Kortikale Porosität bei Diabetes mellitus Typ 2

Zusammenfassung

Die diabetische Osteopathie ist eine komplexe metabolische Knochenerkrankung mit oft normaler Knochenmineraldichte, jedoch einer paradoxen Frakturanfälligkeit. Neben niedrigem Knochenumsatz, pathologischen Knochenmatrixveränderungen, Myopathie, Neuropathie und anderen diabetischen Sekundärkomplikationen dürfte der kortikalen Porosität bei Typ-2-Diabetes mellitus eine besondere pathophysiologische Bedeutung zukommen. Während postmenopausale Typ-2-Diabetikerinnen ohne stattgehabte Frakturen einen dicken und besonders aporösen Kortex aufwiesen, war bei Frauen mit prävalenten Insuffizienzfrakturen ein hochporöser kortikaler Phäntotyp allfällig. Die biomechanische Bedeutung, zeitliche Entwicklung, morphologische Dynamik und mögliche therapeutische Modulierbarkeit dieser Ergebnisse wird in Zukunft noch im Detail zu erforschen sein.

Summary

Typ 2 diabetic bone disease is a complex skeletal condition characterized by normal or even high bone mineral density (BMD). At the same time, patients with type 2 diabetes mellitus suffer from a high susceptibility to fragility fractures. Low bone turnover, pathologic changes of bone matrix, myopathy, neuropathy and other secondary disease complications have an important pathophy-siologic impact on diabetic bone quality. While postmenopausal women with type 2 diabetes without prevalent fractures have been shown to display thick and relatively aporous cortices, the opposite is true for diabetic women with prevalent fractures. These patients have been shown to exhibit overt cortical porosity exceeding the normal reference range. The biomechanical relevance and spatiotemporal dynamics of this finding and potential therapeutic implications for patient care need to be determined in the future.

Schlüsselwörter

Diabetische Osteopoathie - kortikale Porosität - HR-pQCT - Bildgebung

Keywords

Diabetic bone disease - cortical porosity - HRpQCT - imaging

• Literatur

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