Assessment of bone turnover and bone quality in type 2 diabetic bone disease: current concepts and future directions.
Assessment of bone turnover and bone quality in type 2 diabetic bone disease: current concepts and future directions.
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DOI：
10.1038/boneres.2016.1
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发表时间：
2016
期刊：
影响因子：
12.7
通讯作者：
Patsch JM
中科院分区：
文献类型：
--
作者：
Rubin MR;Patsch JM
大量证据表明，除了众所周知的糖尿病并发症外，骨折风险增加也是一个重要的发病率。这种风险可能是由于糖尿病改变了骨特性。已发现骨转换的循环生化标志物在2型糖尿病（T2D）中降低，并且可以独立于骨矿物质密度（BMD）预测骨折。已发现血清硬化蛋白水平在T2D中增加，并且似乎是独立于BMD的骨折风险的预测。骨成像技术，包括骨小梁评分（TBS）和定量CT测试显示糖尿病患者的骨与非糖尿病患者相比存在差异。具体来说，高分辨率外周定量CT（HRpQCT）成像已证明糖尿病绝经后女性的皮质孔隙率增加。其他因素，如骨髓脂肪饱和度和晚期糖基化终产物（AGE）积累也可能与糖尿病患者的骨细胞功能和骨折风险有关。这些数据增加了我们对T2D如何对骨代谢和骨折风险产生不利影响的理解。
Substantial evidence exists that in addition to the well-known complications of diabetes, increased fracture risk is an important morbidity. This risk is probably due to altered bone properties in diabetes. Circulating biochemical markers of bone turnover have been found to be decreased in type 2 diabetes (T2D) and may be predictive of fractures independently of bone mineral density (BMD). Serum sclerostin levels have been found to be increased in T2D and appear to be predictive of fracture risk independent of BMD. Bone imaging technologies, including trabecular bone score (TBS) and quantitative CT testing have revealed differences in diabetic bone as compared to non-diabetic individuals. Specifically, high resolution peripheral quantitative CT (HRpQCT) imaging has demonstrated increased cortical porosity in diabetic postmenopausal women. Other factors such as bone marrow fat saturation and advanced glycation endproduct (AGE) accumulation might also relate to bone cell function and fracture risk in diabetes. These data have increased our understanding of how T2D adversely impacts both bone metabolism and fracture risk.