SGLT2抑制剂对2型糖尿病骨质疏松的影响研究进展  

Research progress on the effect of SGLT2 inhibitors on osteoporosis in type 2 diabetes mellitus

作　　者：刘思琦 郭滢[2] 张春兰[2] 赵娜[2] 王娟丽 LIU Siqi;GUO Ying;ZHANG Chunlan;ZHAO Na;WANG Juanli(Museum of Chinese Medicine Publicity and Education Promotion Department,Heilongjiang University of Chinese Medicine,Heilongjiang Province,Harbin 150040,China;Department of Endocrinology,the First Affiliated Hospital of Heilongjiang University of Chinese Medicine,Heilongjiang Province,Harbin 150040,China;Graduate School,Tianjin University of Traditional Chinese Medicine,Tianjin 300193,China)

机构地区：[1]黑龙江中医药大学中医药博物馆宣教推广部,黑龙江哈尔滨150040 [2]黑龙江中医药大学附属第一医院内分泌科,黑龙江哈尔滨150040 [3]天津中医药大学研究生院,天津300193

出　　处：《中国医药导报》2022年第22期50-53,共4页China Medical Herald

基　　金：黑龙江省中医药科研项目(ZHY19-018、ZHY18-004)。

摘　　要：骨质疏松是糖尿病患者的常伴并发症,严重影响患者的生活质量。随着新型降糖药钠-葡萄糖协同转运蛋白2(SGLT2)抑制剂大量应用于临床,其对骨代谢的影响也受到广泛关注。该药物虽然在降糖、降压等方面表现良好,却可能影响骨代谢,增加骨折风险。为更好地指导临床用药,本文查阅国内外相关文献,详细阐述了SGLT2抑制剂引起骨质疏松的相关因素。影响骨代谢,进而引发骨质疏松乃至骨折可能与钙磷稳态失衡、甲状旁腺激素升高等因素有关。然而目前对上述后果是否确与应用SGLT2抑制剂有关,尚有争议。对于高骨折风险的糖尿病患者,使用此类药物前全面评估患者骨折发生风险应成为临床医生的共识。Osteoporosis is a common complication of diabetes mellitus patients,which seriously affects the quality of life of patients.As a new type of hypoglycemic drug sodium-glucose transporter 2(SGLT2)inhibitors are widely used in clinical,their effects on bone metabolism have also received widespread attention.Although the drug has good performance in lowering glucose and blood pressure,it may affect bone metabolism and increase the risk of fracture.In order to better guide the clinical use of SGLT2 inhibitors,related factors of osteoporosis caused by SGLT2 inhibitors were described in detail by referring to relevant literatures at home and abroad.The influence of bone metabolism,osteoporosis and even fracture may be related to the imbalance of calcium and phosphorus homeostasis and the increase of parathyroid hormone.However,it is still controversial whether the above consequences are actually related to the use of SGLT2 inhibitors.For diabetic patients with high fracture risk,it should be the consensus of clinicians to fully evaluate the risk of fracture before using these medications.

关 键 词：2型糖尿病 钠-葡萄糖协同转运蛋白2抑制剂 骨代谢 骨密度 骨折 

分 类 号：R587.1[医药卫生—内分泌]