Stolarczyk Artur, Sarzyńska Sylwia, Gondek Agata, Cudnoch-Jędrzejewska Agnieszka
Department of Clinical Rehabilitation, Second Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland.
Department of Orthopaedics and Traumatology, Medical University of Warsaw, Warsaw, Poland.
Clin Exp Pharmacol Physiol. 2018 Jul;45(7):619-627. doi: 10.1111/1440-1681.12939. Epub 2018 Apr 25.
Diabetes is a group of metabolic diseases characterized by hyperglycaemia resulting from the defective action or secretion of insulin. Chronic hyperglycaemia can lead to the damage, dysfunction and failure of various organs. In the context of complications of healing and orthopaedic rehabilitation, vascular (microangiopathy) and nerve (neuropathy) disorders deserve particular attention. About 12% of the patients admitted to orthopaedic departments have diabetes. Studies indicate that there is an indisputable link between diabetes and: an increased risk of fractures, the difficult healing of injuries of bones, ligaments and musculotendinous. It appears that one of the main reasons for this is non-enzymatic glycosylation (glycation) of collagen molecules, a phenomenon observed in the elderly and diabetic populations, as it leads to the formation of advanced glycation end products (AGEs). Collagen is one of the major connective tissue components, and is therefore part of ligaments, tendons and bones. AGEs affect the weakening of its structure and biomechanical properties, and thus also affects the weakening of the structure and properties of the above-mentioned tissues. The aim of the study is to undertake an overview of the current knowledge of the impact of diabetes on the risk of some injuries and subsequent healing and rehabilitation of patients following orthopaedic injuries.
糖尿病是一组代谢性疾病,其特征为胰岛素作用或分泌缺陷导致的高血糖症。慢性高血糖会导致各种器官的损伤、功能障碍和衰竭。在愈合及骨科康复并发症的背景下,血管(微血管病变)和神经(神经病变)紊乱值得特别关注。骨科收治的患者中约12%患有糖尿病。研究表明,糖尿病与以下情况之间存在无可争议的联系:骨折风险增加、骨骼、韧带和肌腱损伤愈合困难。造成这种情况的主要原因之一似乎是胶原蛋白分子的非酶糖基化(糖化),这一现象在老年人和糖尿病患者群体中都有观察到,因为它会导致晚期糖基化终产物(AGEs)的形成。胶原蛋白是主要的结缔组织成分之一,因此也是韧带、肌腱和骨骼的组成部分。AGEs会影响其结构和生物力学特性的减弱,进而也会影响上述组织的结构和特性的减弱。本研究的目的是对糖尿病对某些损伤风险以及骨科损伤患者后续愈合和康复的影响的现有知识进行综述。