降糖药对骨代谢的影响

Effects of antidiabetic medicine on bone metabolism

糖尿病和骨质疏松关系复杂,糖尿病类型、慢性并发症如血管病变和肾脏病变可能影响骨代谢,降糖药对骨代谢也有一定影响。二甲双胍、胰岛素和胰高血糖素-1(glucagon-like peptide-1,GLP-1)能增加骨密度,促进骨形成。而噻唑烷二酮类能降低骨密度,抑制骨形成。磺脲类药物及二肽基肽酶Ⅳ(dipeptidyl peptidaseⅣ,DPP-4)抑制剂对骨代谢的影响暂无定论,尚需更多的研究证实。本文就降糖药对骨代谢影响的研究进展作一综述。

The diabetes and osteoporosis have complicated relationship with each other. The type of diabetes,chronic complications of diabetes such as vascular lesions and kidney disease may have effects on bone metabolism,so may be the antidiabetic medicines. Metformin,insulin and glucagon-like peptide-1（ GLP-1） can increase bone density,and promote bone formation. But thiazolidinedione（ TZD） can reduce bone density and inhibit bone formation. The effects of sulfonylurea and dipeptidyl peptidase Ⅳ（ DPP-4） inhibitors on the bone metabolism are uncertain,and more researches are needed. We review the progress of effects of antdiabetic medicine on bone metabolism.