Assessment of fracture risk in patients with type 2 diabetes mellitus / 中华内分泌代谢杂志

ABSTRACT

Fracture risk is higher in the patients with type 2 diabetes mellitus (T2DM) comparing to non-diabetic subjects,but bone mineral density (BMD) in type 2 diabetic patients may be increased,normal or decreased compared to non-diabetic population.Thus,BMD is not an accurate index for deciding to start antiosteoporotic treatment in type 2 diabetic patients with high fracture risk,and the more accurate assessment tools which can reflect the fracture risk in type 2 diabetic patients are needed.Studies have shown that the fracture risk in type 2 diabetic patients is increased with the decreasing of BMD,but the fracture usually happened with relative high BMD.Trabecular bone score is lower in type 2 diabetic patients than that in non-diabetic patients.High-resolution peripheral quantitative computed tomography (HR-pQCT) accurately reflects the bone microstructure of T2DM.FRAX may get more accurate fracture risk in type 2 diabetic patients by replacing rheumatoid arthritis with T2DM.DeFRA is a new algorithm derived from FRAX,which can evaluate fracture risk more accurately than FRAX in type 2 diabetic patients.Skeletal muscle mass is decreased in type 2 diabetic patients.Pentosidine,as one of advanced glycation end products,is related to the fracture risk in type 2 diabetic patients.Based on these data,this paper will review the assessments which may be used to evaluate the fracture risk in type 2 diabetic patients.