Osteoporosis in diabetes mellitus: Possible cellular and molecular mechanisms

Abstract

Osteoporosis, a global age-related health problem in both male and female elderly, insidiously deteriorates the microstructure of bone, particularly at trabecular sites, such as vertebrae, ribs and hips, culminating in fragility fractures, pain and disability. Although osteoporosis is normally associated with senescence and estrogen deficiency, diabetes mellitus (DM), especially type 1 DM, also contributes to and/or aggravates bone loss in osteoporotic patients. This topic highlight article focuses on DM-induced osteoporosis and DM/ osteoporosis comorbidity, covering alterations in bone metabolism as well as factors regulating bone growth under diabetic conditions including, insulin, insulin-like growth factor-1 and angiogenesis. Cellular and molecular mechanisms of DM-related bone loss are also discussed. This information provides a foundation for the better understanding of diabetic complications and for development of early screening and prevention of osteoporosis in diabetic patients.

Low-level laser therapy associated to a resistance training protocol on bone tissue in diabetic rats

“…In the presence of DM, an impaired osteoblast function is observed, with a decrease in RUNX2 expression (5). The results of the present study demonstrated that the resistance training had an osteogenic potential, stimulating the expression of this immunomarker.…”

“…Miazgowski and Czekalski (4) demonstrated that diabetic patients had significantly lower BMD and an increased incidence rate of osteopenia and osteoporosis. Consequently, due to the lower BMD bone fractures are found to have an increased incidence in the presence of both types of diabetes (5). Moreover, lower biomechanical resistance, deficiency in bone mineralization after a fracture and decreased bone calcium and phosphate content were observed in induced diabetic animals (6).…”

Correlation serum level of 25(OH)D and bone density in type 2 diabetes mellitus patients

“…In obese patient with T2DM, there is an increasing load to the bone and insulin resistance resulting in hyperinsulinemia that will trigger bone formation. The influences of hyperglycemia on microvasculature, osteoclasts and osteoblasts, as well as the formation of advanced glycation end products will lead to the increased of bone resorption and inhibition of bone formation [2]. Bone density has positive relationship with levels of vitamin D, that reduce the risk of fracture.…”

“…In 2003, the World Health Organization (WHO) estimates that people suffering from DM in 2025 will increase to 333 million in the world, and from 8.4 million in 2000 to about 21.3 million years 2030 in Indonesia. 1,2 Patients with DM can experience a variety of complications [1,2]. Also known that DM can affect the bone remodeling process which lead to bone disorders.…”

Effect of advanced oxidation protein products on the proliferation and osteogenic differentiation of rat mesenchymal stem cells

“…Osteoporosis is a skeletal disorder characterized by an imbalance between bone resorption and bone formation, culminating in fragility fractures, pain and disability (1). Although the mechanisms involved are unclear, increasing evidence indicates that oxidative stress plays a role in the pathogenesis of osteoporosis (2,3).…”