Background:
Paradoxically, elderly persons with type 2 diabetes mellitus (T2DM) fracture despite having higher bone density than nondiabetics. Systemic factors associated with aging and T2DM may have detrimental, local effects on the skeleton. One such factor could be by altering the microenvironment of the mesenchymal stem-cells (MSCs), multipotent progenitors capable of differentiating into adipocytes or osteoblasts.
Methods
Sera were obtained from four participant groups (n=40 total, 10 per group): 1) young women with normal glucose tolerance (NGTY), 2) post-menopausal women with NGT) 3) post-menopausal women with impaired glucose tolerance (IGT) and 4) post-menopausal women with T2DM. Sera were incubated with human MSCs for 14 days. Cell proliferation and apoptosis were measured using EdU and TUNEL labeling assays, respectively. MSC differentiation for each group were determined using osteogenic and adipogenic gene expression markers quantified by qRT-PCR, as well as Alizarin Red and Oil Red O staining.
Results:
Expression of adipogenic genes was greater than 2 fold higher (P<0.05) in MSCs cultured with T2DM sera compared to those incubated with NGTY, NGT or IGT sera. The increase in adipogenic gene expression corresponded with increased Oil Red O staining. Despite the increased adipogenic differentiation of MSCs exposed to T2DM sera, cell proliferation and apoptosis rates as well as osteoblastic activity were not significantly different amongst the four conditions.
Conclusions:
Systemic, circulating factors in the serum of older women with T2DM may promote MSC differentiation into adipocytes versus osteoblasts. Increased differentiation of MSCs into adipocytes is one possible mechanism by which T2DM increases fracture risk.