降糖药对骨代谢的影响

摘要

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（ dipep-tidyl peptidase Ⅳ， 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 .