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甲状腺功能障碍、糖尿病和肥胖患者的特定肌肉骨骼疾病

Selected musculoskeletal disorders in patients with thyroid dysfunction, diabetes, and obesity.

作者信息

Dyrek Nicola, Wikarek Agnieszka, Niemiec Małgorzata, Kocełak Piotr

机构信息

Students' Scientific Society at the Pathophysiology Unit, Department of Pathophysiology, Faculty of Medical Science, The Medical University of Silesia, Katowice, Poland.

Pathophysiology Unit, Department of Pathophysiology, Faculty of Medical Science, The Medical University of Silesia, Katowice, Poland.

出版信息

Reumatologia. 2023;61(4):305-317. doi: 10.5114/reum/170312. Epub 2023 Aug 31.

Abstract

Many medical conditions affect the skeletal system and constitute independent risk factors for fractures. The action of thyroid hormones is necessary to maintain adequate development, mineralization, and bone strength. Untreated hyperthyroidism can lead to a decrease in bone mineral density (BMD), osteoporosis, and pathological fractures. In hypothyroidism, the changes in the quality of bone structure lead to an increase in the frequency of fractures. Excessive body weight negatively impacts fracture risk, increases the risk of osteoarthritis and accelerates the development of rheumatoid arthritis and osteoporosis. Type 1 and type 2 diabetes are associated with an increased risk of bone fractures despite different etiopathogenesis due to the duration of the disease and the pro-inflammatory state, the incorporation of advanced glycation end products (AGEs) into the bone matrix, and microvascular disorders. This study summarizes the current literature on the influence of thyroid dysfunction, obesity, and diabetes on the skeletal system.

摘要

许多医学病症会影响骨骼系统,并构成骨折的独立危险因素。甲状腺激素的作用对于维持骨骼的充分发育、矿化和骨强度是必要的。未经治疗的甲状腺功能亢进会导致骨矿物质密度(BMD)降低、骨质疏松和病理性骨折。在甲状腺功能减退症中,骨结构质量的变化会导致骨折发生率增加。体重过重会对骨折风险产生负面影响,增加骨关节炎的风险,并加速类风湿性关节炎和骨质疏松症的发展。1型和2型糖尿病尽管病因发病机制不同,但由于疾病持续时间、促炎状态、晚期糖基化终末产物(AGEs)掺入骨基质以及微血管疾病,与骨折风险增加相关。本研究总结了当前关于甲状腺功能障碍、肥胖和糖尿病对骨骼系统影响的文献。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d3ec/10515130/e72c8c49382c/RU-61-170312-g001.jpg

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