Diagnostic and Interventional Radiology, The "Rizzoli" Orthopaedic Institute, Via G. C. Pupilli 1, 40136, Bologna, Italy.
Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Division of Radiology S.Orsola-Malpighi Hospital, University of Bologna, Via G. Massarenti 9, 40138, Bologna, Italy.
Endocrine. 2017 Dec;58(3):426-441. doi: 10.1007/s12020-017-1278-5. Epub 2017 Mar 14.
Diabetes is an important concern in terms of medical and socioeconomic costs; a high risk for low-trauma fractures has been reported in patients with both type 1 and type 2 diabetes. The mechanism involved in the increased fracture risk from diabetes is highly complex and still not entirely understood; obesity could play an important role: recent evidence suggests that the influence of fat on bone is mainly dependent on the pattern of regional fat deposition and that an increased amount of visceral adipose tissue negatively affects skeletal health.Correct and timely individuation of people with high fracture risk is critical for both prevention and treatment: Dual-energy X-ray Absorptiometry (currently the "gold standard" for diagnosis of osteoporosis) underestimates fracture risk in diabetic patients and therefore is not sufficient by itself to investigate bone status. This paper is focused on imaging, covering different modalities involved in the evaluation of skeletal deterioration in diabetes, discussing the limitations of conventional methods and exploring the potential of new tools and recent high-resolution techniques, with the intent to provide interesting insight into pathophysiology and fracture risk.
糖尿病是一个涉及医疗和社会经济成本的重要问题；有报道称，1 型和 2 型糖尿病患者发生低创伤性骨折的风险较高。糖尿病导致骨折风险增加的机制非常复杂，仍不完全清楚；肥胖可能起着重要作用：最近的证据表明，脂肪对骨骼的影响主要取决于区域性脂肪沉积的模式，而内脏脂肪组织的增加会对骨骼健康产生负面影响。正确和及时地确定高骨折风险人群对于预防和治疗都至关重要：双能 X 射线吸收法（目前是骨质疏松症诊断的“金标准”）低估了糖尿病患者的骨折风险，因此仅凭其本身不足以调查骨骼状况。本文重点介绍影像学，涵盖了评估糖尿病骨骼恶化所涉及的不同方式，讨论了传统方法的局限性，并探讨了新工具和最近的高分辨率技术的潜力，旨在为病理生理学和骨折风险提供有趣的见解。
