Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan No. 1, Wangfujing, Dongcheng District, Beijing, 100730, China.
Osteoporos Int. 2018 Aug;29(8):1721-1736. doi: 10.1007/s00198-018-4532-7. Epub 2018 May 7.
Substantial evidence exists that diabetes mellitus is associated with an increased risk of osteoporotic fractures. Low bone strength as well as bone extrinsic factors are probably contributing to the increased bone fragility in diabetes. Bone density and quality are important determinants of bone strength. Although bone mineral density (BMD) and the fracture risk assessment tool (FRAX) are very useful clinical tools in assessing bone strength, they may underestimate the fracture risk in diabetes mellitus. Through advances in new technologies such as trabecular bone score (TBS) and peripheral quantitative computed tomography (pQCT), we can better assess the bone quality and fracture risk of patients with diabetes mellitus. Invasive assessments such as microindentation and histomorphometry have been great complement to the existing bone analysis techniques. Bone turnover markers have been found to be altered in diabetes mellitus patients and may be associated with fractures. This review will give a brief summary of the current development and clinical uses of these assessments.
大量证据表明，糖尿病与骨质疏松性骨折的风险增加有关。骨强度降低以及骨外因素可能导致糖尿病患者的骨脆性增加。骨密度和质量是骨强度的重要决定因素。虽然骨矿物质密度 (BMD) 和骨折风险评估工具 (FRAX) 是评估骨强度非常有用的临床工具，但它们可能低估了糖尿病患者的骨折风险。通过 trabecular bone score (TBS) 和 peripheral quantitative computed tomography (pQCT) 等新技术的进步，我们可以更好地评估糖尿病患者的骨质量和骨折风险。微压痕和组织形态计量学等有创评估方法极大地补充了现有的骨分析技术。已经发现糖尿病患者的骨转换标志物发生改变，并且可能与骨折有关。本文将简要总结这些评估方法的当前发展和临床应用。
