糖尿病与脆性骨折——一种新兴的流行病？

Diabetes and fragility fractures - a burgeoning epidemic?

作者信息

Epstein Sol, LeRoith Derek

机构信息

Mt. Sinai School of Medicine, Department Of Endocrinology, Diabetes and Bone Diseases, 1 Gustave Levy Place, New York, New York 10029, USA.

出版信息

Bone. 2008 Jul;43(1):3-6. doi: 10.1016/j.bone.2008.03.017. Epub 2008 Apr 8.

DOI:10.1016/j.bone.2008.03.017

PMID:18486581

Abstract

Diabetes and osteoporosis are both diseases of epidemic proportions whose incidence is increasing worldwide. The etiology of osteoporosis is multifactorial and may differ for type 1(T1DM) as compared to type 2 (T2DM). Fragility fractures are common to both types of diabetes with hip fractures occurring more frequently in the elderly T2DM population. The use of oral PPAR gamma agonists in the treatment of T2DM has also added to the risk of fracture. This perspective discusses the etiologies and issues relating to the association of diabetes with osteoporosis and fractures and suggests some theories to clarify the underlying pathophysiology. Unfortunately at this time treatment for osteoporosis and fractures remains empirical.

摘要

糖尿病和骨质疏松症都是发病率呈全球上升趋势的流行病。骨质疏松症的病因是多因素的，1型糖尿病（T1DM）与2型糖尿病（T2DM）的病因可能有所不同。脆性骨折在两种类型的糖尿病中都很常见，髋部骨折在老年T2DM人群中更为频繁发生。口服PPARγ激动剂用于治疗T2DM也增加了骨折风险。这篇综述讨论了糖尿病与骨质疏松症及骨折关联的病因和问题，并提出了一些理论来阐明潜在的病理生理学。遗憾的是，目前骨质疏松症和骨折的治疗仍然是经验性的。