Blakytny Robert, Spraul Maximilian, Jude Edward B
University of Ulm, Ulm, Germany.
Int J Low Extrem Wounds. 2011 Mar;10(1):16-32. doi: 10.1177/1534734611400256.
With the increasing worldwide prevalence of diabetes the resulting complications, their consequences and treatment will lead to a greater social and financial burden on society. One of the many organs to be affected is bone. Loss of bone is observed in type 1 diabetes, in extreme cases mirroring osteoporosis, thus a greater risk of fracture. In the case of type 2 diabetes, both a loss and an increase of bone has been observed, although in both cases the quality of the bone overall was poorer, again leading to a greater risk of fracture. Once a fracture has occurred, healing is delayed in diabetes, including nonunion. The reasons leading to such changes in the state of the bone and fracture healing in diabetes is under investigation, including at the cellular and the molecular levels. In comparison with our knowledge of events in normal bone homeostasis and fracture healing, that for diabetes is much more limited, particularly in patients. However, progress is being made, especially with the use of animal models for both diabetes types. Identifying the molecular and cellular changes in the bone in diabetes and understanding how they arise will allow for targeted intervention to improve diabetic bone, thus helping to counter conditions such as Charcot foot as well as preventing fracture and accelerating healing when a fracture does occur.
随着糖尿病在全球范围内的患病率不断上升，其所引发的并发症、后果及治疗将给社会带来更大的社会和经济负担。骨骼是众多受影响的器官之一。1型糖尿病患者会出现骨质流失，在极端情况下类似于骨质疏松症，因此骨折风险更高。在2型糖尿病患者中，既有骨质流失，也有骨质增加的情况，不过在这两种情况下，总体骨质质量都较差，同样导致骨折风险更高。一旦发生骨折，糖尿病患者的愈合会延迟，包括骨不连。导致糖尿病患者骨骼状态及骨折愈合发生此类变化的原因正在研究中，包括细胞和分子层面。与我们对正常骨稳态和骨折愈合过程的了解相比，对糖尿病的了解要有限得多，尤其是在患者方面。然而，目前正在取得进展，特别是通过使用两种糖尿病类型的动物模型。确定糖尿病患者骨骼中的分子和细胞变化，并了解它们是如何产生的，将有助于进行有针对性的干预，以改善糖尿病患者的骨骼状况，从而有助于应对诸如夏科氏足等病症，并在骨折发生时预防骨折并加速愈合。
