2型糖尿病患者骨质疏松和骨折的风险。

C. Poiană, C. Capatina
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引用次数: 33

摘要

与一般人群相比,2型糖尿病(T2DM)与脆性骨折的风险增加有关。骨折风险升高的发病机制是多因素的,在很大程度上仍然难以捉摸。与原发性骨质疏松症相比,T2DM患者的骨矿物质密度(BMD)比对照组增加,这表明糖尿病患者的骨质量发生了特异性改变。更重要的是,在这些患者中观察到的骨密度特异性增加至少在一定程度上损害了双能x线吸收仪(DXA)对骨质疏松症的经典诊断和FRAX(骨折风险评估工具)对当前骨折风险的估计。骨小梁评分(TBS)和经TBS调整的FRAX可以改善T2DM患者骨折风险的估计,但未来需要改进的工具和具体的风险分层标准。通过优化糖尿病控制和规范骨质疏松治疗,可以降低T2DM患者的骨折风险(大多数药物对T2DM和原发性骨质疏松患者的疗效相似)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
OSTEOPOROSIS AND FRACTURE RISK IN PATIENTS WITH TYPE 2 DIABETES MELLITUS.
Type 2 diabetes mellitus (T2DM) is associated with an increased risk of fragility fractures compared to the general population. The pathogenesis of the elevated fracture risk is multifactorial and still largely elusive. In contrast to primary osteoporosis, in T2DM the bone mineral density (BMD) is increased compared to controls, suggesting that specific alterations in bone quality occur in diabetic patients. Even more, the specific increase in BMD observed in these patients impairs at least in part both the classical diagnosis of osteoporosis by dual-energy X-ray absorptiometry (DXA) and the current fracture risk estimation by FRAX (fracture risk assessment tool). Trabecular bone score (TBS) and TBS-adjusted FRAX could improve fracture risk estimation in patients with T2DM but improved tools are needed in the future as well as specific risk stratification criteria. Decreases in the fracture risk of patients with T2DM can be obtained by optimal diabetes control and standard treatment of osteoporosis (most drugs appear to have similar efficacy in patients with T2DM and primary osteoporosis).
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