Sakai Akinori, Menuki Kunitaka, Zenke Yukichi, Yamanaka Yoshiaki, Furukawa Kayoko, Fuse Yoshifumi
Department of Orthopaedic Surgery, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan,
J Orthop Sci. 2013 Sep;18(5):811-8. doi: 10.1007/s00776-013-0419-9. Epub 2013 Jun 8.
Recent meta-analysis data reveal that patients with type 2 diabetes mellitus (DM) have a higher risk of fracture, despite higher bone mineral density (BMD), than patients without type 2 DM. The purpose of this study was to compare BMD and distal radial shortening after low-energy Colles' fractures among Japanese postmenopausal women aged ≥50 years with type 2 DM with those in women without it (non-DM).
One-hundred and ten postmenopausal women aged ≥50 years with distal radius fractures resulting from a fall were enrolled in this study. Twelve patients had DM. BMD, type I collagen cross-linked N-telopeptide (NTX), undercarboxylated osteocalcin (ucOC), estimated glomerular filtration rate (eGFR), grip strength of the unfractured hand, unipedal standing time, and the degree of radial shortening were measured.
There were no significant differences in age and body height between the two groups. The DM group had significantly greater body weight and body mass index than the non-DM group. BMDs of the lumbar spine and proximal hip were significantly higher in the DM group than in the non-DM group. NTX, ucOC, grip strength, and the percentage of women with unipedal standing time <15 s did not differ between the two groups. Stepwise regression analysis identified DM and shorter unipedal standing time as significant factors associated with more radial shortening, and identified more radial shortening and lower eGFR as significant factors associated with DM.
More radial shortening after low-energy Colles' fractures was significantly associated with type 2 DM among postmenopausal women aged ≥50 years, irrespective of BMD.
近期的荟萃分析数据显示，2型糖尿病（DM）患者尽管骨矿物质密度（BMD）较高，但与非2型DM患者相比，骨折风险更高。本研究的目的是比较≥50岁的日本绝经后2型DM女性与非DM女性在低能量柯莱斯骨折后骨密度和桡骨远端缩短情况。
本研究纳入了110名≥50岁因跌倒导致桡骨远端骨折的绝经后女性。其中12名患者患有DM。测量了骨密度、I型胶原交联N-端肽（NTX）、未羧化骨钙素（ucOC）、估算肾小球滤过率（eGFR）、未骨折手的握力、单足站立时间以及桡骨缩短程度。
两组在年龄和身高方面无显著差异。DM组的体重和体重指数显著高于非DM组。DM组腰椎和近端髋部的骨密度显著高于非DM组。两组之间NTX、ucOC、握力以及单足站立时间<15秒的女性比例无差异。逐步回归分析确定DM和较短的单足站立时间是与更多桡骨缩短相关的显著因素，确定更多桡骨缩短和较低的eGFR是与DM相关的显著因素。
≥50岁的绝经后女性中，低能量柯莱斯骨折后更多的桡骨缩短与2型DM显著相关，与骨密度无关。
