Hofbauer Lorenz C, Brueck Carolin C, Singh Shiv K, Dobnig Harald
Division of Gastroenterology and Endocrinology, Department of Medicine, Philipps-University, Marburg, Germany.
J Bone Miner Res. 2007 Sep;22(9):1317-28. doi: 10.1359/jbmr.070510.
Demographic trends with longer life expectancy and a lifestyle characterized by low physical activity and high-energy food intake contribute to an increasing incidence of diabetes mellitus and osteoporosis. Diabetes mellitus is a risk factor for osteoporotic fractures. Patients with recent onset of type 1 diabetes mellitus may have impaired bone formation because of the absence of the anabolic effects of insulin and amylin, whereas in long-standing type 1 diabetes mellitus, vascular complications may account for low bone mass and increased fracture risk. Patients with type 2 diabetes mellitus display an increased fracture risk despite a higher BMD, which is mainly attributable to the increased risk of falling. Strategies to improve BMD and to prevent osteoporotic fractures in patients with type 1 diabetes mellitus may include optimal glycemic control and aggressive prevention and treatment of vascular complications. Patients with type 2 diabetes mellitus may additionally benefit from early visual assessment, regular exercise to improve muscle strength and balance, and specific measures for preventing falls.
人口统计学趋势显示预期寿命延长，加之低体力活动和高能量食物摄入的生活方式，导致糖尿病和骨质疏松症的发病率不断上升。糖尿病是骨质疏松性骨折的一个危险因素。近期发病的1型糖尿病患者可能由于缺乏胰岛素和胰淀素的合成代谢作用而导致骨形成受损，而在长期的1型糖尿病中，血管并发症可能导致骨量降低和骨折风险增加。2型糖尿病患者尽管骨密度较高，但骨折风险仍增加，这主要归因于跌倒风险增加。改善1型糖尿病患者骨密度和预防骨质疏松性骨折的策略可能包括优化血糖控制以及积极预防和治疗血管并发症。2型糖尿病患者可能还会从早期视力评估、定期锻炼以增强肌肉力量和平衡能力以及预防跌倒的具体措施中获益。
