Type 2 diabetes and bone fractures.
Type 2 diabetes and bone fractures.
复制标题
DOI：
10.1097/med.0b013e328350a6e1
复制
发表时间：
2012-04
期刊：
影响因子：
--
通讯作者：
Moseley KF
中科院分区：
文献类型：
--
作者：
Moseley KF
讨论目前的文献和假设有关的病理生理学增加的骨脆性和骨折的男性和女性2型糖尿病。尽管骨密度高，但研究表明，患有2型糖尿病（T2 DM）的男性和女性骨折的风险增加。2型糖尿病的并发症包括视网膜病变和自主神经功能障碍可能通过增加跌倒风险而导致骨折。肾病可导致肾性骨营养不良。瘦体重和潜在的脂肪量，可能还有助于糖尿病患者的骨骼健康。越来越多的人认识到骨髓微环境对有效的骨重建至关重要。包括噻唑烷二酮类和选择性5-羟色胺再摄取抑制剂在内的药物也可能通过作用于间充质干细胞分化和成骨细胞生成而损害骨重塑。T2 DM与全身性炎症、晚期糖基化终产物蓄积和活性氧生成的显著变化相关。这些全身性变化也可能直接和不利地影响重塑周期，并导致T2 DM的骨脆性，但需要更多的研究。骨折是一种毁灭性的事件，会对健康造成可怕的后果。确定T2 DM骨折的外在和内在生化原因将加速发现在这一高危人群中预防和治疗骨折的有效策略。
To discuss current literature and hypotheses pertaining to the pathophysiology of increased bone fragility and fracture in men and women with type 2 diabetes mellitus. Despite high bone mineral density, studies have shown that men and women with type 2 diabetes mellitus (T2DM) are at increased risk for fracture. Complications of T2DM including retinopathy and autonomic dysfunction may contribute to bone fracture by increasing fall risk. Nephropathy may lead to renal osteodystrophy. Lean mass and potentially fat mass, may additionally contribute to skeletal health in diabetes. There is increasing acknowledgement that the marrow microenvironment is critical to efficient bone remodeling. Medications including thiazolidinediones and selective serotonin reuptake inhibitors may also impair bone remodeling by acting on mesenchymal stem cell differentiation and osteoblastogenesis. T2DM is associated with significant alterations in systemic inflammation, advanced glycation end-product accumulation and reactive oxygen species generation. These systemic changes may also directly and adversely impact the remodeling cycle and lead to bone fragility in T2DM, though more research is needed. Fracture is a devastating event with dismal health consequences. Identifying the extrinsic and intrinsic biochemical causes of bone fracture in T2DM will speed the discovery of effective strategies for fracture prevention and treatment in this at-risk population.