2型糖尿病患者骨质疏松症及骨折的评估与治疗
Assessment and treatment of osteoporosis and fractures in type 2 diabetes.
作者信息
Sheu Angela, Greenfield Jerry R, White Christopher P, Center Jacqueline R
机构信息
Bone Biology Division, Garvan Institute of Medical Research, Sydney, Australia; Clinical School, St Vincent's Hospital, Faculty of Medicine, University of New South Wales Sydney, Sydney, Australia; Department of Endocrinology and Diabetes, St Vincent's Hospital, Sydney, Australia.
Clinical School, St Vincent's Hospital, Faculty of Medicine, University of New South Wales Sydney, Sydney, Australia; Department of Endocrinology and Diabetes, St Vincent's Hospital, Sydney, Australia; Diabetes and Metabolism, Garvan Institute of Medical Research, Sydney, Australia.
出版信息
Trends Endocrinol Metab. 2022 May;33(5):333-344. doi: 10.1016/j.tem.2022.02.006. Epub 2022 Mar 17.
There is substantial, and growing, evidence that type 2 diabetes (T2D) is associated with skeletal fragility, despite often preserved bone mineral density. As post-fracture outcomes, including mortality, are worse in people with T2D, bone management should be carefully considered in this highly vulnerable group. However, current fracture risk calculators inadequately predict fracture risk in T2D, and dedicated randomised controlled trials identifying optimal management in patients with T2D are lacking, raising questions about the ideal assessment and treatment of bone health in these people. We synthesise the current literature on evaluating bone measurements in T2D and summarise the evidence for safety and efficacy of both T2D and anti-osteoporosis medications in relation to bone health in these patients.
有大量且不断增加的证据表明，2型糖尿病（T2D）与骨骼脆弱有关，尽管骨矿物质密度通常保持正常。由于T2D患者骨折后的预后（包括死亡率）更差，因此在这个高度脆弱的群体中应仔细考虑骨骼管理。然而，目前的骨折风险计算器无法充分预测T2D患者的骨折风险，而且缺乏专门针对T2D患者确定最佳治疗方案的随机对照试验，这引发了关于这些人群骨骼健康的理想评估和治疗的问题。我们综合了目前关于评估T2D患者骨测量的文献，并总结了T2D药物和抗骨质疏松药物对这些患者骨骼健康的安全性和有效性证据。
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