1型糖尿病对骨折愈合影响的研究进展

Effects of type 1 diabetes mellitus on the healing of fractures

摘要:

骨折是指骨结构的连续性完全或部分断裂。当合并有1型糖尿病(T1DM)时会降低骨强度,增加骨折风险。且治疗不当会产生骨延迟愈合、不愈合及感染性骨髓炎等并发症。因糖尿病(DM)产生的高糖血症和低胰岛素血症会使晚期糖基化终末产物和炎症因子表达增加,使骨愈合过程中胶原蛋白功能、微血管结构、骨吸收和重塑过程以及生物力学环境发生改变,这些变化都不利于骨折愈合的发展。目前T1DM影响骨折愈合的分子机制尚未明确表述。针对此问题,本文通过查阅国内外近几年相关文献,进行了分析和综述,以期为临床医师对合并有糖尿病的骨折患者靶向治疗提供理论依据。

Abstract:

Bone fracture is a complete or partial break of the bone structure. Concomitant type 1 diabetes mellitus (T1DM) weakens the bone strength and increases the risk of fractures. Moreover, improper treatment is not conducive to the healing process of the fracture, resulting in the delayed healing, bone nonunion, infectious osteomyelitis and other complications. Hyperglycemia and hypoinsulinemia caused by diabetes mellitus (DM) may increase the expression of advanced glycation end products (AGEs) and inflammatory factors, altering the collagen functions, microvascular structures, bone absorption, reconstruction and biomechanical environment in the healing process of the fractured bone. These changes are not conducive to the healing of the fracture. At present, the molecular mechanism of the effects of T1DM on the healing fractures remains little known. This review is intended to investigate such effects, and thought to be beneficial for treating patients with diabetes mellitus combined with bone fracture.