Department of Internal Medicine, Endocrine Metabolic Sciences and Biochemistry, University of Siena, Siena, Italy.
Nutr Metab Cardiovasc Dis. 2010 Nov;20(9):683-90. doi: 10.1016/j.numecd.2010.07.008.
Diabetes and osteoporosis are common and complex disorders with an enormous health burden that can be often associated especially in middle-age and elderly individuals. Although there is raising awareness of the higher fractures rates among patients with type 1 (DM1) and 2 (DM2) diabetes, there are few data available on the pathogenetic mechanisms responsible for this increased risk. Importantly, several experimental and clinical observations suggest that bone abnormalities associated with diabetes may differ, at least in part, from those associated with senile or post-menopausal osteoporosis. This implies that specific preventive and therapeutic strategies have to be developed and tested to prevent fractures in DM1 and DM2 patients. It is also likely that shared (i.e. due to glucose-toxicity) as well as different (i.e. due to insulin levels or other hormones) mechanisms may be associated with bone fragility in DM1 and DM2. Moreover, the hypothesis of an endocrine role of the skeleton in the regulation of glucose metabolism and insulin sensitivity has been recently proposed by experimental observations. This review summarizes the recent clinical and experimental advances on glucose tolerance, bone fragility and osteoporosis associated with diabetes.
糖尿病和骨质疏松症是常见且复杂的疾病，会给健康带来巨大负担，尤其是在中年和老年人群中更为常见。尽管人们越来越意识到 1 型（DM1）和 2 型（DM2）糖尿病患者骨折发生率较高，但关于导致这种风险增加的发病机制的数据却很少。重要的是，一些实验和临床观察表明，与糖尿病相关的骨骼异常至少在一定程度上与与衰老或绝经后骨质疏松症相关的骨骼异常不同。这意味着必须开发和测试特定的预防和治疗策略，以预防 DM1 和 DM2 患者发生骨折。共同的（即由于葡萄糖毒性）和不同的（即由于胰岛素水平或其他激素）机制可能与 DM1 和 DM2 中的骨脆弱性相关，这也是很有可能的。此外，最近的实验观察提出了骨骼在调节葡萄糖代谢和胰岛素敏感性中的内分泌作用的假说。这篇综述总结了与糖尿病相关的葡萄糖耐量、骨脆性和骨质疏松症的最新临床和实验进展。
