Meta-analysis of Diabetes Mellitus-Associated Differences in Bone Structure Assessed by High-Resolution Peripheral Quantitative Computed Tomography.

IF 4.2 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Current Osteoporosis Reports Pub Date : 2022-12-01 Epub Date: 2022-10-03 DOI:10.1007/s11914-022-00755-6
Matthias Walle, Danielle E Whittier, Morten Frost, Ralph Müller, Caitlyn J Collins
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Abstract

Purpose of review: Diabetes mellitus is defined by elevated blood glucose levels caused by changes in glucose metabolism and, according to its pathogenesis, is classified into type 1 (T1DM) and type 2 (T2DM) diabetes mellitus. Diabetes mellitus is associated with multiple degenerative processes, including structural alterations of the bone and increased fracture risk. High-resolution peripheral computed tomography (HR-pQCT) is a clinically applicable, volumetric imaging technique that unveils bone microarchitecture in vivo. Numerous studies have used HR-pQCT to assess volumetric bone mineral density and microarchitecture in patients with diabetes, including characteristics of trabecular (e.g. number, thickness and separation) and cortical bone (e.g. thickness and porosity). However, study results are heterogeneous given different imaging regions and diverse patient cohorts.

Recent findings: This meta-analysis assessed T1DM- and T2DM-associated characteristics of bone microarchitecture measured in human populations in vivo reported in PubMed- and Embase-listed publications from inception (2005) to November 2021. The final dataset contained twelve studies with 516 participants with T2DM and 3067 controls and four studies with 227 participants with T1DM and 405 controls. While T1DM was associated with adverse trabecular characteristics, T2DM was primarily associated with adverse cortical characteristics. These adverse effects were more severe at the radius than the load-bearing tibia, indicating increased mechanical loading may compensate for deleterious bone microarchitecture changes and supporting mechanoregulation of bone fragility in diabetes mellitus. Our meta-analysis revealed distinct predilection sites of bone structure aberrations in T1DM and T2DM, which provide a foundation for the development of animal models of skeletal fragility in diabetes and may explain the uncertainty of predicting bone fragility in diabetic patients using current clinical algorithms.

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通过高分辨率外周定量计算机断层扫描评估与糖尿病相关的骨结构差异的 Meta 分析。
综述的目的:糖尿病的定义是因糖代谢改变引起的血糖水平升高,根据其发病机制可分为 1 型糖尿病(T1DM)和 2 型糖尿病(T2DM)。糖尿病与多种退行性病变有关,包括骨结构改变和骨折风险增加。高分辨率外周计算机断层扫描(HR-pQCT)是一种适用于临床的容积成像技术,可揭示体内骨的微观结构。许多研究使用 HR-pQCT 评估糖尿病患者的体积骨矿物质密度和微结构,包括骨小梁(如数量、厚度和分离度)和皮质骨(如厚度和孔隙度)的特征。然而,由于成像区域和患者群体不同,研究结果也不尽相同:这项荟萃分析评估了从开始(2005 年)到 2021 年 11 月期间,在 PubMed 和 Embase 收录的出版物中报道的 T1DM 和 T2DM 相关人群体内测量的骨微观结构特征。最终的数据集包含 12 项研究,其中有 516 名 T2DM 患者和 3067 名对照组患者;另外还有 4 项研究,其中有 227 名 T1DM 患者和 405 名对照组患者。T1DM 与不良的小梁特征有关,而 T2DM 主要与不良的皮质特征有关。这些不良影响在桡骨比承重的胫骨更为严重,这表明增加机械负荷可能会补偿有害的骨微结构变化,并支持糖尿病患者骨脆性的机械调节。我们的荟萃分析揭示了 T1DM 和 T2DM 骨结构畸变的不同偏好部位,这为糖尿病骨骼脆性动物模型的开发奠定了基础,并可能解释了使用当前临床算法预测糖尿病患者骨脆性的不确定性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Current Osteoporosis Reports
Current Osteoporosis Reports Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
8.80
自引率
2.30%
发文量
44
期刊介绍: This journal intends to provide clear, insightful, balanced contributions by international experts that review the most important, recently published clinical findings related to the diagnosis, treatment, management, and prevention of osteoporosis. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as current and future therapeutics, epidemiology and pathophysiology, and evaluation and management. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.
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