2型糖尿病患者骨代谢改变的研究进展  

Research progresses in the influences of type 2 diabetes on bone metabolism

作　　者：赵心 张晓梅[1] 纪立农[2] ZHAO Xin;ZHANG Xiaomei;JI Linong(Department of Endocrinology,Peking University International Hospital,Beijing 102206,China)

机构地区：[1]北京大学国际医院内分泌科,102206 [2]北京大学人民医院内分泌科

出　　处：《中国糖尿病杂志》2018年第7期613-616,共4页Chinese Journal of Diabetes

摘　　要：T2DM和骨质疏松症(OP)均是常见的慢性疾病,T2DM并发症和骨质疏松性骨折更是老年患者发病和死亡的两个重要原因,T2DM与OP的发生发展有许多共同特点,如遗传易感性、分子机制和环境因素。血糖水平和骨骼的平衡都受共同调节因子的控制,包括胰岛素、晚期糖基化终产物的积累、肠促胰素和胰升血糖素样肽及骨钙素。近些年,脆性骨折更被视为糖尿病的并发症之一,高血糖水平通过诱导异常的骨细胞功能和基质结构来破坏骨骼的微结构、增加成骨细胞凋亡、减少成骨细胞分化,因此可能加速骨骼的吸收。T2DM患者骨密度水平可能升高,但其骨折风险增加,导致骨折风险评估变得更加困难。本文通过分析T2DM对骨代谢影响的研究,探讨T2DM对骨代谢、力学特性和骨折风险的影响。Objective Type 2 diabetes mellitus（T2 DM）and osteoporosis are common chronic diseases.Complications of T2 DM and osteoporotic fractures are two important reasons for the death of elderly patients.The progression of the two diseasessharesmany common characteristics,such as genetic susceptibility,molecular mechanism and environmental factors.The balance of blood glucose level and bone are controlled by the similar regulating factors,including insulin,advanced glycation end products,incretin,glucagon like peptide and osteocalcin.In recent years,brittle fracture is regarded as one of the complications of diabetes. High glucose level can induce bone destruction and bone marrow microstructures,which increases osteoblast apoptosis and reduces osteoblast differentiation with abnormal bone cell function and matrix structure.The level of bone mineral density in patients with T2 DM may increase,but the risk of fracture also increases,which makes it more difficult to assess the risk of fracture.In this review,the influences of type 2 diabetes on bone metabolism were analyzed to explore the effects of type 2 diabetes on bone metabolism,mechanical properties and fracture risk.

关 键 词：糖尿病 2型 骨质疏松 骨代谢 骨密度 骨折 

分 类 号：R580[医药卫生—内分泌] R587.2[医药卫生—内科学]