使用无创成像技术识别成人糖尿病患者骨骼脆弱的原因:综述

IF 3.4 Q2 ENDOCRINOLOGY & METABOLISM
JBMR Plus Pub Date : 2024-01-19 DOI:10.1093/jbmrpl/ziae003
Shannon R Emerzian, F. Johannesdottir, E. W. Yu, M. Bouxsein
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引用次数: 0

摘要

糖尿病是一种以持续高血糖为特征的疾病,与神经病变、肾病、视网膜病变和心血管疾病等多种并发症相关。值得注意的是,骨骼脆弱已成为 1 型(T1D)和 2 型(T2D)糖尿病患者的重要并发症。本综述探讨了评估成人 T1D 和 T2D 患者骨骼状况的非侵入性成像研究,强调了与每种情况相关的不同骨骼表型,并指出了在了解糖尿病患者骨骼健康方面存在的差距。传统的 DXA-BMD 无法完全捕捉糖尿病患者骨折风险增加的情况,而定量计算机断层扫描 (QCT)、外周 QCT (pQCT)、高分辨率 pqCT (HR-pQCT) 和磁共振成像 (MRI) 等最新技术可以深入了解三维骨密度、微观结构和强度。值得注意的是,可能由于设计、结果测量的不同,以及 T1D 和 T2D 之间潜在的分类错误,现有研究呈现出不同的结果。因此,糖尿病患者骨骼脆性的真正本质仍有待全面了解。由于 T1D 和 T2D 的病症多种多样,亚型也不尽相同,因此未来的研究应根据糖尿病的表型深入探讨骨骼脆性问题,并侧重于在更大规模、更多样化的队列中进行纵向研究,以阐明 T1D 和 T2D 对骨骼健康和骨折结果的复杂影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Use of non-invasive imaging to identify causes of skeletal fragility in adults with diabetes: a review
Diabetes, a disease marked by consistent high blood glucose levels, is associated with various complications such as neuropathy, nephropathy, retinopathy, and cardiovascular disease. Notably, skeletal fragility has emerged as a significant complication in both type 1 (T1D) and type 2 (T2D) diabetic patients. This review examines non-invasive imaging studies that evaluate skeletal outcomes in adults with T1D and T2D, emphasizing distinct skeletal phenotypes linked with each condition and pinpointing gaps in understanding bone health in diabetes. While traditional DXA-BMD does not fully capture the increased fracture risk in diabetes, recent techniques such as quantitative computed tomography (QCT), peripheral QCT (pQCT), high-resolution pqCT (HR-pQCT) and magnetic resonance imaging (MRI) provide insights into 3D bone density, microstructure, and strength. Notably, existing studies present heterogeneous results possibly due to variations in design, outcome measures, and potential misclassification between T1D and T2D. Thus, the true nature of diabetic skeletal fragility is yet to be fully understood. As T1D and T2D are diverse conditions with heterogeneous subtypes, future research should delve deeper into skeletal fragility by diabetic phenotypes, and focus on longitudinal studies in larger, diverse cohorts to elucidate the complex influence of T1D and T2D on bone health and fracture outcomes.
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来源期刊
JBMR Plus
JBMR Plus Medicine-Orthopedics and Sports Medicine
CiteScore
5.80
自引率
2.60%
发文量
103
审稿时长
8 weeks
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