MLR、WLR和OSTA指数与2型糖尿病患者骨密度的研究进展

Research Progress on MLR, WLR and OSTA Indices and Bone Mineral Density in Patients with Type 2 Diabetes Mellitus

2型糖尿病性骨质疏松(Type 2 Diabetic Osteoporosis, T2DOP)是由2型糖尿病(Type 2 Diabetes Mellitus, T2DM)导致的以骨量减少、骨微结构受损、骨强度降低和骨折风险增加为特征的肌骨系统并发症,早期无症状且发病机制复杂,诊断方法有限,患者的致残率和死亡率高。当前对T2DOP的治疗主要采用抗糖尿病药物和抗骨质疏松药物。糖尿病患者任意部位骨折风险增加达32%,髋部骨折风险增加77%。即使部分2型糖尿病患者有较高的骨密度,仍具有较高的骨折风险,而骨折风险评分可能低估其骨折风险。糖尿病患者血糖控制差和病程延长是骨折的决定性因素,跌倒是外周骨折的主要危险因素,微血管病变加速骨量丢失。糖尿病影响所有类型骨细胞,降低骨转换率,降低骨强度。为此,本文总结相关文献内容,并介绍MLR、WLR和OSTA指数与2型糖尿病患者骨密度的研究进展为今后的研究提供参考。

Type 2 diabetic osteoporosis is a musculoskeletal system complication caused by type 2 diabetes mellitus, characterized by decreased bone mass, impaired bone microstructure, decreased bone strength, and increased risk of fracture. It is asymptomatic in the early stage, with complex pathogenesis, limited diagnostic methods, and high morbidity and mortality. At present, T2DOP is mainly treated with anti-diabetic drugs and anti-osteoporosis drugs. Patients with diabetes had a 32 percent increased risk of fracture at any site and a 77 percent increased risk of hip fracture. Even if some people with type 2 diabetes have higher bone density, they still have a higher risk of fracture, and the fracture risk score may underestimate their fracture risk. Poor glycemic control and prolonged disease course in diabetic patients are the decisive factors for fracture, fall is the main risk factor for peripheral fracture, and microvascular disease accelerates bone mass loss. Diabetes affects all types of bone cells, reducing the rate of bone turnover and reducing bone strength. To this end, this paper summarizes the relevant literature and introduces the research progress of MLR, WLR and OSTA index and BMD in type 2 diabetes patients to provide reference for future research.