Sundararaghavan Vikram, Mazur Matthew M, Evans Brad, Liu Jiayong, Ebraheim Nabil A
Department of Orthopaedic Surgery, University of Toledo Medical Center, Toledo, OH, USA.
Department of Orthopaedic Surgery, University of Toledo Medical Center, 3065 Arlington Avenue, Toledo, OH 43614, USA.
Ther Adv Musculoskelet Dis. 2017 Mar;9(3):67-74. doi: 10.1177/1759720X16687480. Epub 2017 Jan 24.
As the prevalence of diabetes is increasing worldwide, research on some of the lesser-known effects, including impaired bone health, are gaining a lot of attention. The two most common forms of diabetes are type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM). These two differ in their physiology, with T1DM stemming from an inability to produce insulin, and T2DM involving an insufficient response to the insulin that is produced. This review aims to highlight the most current information regarding diabetes as it relates to bone health. It looks at biochemical changes that characterize diabetic bone; notably increased adiposity, altered bone metabolism, and variations in bone mineral density (BMD). Then several hypotheses are analyzed, concerning how these changes may be detrimental to the highly orchestrated processes that are involved in bone formation and turnover, and ultimately result in the distinguishing features of diabetic bone. The review proceeds by explaining the effects of antidiabetes medications on bone health, then highlighting several ways that diabetes can play a part in other clinical treatment outcomes. With diabetes negatively affecting bone health and creating other clinical problems, and its treatment options potentiating these effects, physicians should consider the use of anti-osteoporotic drugs to supplement standard anti-diabetes medications in patients suffering with diabetic bone loss.
随着糖尿病在全球的患病率不断上升，对一些鲜为人知的影响（包括骨骼健康受损）的研究正受到广泛关注。糖尿病最常见的两种类型是1型糖尿病（T1DM）和2型糖尿病（T2DM）。这两种类型在生理机制上有所不同，T1DM源于无法产生胰岛素，而T2DM则是对所产生的胰岛素反应不足。本综述旨在突出有关糖尿病与骨骼健康相关的最新信息。它探讨了表征糖尿病性骨骼的生化变化；特别是肥胖增加、骨代谢改变以及骨矿物质密度（BMD）的变化。然后分析了几个假说，涉及这些变化如何可能对参与骨形成和骨转换的高度协调过程产生不利影响，并最终导致糖尿病性骨骼的特征。综述接着解释了抗糖尿病药物对骨骼健康的影响，然后强调了糖尿病在其他临床治疗结果中可能起作用的几种方式。鉴于糖尿病会对骨骼健康产生负面影响并引发其他临床问题，且其治疗选择会加剧这些影响，医生应考虑在患有糖尿病性骨质流失的患者中使用抗骨质疏松药物来补充标准抗糖尿病药物。
