El Oraby Hussein A, Abdelsalam Mona M, Eid Yara M, El Hilaly Rana, Marzouk Heba A
Department of Endocrinology and Metabolism, Faculty of Medicine, Ain Shams University Hospitals, Cairo, Egypt.
Department of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Ain Shams University Hospitals, Cairo, Egypt.
Curr Diabetes Rev. 2019;15(5):395-401. doi: 10.2174/1573399814666180711115845.
Charcot arthropathy is one of the disabling diabetes complications. There are enigmatic areas concerning its underlying pathophysiology and risk predictors. Osteoporosis and local osteopenia have been postulated to have a role in Charcot arthropathy development, but it is still controversial.
The study aims to compare bone mineral density among type 2 diabetics with and without Charcot arthropathy.
Two groups with type 2 diabetes participated in this study; Group I [30] patients with Charcot arthropathy while Group II [30] patients without charcot arthropathy. All patients underwent full clinical examination and complete history taking with special emphasis on foot problems. Laboratory investigations were done that included fasting blood sugar, postprandial blood sugar, glycosylated hemoglobin, serum calcium, serum phosphorus, and alkaline phosphatase. All patients underwent MRI for both feet and dual energy X-ray absorptiometry scan of the lumbar spine and femur. The demographic data, clinical data, the presence or absence of comorbidities and bone mineral density were compared for both groups.
Bone mineral density was significantly lower in Group I than Group II with median lumber T score (-0.15, 1.99 p <0.001), median Femur T score (0.050, 2.400, p <0.001). Group I showed higher propensity for hypertension, neuropathy, micro-albuminuria with peripheral arterial disease (23.33 %) compared to Group II (p <0.001). Multiple logistic regression analysis revealed that female gender and low femur bone mineral density can be risk predictors of the condition.
Bone mineral density is lower in patients with Charcot arthropathy with female gender and Femur T score as risk predictors. Peripheral arterial disease shows greater incidence in Charcot patients than was previously reported.
夏科氏关节病是糖尿病致残性并发症之一。其潜在病理生理学和风险预测因素存在一些尚不明确的领域。骨质疏松和局部骨质减少被认为在夏科氏关节病的发展中起作用，但仍存在争议。
本研究旨在比较患有和未患有夏科氏关节病的2型糖尿病患者的骨密度。
两组2型糖尿病患者参与了本研究；第一组[30例]为患有夏科氏关节病的患者，而第二组[30例]为未患有夏科氏关节病的患者。所有患者均接受了全面的临床检查和详细的病史采集，特别关注足部问题。进行了实验室检查，包括空腹血糖、餐后血糖、糖化血红蛋白、血清钙、血清磷和碱性磷酸酶。所有患者均接受了双足的磁共振成像（MRI）以及腰椎和股骨的双能X线吸收法扫描。比较了两组的人口统计学数据、临床数据、合并症的有无以及骨密度。
第一组的骨密度显著低于第二组，腰椎T值中位数为（-0.15，1.99，p<0.001），股骨T值中位数为（0.050，2.400，p<0.001）。与第二组相比，第一组患高血压、神经病变、微量白蛋白尿合并外周动脉疾病的倾向更高（23.33%）（p<0.001）。多因素逻辑回归分析显示，女性性别和低股骨骨密度可能是该疾病的风险预测因素。
患有夏科氏关节病的患者骨密度较低，女性性别和股骨T值为风险预测因素。夏科氏病患者外周动脉疾病的发病率高于先前报道。
