-Charcot foot in Type I but not in Type 2 diabetes. Type 2 patients had high temperature and vibration thresholds in contrast to Type 1 patients who had a high temperature threshold only.