Kanazawa Ippei
Internal Medicine 1, Shimane University Faculty of Medicine.
Clin Calcium. 2009 Sep;19(9):1319-25.
Accumulative evidence shows that type 2 diabetes patients have high fracture rate in spite of the absence of bone mineral density (BMD) reduction. The etiology and treatment of diabetes-related bone disease have recently attracted widespread attention. Recent epidemiologic studies have shown that the fracture rate was decreased in patients treated with metformin, one of the anti-hyperglycemic agents by improving insulin resistance. Several studies have indicated that metformin directly stimulated the differentiation of osteoblastic cells, and that metformin reversed deleterious effects of advanced glycation end products on these cells. Further longitudinal studies are needed to clarify the effects of metformin on BMD, bone turnover markers, and fracture risks in type 2 diabetes.
越来越多的证据表明，2型糖尿病患者尽管没有骨矿物质密度（BMD）降低，但骨折率却很高。糖尿病相关骨病的病因和治疗最近引起了广泛关注。最近的流行病学研究表明，使用二甲双胍（一种通过改善胰岛素抵抗来降血糖的药物）治疗的患者骨折率降低。多项研究表明，二甲双胍直接刺激成骨细胞的分化，并且二甲双胍可逆转晚期糖基化终产物对这些细胞的有害作用。需要进一步的纵向研究来阐明二甲双胍对2型糖尿病患者的骨密度、骨转换标志物和骨折风险的影响。
