Bone fragility in diabetes: novel concepts and clinical implications

被引：328

作者：

Hofbauer, Lorenz C. ^{[1
,2
]}

Busse, Bjoern ^{[3
]}

Eastell, Richard ^{[4
]}

Ferrari, Serge ^{[5
,6
]}

Frost, Morten ^{[7
,8
]}

Mueller, Ralph ^{[9
]}

Burden, Andrea M. ^{[10
]}

Rivadeneira, Fernando ^{[11
]}

Napoli, Nicola ^{[12
,13
,14
]}

Rauner, Martina ^{[1
,2
]}

机构：

[1] Tech Univ Dresden, Univ Med Ctr, Div Endocrinol Diabet & Bone Dis, Dept Med 3, D-01307 Dresden, Germany

[2] Tech Univ Dresden, Univ Med Ctr, Ctr Hlth Aging, D-01307 DRE Dresden, Germany

[3] Univ Med Ctr Hamburg Eppendorf, Dept Osteol & Biomech, Hamburg, Germany

[4] Univ Sheffield, Mellanby Ctr Musculoskeletal Res, Dept Oncol & Metab, Sheffield, S Yorkshire, England

[5] Geneva Univ Hosp, Serv & Lab Bone Dis, Geneva, Switzerland

[6] Fac Med, Geneva, Switzerland

[7] Odense Univ Hosp, Mol Endocrinol Lab, Odense, Denmark

[8] Odense Univ Hosp, Steno Diabet Ctr Odense, Odense, Denmark

[9] Swiss Fed Inst Technol, Dept Hlth Sci & Technol, Inst Biomech, Zurich, Switzerland

[10] Swiss Fed Inst Technol, Dept Chem & Appl Biosci, Inst Pharmaceut Sci, Zurich, Switzerland

[11] Erasmus MC, Dept Internal Med, Rotterdam, Netherlands

[12] Campus Biomed Univ Rome, RU Endocrinol & Diabet, Rome, Italy

[13] Fdn Policlin Campus Biomed, Rome, Italy

[14] Washington Univ, Div Bone & Mineral Dis, St Louis, MO 63110 USA

来源：

LANCET DIABETES & ENDOCRINOLOGY | 2022年 / 10卷 / 03期

关键词：

VERTEBRAL FRACTURE RISK; GLYCATION END-PRODUCTS; POSTMENOPAUSAL WOMEN; MINERAL DENSITY; HIP FRACTURE; OLDER-ADULTS; SERUM SCLEROSTIN; MUSCULOSKELETAL HEALTH; DEFECT REGENERATION; MARROW ADIPOSITY;

D O I：

10.1016/S2213-8587(21)00347-8

中图分类号：

R5 [内科学];

学科分类号：

100201 [内科学];

摘要：

Increased fracture risk represents an emerging and severe complication of diabetes. The resulting prolonged immobility and hospitalisations can lead to substantial morbidity and mortality. In type 1 diabetes, bone mass and bone strength are reduced, resulting in up to a five-times greater risk of fractures throughout life. In type 2 diabetes, fracture risk is increased despite a normal bone mass. Conventional dual-energy x-ray absorptiometry might underestimate fracture risk, but can be improved by applying specific adjustments. Bone fragility in diabetes can result from cellular abnormalities, matrix interactions, immune and vascular changes, and musculoskeletal maladaptation to chronic hyperglycaemia. This Review summarises how the bone microenvironment responds to type 1 and type 2 diabetes, and the mechanisms underlying fragility fractures. We describe the value of novel imaging technologies and the clinical utility of biomarkers, and discuss current and future therapeutic approaches that protect bone health in people with diabetes.

引用

页码：207 / 220

页数：14

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