糖尿病中的骨健康和骨折风险:一项多中心研究
Özen Öz Gül1, Zeynep Cantürk2, Sadettin Öztürk3
1Department of Endocrinology, Bursa Uludağ University Medical School, Bursa, Türkiye. ozenoz@uludag.edu.tr.
Archives of osteoporosis
|February 16, 2026
概括
患有糖尿病的成年人有不同的骨健康风险. 1型糖尿病与较低的骨密度有关,而2型糖尿病增加骨折风险,尽管骨密度较高,需要个性化骨评估.
科学领域:
- 内分泌学和骨代谢 骨质代谢
- 糖尿病研究研究 糖尿病研究
- 骨质疏松症和脆弱性骨折 骨质疏松症和脆弱性骨折
背景情况:
- 糖尿病 (DM) 是骨脆弱的一个已知的危险因素.
- 1型DM (T1DM) 通常与低骨矿物密度 (BMD) 相关,而2型DM (T2DM) 往往具有更高的BMD,但骨折风险增加.
- 对不同类型糖尿病患者骨健康的大规模比较研究是有限的.
研究的目的:
- 评估T1DM和T2DM成年人的骨健康,包括骨质疏松症,骨质疏松症和骨折风险.
- 为了确定糖尿病人群中低骨矿物质密度的预测因素.
主要方法:
- 一个多中心,横截面研究涉及2562名患者 (224名T1DM,2338名T2DM) 在土耳其的27个中心.
- 骨矿物质密度 (BMD) 使用双能X射线吸收计 (DXA) 进行评估.
- 骨折风险使用土耳其适应的FRAX®算法对40岁及以上的患者进行估计,多项逻辑回归识别了低BMD的独立预测因素.
主要成果:
- 骨质疏松症的患病率在T1DM中为5.5%,在T2DM中为9.6% (大腿T分数).
- 与T2DM患者相比,T1DM患者在所有骨部位的调整后的BMD显著降低.
- T2DM患者表现出较高的FRAX基骨折风险和较高的跌倒相关骨折发生率. 骨质疏松症的独立预测因素包括年龄较大,女性性别,较低的BMI,降低的水平,皮质类固醇使用,白色素尿,高血压和较少使用SGLT2抑制剂. T1DM与骨质疏松症相关,但与骨质疏松症无关.
结论:
- 在T1DM和T2DM之间存在明显的骨损伤和骨折风险模式.
- 个性化骨健康评估对于常规糖尿病护理至关重要.
- 可改变的因素,包括使用SGLT2抑制剂,与糖尿病患者的骨质疏松症风险有关.
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