Diagnosis and management of bone fragility in diabetes: an emerging challenge

被引：274

作者：

Ferrari, S. L. ^{[1
,2
]}

Abrahamsen, B. ^{[3
,4
]}

Napoli, N. ^{[5
,6
]}

Akesson, K. ^{[7
]}

Chandran, M. ^{[8
]}

Eastell, R. ^{[9
,11
,12
]}

Fuleihan, G. El-Hajj ^{[10
]}

Josse, R. ^{[13
]}

Kendler, D. L. ^{[14
]}

Kraenzlin, M. ^{[15
]}

Suzuki, A. ^{[16
]}

Pierroz, D. D. ^{[17
]}

Schwartz, A. V. ^{[18
]}

Leslie, W. D. ^{[19
]}

机构：

[1] Geneva Univ Hosp, Dept Internal Med Specialties, Div Bone Dis, CH-1205 Geneva, Switzerland

[2] Fac Med, CH-1205 Geneva, Switzerland

[3] Holbaek Cent Hosp, Dept Med, Holbaek, Denmark

[4] Univ Southern Denmark, Inst Clin Res, OPEN, Odense, Denmark

[5] Univ Campus Biomed Roma, Dept Med, Unit Endocrinol & Diabet, Rome, Italy

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

[7] Lund Univ, Clin & Mol Osteoporosis Unit, Dept Clin Sci, Malmo, Sweden

[8] Singapore Gen Hosp, Dept Endocrinol, Osteoporosis & Bone Metab Unit, Singapore, Singapore

[9] Univ Sheffield, Mellanby Ctr Bone Res, Acad Unit Bone Metab, Sheffield, S Yorkshire, England

[10] Amer Univ Beirut, Med Ctr, WHO Collaborating Ctr Metab Bone Disorders, Dept Internal Med,Div Endocrinol,Calcium Metab &, Beirut, Lebanon

[11] Univ Toronto, Dept Med, Toronto, ON, Canada

[12] Univ Toronto, Dept Nutr Sci, Toronto, ON, Canada

[13] St Michaels Hosp, Div Endocrinol & Metab, Toronto, ON, Canada

[14] Univ British Columbia, Div Endocrinol, Dept Med, Vancouver, BC, Canada

[15] Endonet Endocrine Clin & Lab, Basel, Switzerland

[16] Fujita Hlth Univ, Div Endocrinol & Metab, Toyoake, Aichi, Japan

[17] Int Osteoporosis Fdn, Nyon, Switzerland

[18] Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA

[19] Univ Manitoba, Dept Internal Med, Winnipeg, MB, Canada

来源：

OSTEOPOROSIS INTERNATIONAL | 2018年 / 29卷 / 12期

基金：

英国医学研究理事会;

关键词：

Diabetes; Diabetes-related bone disease; Fracture; Osteoporosis; FRACTURE RISK-ASSESSMENT; BODY-MASS INDEX; POSTMENOPAUSAL WOMEN; MINERAL DENSITY; TRABECULAR BONE; VERTEBRAL FRACTURES; SCLEROSTIN LEVELS; GLYCEMIC CONTROL; QUANTITATIVE ULTRASOUND; MATERIAL STRENGTH;

D O I：

10.1007/s00198-018-4650-2

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Fragility fractures are increasingly recognized as a complication of both type 1 and type 2 diabetes, with fracture risk that increases with disease duration and poor glycemic control. Yet the identification and management of fracture risk in these patients remains challenging. This review explores the clinical characteristics of bone fragility in adults with diabetes and highlights recent studies that have evaluated bone mineral density (BMD), bone microstructure and material properties, biochemical markers, and fracture prediction algorithms (i.e., FRAX) in these patients. It further reviews the impact of diabetes drugs on bone as well as the efficacy of osteoporosis treatments in this population. We finally propose an algorithm for the identification and management of diabetic patients at increased fracture risk.

引用

页码：2585 / 2596

页数：12

共 116 条

[1] Characteristics of patients who suffer major osteoporotic fractures despite adhering to alendronate treatment: a National Prescription registry study [J].