Bone mineral density and bone metabolism in diabetes mellitus
Bone mineral density and bone metabolism in diabetes mellitus
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DOI：
10.1055/s-2007-979106
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发表时间：
1997-11-01
影响因子：
2.2
通讯作者：
Beyer, J
中科院分区：
文献类型：
--
作者：
Piepkorn, B;Kann, P;Beyer, J
糖尿病对骨代谢和骨密度的影响存在争议。在动物模型或儿童和青少年中，由于自身免疫过程引起的糖尿病似乎与低转换骨量减少有关。许多因素被讨论为参与，但在这个年龄组的临床症状是失踪。当在外周部位如前臂远端或股骨颈测量时，患有IDDM的任何性别的成年患者均显示骨矿物质密度降低，糖尿病并发症如神经病变和微血管病变似乎表明骨量不足。在这些患者中，骨质减少伴随着骨代谢的高转换情况，可能是由于微血管并发症。相反，NIDDM患者，尤其是超重女性，骨密度正常甚至增加。到目前为止，还没有令人信服的证据表明糖尿病患者中骨质疏松性骨折的发生率增加。因此，全身性糖尿病骨质减少似乎没有很大的流行病学意义。
The effect of diabetes mellitus on bone metabolism and bone mineral density is discussed controversially. Diabetes mellitus due to an autoimmune process seems to be associated with low turnover osteopenia either in the animal model or in children and adolescents. A number of factors are discussed as being involved, but in this age group clinical symptoms are missing. Adult patients of either sex with IDDM show a reduced bone mineral density when measured at peripheral sites such as the distal forearm or the femoral neck, diabetic complications such as neuropathy and microangiopathy seem to pronounce the deficit of bone mass. In these patients, osteopenia is accompanied by a high turnover situation of bone metabolism, possibly due to microvascular complications. In contrast, patients with NIDDM and here especially overweight women have a normal or even increased bone mineral density. Up to now, there is no convincing evidence for an increased incidence of osteoporotic fractures in diabetic patients. Systemic diabetic osteopenia therefore does not seem to be of great epidemiological relevance.