Bone damage in type 2 diabetes mellitus

被引:77
作者
Carnevale, V. [1 ]
Romagnoli, E. [2 ]
D'Erasmo, L. [3 ]
D'Erasmo, E. [3 ]
机构
[1] Casa Sollievo Sofferenza Hosp, IRCCS, Unit Internal Med, I-71013 San Giovanni Rotondo, FG, Italy
[2] Univ Roma La Sapienza, Dept Expt Med, I-00161 Rome, Italy
[3] Univ Roma La Sapienza, Dept Internal Med & Med Specialties, I-00161 Rome, Italy
关键词
Type 2 diabetes mellitus; Bone mineral density; Bone quality; Fractures; Clinical risk factors; FRACTURE RISK; MINERAL DENSITY; POSTMENOPAUSAL WOMEN; VERTEBRAL FRACTURES; SCLEROSTIN LEVELS; VITAMIN-D; CORTICAL POROSITY; HIP-FRACTURES; OLDER-ADULTS; STRENGTH;
D O I
10.1016/j.numecd.2014.06.013
中图分类号
R5 [内科学];
学科分类号
100201 [内科学];
摘要
This review focuses on the mechanisms determining bone fragility in patients with type 2 diabetes mellitus (T2DM). Despite bone mineral density (BMD) is usually normal or more often increased in these patients, fracture incidence is high, probably because of altered bone "quality". The latter seems to depend on several, only partly elucidated, mechanisms, such as the increased skeletal content of advanced glycation end-products causing collagen deterioration, the altered differentiation of bone osteogenic cells, the altered bone turnover and micro-architecture. Disease duration, its severity and metabolic control, the type of therapy, the presence or absence of complications, as like as the other known predictors for falls, are all relevant contributing factors affecting fracture risk in T2DM. In these patients the estimate of fracture risk in the everyday clinical practice may be challenging, due to the lower predictive capacity of both BMD and risk factors-based algorithms (e.g. FRAX). (C) 2014 Elsevier B.V. All rights reserved.
引用
收藏
页码:1151 / 1157
页数:7
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