| With the increasing prevalence of diabetes and osteoporosis in China, diabetic osteoporosis has become an important cause of disability and mortality in patients with diabetes, which seriously affects the quality of life of patients and is a heavy burden to individuals and society. Type 1 diabetic patients have lower bone mineral density and increased fracture risk, whereas type 2 diabetic patients often have normal or increased bone density, but still increased risk of fracture, which cannot be explained by dual energy X-ray bone density measurement. With high sensitivity, strong specificity and good stability, bone turnover markers have been widely studied in diabetes in recent years, including bone alkaline phosphatase (BALP) , procollagen 1 N-terminal peptide (P1NP), type 1 collagen protein C-terminal crosslinking peptide ( CTX) , osteocalcin ( OC) , osteoprotegerin ( OPG) and deoxypyridinoline (DPD). Bone turnover markers can reflect the specific changes of bone resorption and bone formation, reflect bone strength, and reflect the changes in bone mass much earlier than bone mineral density (BMD). A large number of clinical studies have found that they provide new approaches for clinical early detection and diagnosis of diabetic osteoporosis, as well as fracture risk assessment in diabetic patients. Combined monitoring of bone turnover markers and BMD and more comprehensive and reasonable assessment of bone turnover could enable timely identification of the high risk population, and early diagnosis and treatment of diabetic osteoporosis patients, therefore play a role in fracture prevention. This paper reviews the research progress on bone turnover markers in diabetes. |