Martínez-Montoro José Ignacio, García-Fontana Beatriz, García-Fontana Cristina, Muñoz-Torres Manuel
Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Instituto de Investigación Biomédica de Málaga (IBIMA), Faculty of Medicine, University of Malaga, 29010 Malaga, Spain.
Bone Metabolic Unit, Endocrinology and Nutrition Division, University Hospital Clínico San Cecilio, 18016 Granada, Spain.
J Clin Med. 2022 Apr 14;11(8):2206. doi: 10.3390/jcm11082206.
Bone fragility is a common complication in subjects with type 2 diabetes mellitus (T2DM). However, traditional techniques for the evaluation of bone fragility, such as dual-energy X-ray absorptiometry (DXA), do not perform well in this population. Moreover, the Fracture Risk Assessment Tool (FRAX) usually underestimates fracture risk in T2DM. Importantly, novel technologies for the assessment of one microarchitecture in patients with T2DM, such as the trabecular bone score (TBS), high-resolution peripheral quantitative computed tomography (HR-pQCT), and microindentation, are emerging. Furthermore, different serum and urine bone biomarkers may also be useful for the evaluation of bone quality in T2DM. Hence, in this article, we summarize the limitations of conventional tools for the evaluation of bone fragility and review the current evidence on novel approaches for the assessment of quality and bone microstructure alterations in patients with T2DM.
骨脆性是2型糖尿病（T2DM）患者的常见并发症。然而，传统的骨脆性评估技术，如双能X线吸收法（DXA），在该人群中效果不佳。此外，骨折风险评估工具（FRAX）通常会低估T2DM患者的骨折风险。重要的是，用于评估T2DM患者骨微结构的新技术正在涌现，如小梁骨评分（TBS）、高分辨率外周定量计算机断层扫描（HR-pQCT）和微压痕技术。此外，不同的血清和尿液骨生物标志物也可能有助于评估T2DM患者的骨质量。因此，在本文中，我们总结了传统骨脆性评估工具的局限性，并综述了目前关于评估T2DM患者骨质量和骨微结构改变的新方法的证据。
