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糖尿病骨病(骨质疏松症)综述

REVIEW ON BONE DISEASE (OSTEOPOROSIS) IN DIABETES MELLITUS.

作者信息

El-Tawdy Ahmed Hassan Fawzi, Ibrahim Eissa Abdel Hamed, Al Sakhawy Eman Mahmoud Aly, Morsy Tosson A

出版信息

J Egypt Soc Parasitol. 2017 Apr;47(1):35-46.

Abstract

Osteoporosis is the most common bone disease known, affecting an estimated 200 million people worldwide. Approximately 30% of all postmenopausal women are affected and up to 40% developed a fragility fracture within their lifetime. Over time, a number of risk factors have been associated with osteoporosis and are useful when used in screening tools and treatment algorithms. Diabetes, although identified more than half a century ago as being associated with bone frailty, has come to the forefront only within last decade as an important osteoporosis risk factor. While both type 1 (DM1) and type 2 (DM2) diabetes increased fracture risk, the link is far more profound with DM1. DM1 accounts for approximately 5% of all cases of diabetes in the USA and is associated with a 6.4-6.9-fold increase in the relative risk of hip fracture compared to individuals without diabetes. As life expectancy continues to increase for those living with DM1, an increase in number of fractures occurring in this population is expected in the future. For understanding of bone fragility in DM1 calls for an update of diabetes guidelines, better screening tools, and more research into the use of therapeutic strategies in these patients.

摘要

骨质疏松症是已知最常见的骨病,全球约有2亿人受其影响。所有绝经后女性中约30%受其影响,高达40%的人在一生中会发生脆性骨折。随着时间的推移,许多风险因素与骨质疏松症相关联,在筛查工具和治疗方案中使用时很有帮助。糖尿病虽然在半个多世纪前就被认定与骨脆弱有关,但直到最近十年才作为一个重要的骨质疏松症风险因素受到关注。1型糖尿病(DM1)和2型糖尿病(DM2)都会增加骨折风险,但与DM1的关联更为密切。DM1在美国所有糖尿病病例中约占5%,与无糖尿病个体相比,髋部骨折的相对风险增加6.4至6.9倍。随着DM1患者预期寿命的持续增加,预计该人群未来骨折数量会增多。为了解DM1患者的骨脆弱情况,需要更新糖尿病指南、改进筛查工具,并对这些患者治疗策略的应用开展更多研究。

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