Ito Masako, Chiba Ko
Center for Gender Equality, Nagasaki University, Japan.
Clin Calcium. 2014 Nov;24(11):1615-20.
Diabetes mellitus (DM) and chronic renal disease (CKD) show the dissociation between their bone mineral density (BMD) and their fracture risk. High-resolution peripheral computed tomography (HR-pQCT) contributes to investigate the deterioration of structural properties in these diseases. In type2 DM, the increase in cortical porosity account for its high fracture risk. In CKD, parathyroid hormone (PTH) is anabolic in trabecular bone and catabolic in cortical bone, which produces complicated bone feature. If hyperparathyroidism is severe, cortical thinning and increased cortical porosity appear in the compact bone, and irregular thickened trabeculae and dissecting intra-trabecular resorption appear in the cancellous bone. Even in the early stage of CKD, the bone microstructural changes are observed. For further investigation of the structural changes in relation to biomechanical properties in type2 DM and CKD, the longitudinal studies are required using in vivo HR-pQCT.
糖尿病（DM）和慢性肾脏病（CKD）表现出骨矿物质密度（BMD）与骨折风险之间的分离。高分辨率外周计算机断层扫描（HR-pQCT）有助于研究这些疾病中骨结构特性的恶化情况。在2型糖尿病中，皮质骨孔隙率增加是其骨折风险高的原因。在慢性肾脏病中，甲状旁腺激素（PTH）对小梁骨具有合成代谢作用，而对皮质骨具有分解代谢作用，这产生了复杂的骨特征。如果甲状旁腺功能亢进严重，密质骨会出现皮质变薄和皮质骨孔隙率增加，松质骨会出现不规则增厚的小梁和小梁内吸收。即使在慢性肾脏病的早期阶段，也能观察到骨微结构的变化。为了进一步研究2型糖尿病和慢性肾脏病中与生物力学特性相关的结构变化，需要使用体内HR-pQCT进行纵向研究。
