Type 2 Diabetes Mellitus Increases the Risk to Hip Fracture in Postmenopausal Osteoporosis by Deteriorating the Trabecular Bone Microarchitecture and Bone Mass

Mohsin, Sahar; Kaimala, Suneesh; Sunny, Jens Jolly; Adeghate, Ernest; Brown, E.

doi:10.1155/2019/3876957

Cited by 29 publications

(24 citation statements)

References 41 publications

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“…More recently, researchers are emphasizing the biochemical effect of DM on OS. An animal study suggests that diabetic condition deteriorates bone health by disturbing the trabecular bone architecture and BMD [18]. In an individual with T1DM, reduction in BMD can be observed and, therefore, it is reasonable that T1DM can lead to an increased risk of fracture [4][5].…”

Section: Review Osteoporotic Fractures and Diabetesmentioning

confidence: 99%

“…However, in T2DM, normal or increased BMD can be observed [5][6]. Despite this fact, evidence suggests that the risk of fracture is higher in T2DM as compared to a non-diabetic patient [9,[17][18]. These facts prove that more complex biochemical activities are causing the fragility, particularly in T2DM.…”

Section: Review Osteoporotic Fractures and Diabetesmentioning

confidence: 99%

“…Some complications of diabetes could indirectly lead to osteoporotic fracture. One animal studies suggest that diabetes disrupt the trabecular architecture of femoral head, therefore leading to higher chance osteoporotic fragility in diabetic rat than control [18]. Diabetes can also induce osteoporotic fragility through diabetic nephropathy [7] and non-alcoholic liver disease [27].…”

Section: Review Osteoporotic Fractures and Diabetesmentioning

confidence: 99%

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The Future of Metformin in the Prevention of Diabetes-Related Osteoporosis

Aung¹,

Amin²,

Gulraiz³

et al. 2020

Cureus

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As a worldwide aging population is on the rise, osteoporosis (OS) is becoming a global health burden. Therefore, many researchers and health authorities are looking into the potential prevention and treatment of OS. Although previously regarded as two separate pathological processes, diabetes (DM) and OS are now regarded as two conditions that can occur together. It is now believed that OS can develop as a complication of DM. This relationship is further evidenced through a reduction in bone mineral density in type-1 diabetes with a resulting increased risk of fracture. Although bone mineral density in type-2 diabetes mellitus is normal or increased, there is also increased fragility due to decreased bone quality. These abnormal bone qualities tend to occur through the production of reduced bone microvasculature and advanced glycation end product, AGE. Interestingly, one of the most common treatments for DM, metformin (MF), shows a promising result on the protection of diabetes and non-diabetes related bone turnover. It is believed that MF modulates its effect through the adenosine monophosphate-activated protein kinase (AMPK) pathway. Recent data regarded AMPK as a vital mediator of homeostasis. It is involved not only in glucose metabolism but also in osteogenesis. AMPK can directly influence the production of mature and good quality bone by decreasing osteoclasts, increasing osteoblast formation, and enhancing bone mineral deposition. As an activator of AMPK, MF also upregulates osteogenesis. Furthermore, MF can influence osteogenesis through a non-AMPK pathway, such as the fructose 1-6 phosphatase pathway, by reducing glucose levels. While already recognized as a safe and effective treatment for DM, this article discusses whether MF can be used for the prevention and treatment of OS.

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Section: Review Osteoporotic Fractures and Diabetesmentioning

confidence: 99%

Section: Review Osteoporotic Fractures and Diabetesmentioning

confidence: 99%

Section: Review Osteoporotic Fractures and Diabetesmentioning

confidence: 99%

See 1 more Smart Citation

The Future of Metformin in the Prevention of Diabetes-Related Osteoporosis

Aung¹,

Amin²,

Gulraiz³

et al. 2020

Cureus

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“…Bone mineral density (BMD), an indication of bone mass and mineralization, is recognized as one of the major determinants of bone strength and a major tool to detect osteoporosis and predict fracture risk in the general population [ 3 ]. Interestingly, epidemiological studies have found that although BMD values are reduced, normal, or increased in patients with T2DM, compared with non-diabetic patients, the risk of fracture is increased [ 1 , 4 , 5 ], indicating that increased risk of fractures may be due to impaired bone quality and extra-bone factors [ 1 ], however, the underlying mechanism has not been clearly determined, and there are few effective therapies for diabetic osteoporosis. Therefore, it is of great significance to find clinically suitable indicators of osteoporosis for the early prevention and treatment of diabetic osteoporosis.…”

Section: Introductionmentioning

confidence: 99%

Association of circulating B-type natriuretic peptide with osteoporosis in a Chinese type 2 diabetic population

Chen

Yan

Wan

et al. 2021

BMC Musculoskelet Disord

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Background Altered circulating levels and genetic variation of B-type natriuretic peptide (BNP), has been associated with lower bone mineral density (BMD) values and incidence of osteoporosis in peritoneal dialysis patients, renal transplant recipients, and postmenopausal women. The potential relationship of circulating BNP with osteoporosis in patients with type 2 diabetes mellitus (T2DM), however, has not yet been studied. Methods Circulating BNP levels were measured in 314 patients with T2DM, and participants were divided into normal BMD group (n = 73), osteopenia group (n = 120), and osteoporosis group (n = 121). The association of circulating BNP with diabetic osteoporosis and other parameters was analyzed. Results Circulating BNP was significantly higher in diabetic osteoporosis subjects than normal and osteopenia groups (P < 0.01 or P < 0.05). Circulating BNP levels correlated significantly and positively with neutrophil to lymphocyte ratio, systolic blood pressure, urinary albumin-to-creatinine ratio, and prevalence of hypertension, peripheral arterial disease, diabetic retinopathy, peripheral neuropathy, and nephropathy, and negatively with triglyceride, fasting blood glucose, lymphocyte count, hemoglobin, estimated glomerular filtration rate, bilirubin, osteoporosis self-assessment tool for Asians, BMD at different skeletal sites and corresponding T scores (P < 0.01 or P < 0.05). After multivariate adjustment, circulating BNP remained independently significantly associated with the presence of osteoporosis (odds ratio, 2.710; 95% confidence interval, 1.690–4.344; P < 0.01). BMD at the femoral neck and total hip and corresponding T scores were progressively decreased, whereas the prevalence of osteoporosis was progressively increased with increasing BNP quartiles (P for trend< 0.01). Moreover, receiver-operating characteristic analysis revealed that the optimal cutoff point of circulating BNP to indicate diabetic osteoporosis was 16.35 pg/ml. Conclusions Circulating BNP level may be associated with the development of osteoporosis, and may be a potential biomarker for diabetic osteoporosis.

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“…Up to very recently, there were early reports available, concerning mostly the effect on bone mineral density (BMD) and bone turnover markers [ 15 – 19 ]. However, in the last years, several reports have been published, shedding more light on the pathogenesis of changes developing under the influence of both pathologies in rodents [ 20 – 27 ].…”

Section: Introductionmentioning

confidence: 99%

Negligible Effect of Estrogen Deficiency on Development of Skeletal Changes Induced by Type 1 Diabetes in Experimental Rat Models

Janas

Kruczek

Londzin

et al. 2020

Mediators of Inflammation

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Although postmenopausal osteoporosis often occurs concurrently with diabetes, little is known about interactions between estrogen deficiency and hyperglycemia in the skeletal system. In the present study, the effects of estrogen deficiency on the development of biochemical, microstructural, and mechanical changes induced by streptozotocin-induced diabetes mellitus (DM) in the rat skeletal system were investigated. The experiments were carried out on nonovariectomized (NOVX) and ovariectomized (OVX) control and diabetic mature female Wistar rats. Serum levels of bone turnover markers (CTX-I and osteocalcin) and 23 cytokines, bone mass and mineralization, histomorphometric parameters, and mechanical properties of cancellous and compact bone were determined. The results were subjected to two-way ANOVA and principal component analysis (PCA). Estrogen deficiency induced osteoporotic changes, with increased bone resorption and formation, and worsening of microstructure (femoral metaphyseal BV/TV decreased by 13.0%) and mechanical properties of cancellous bone (the maximum load in the proximal tibial metaphysis decreased by 34.2%). DM in both the NOVX and OVX rats decreased bone mass, increased bone resorption and decreased bone formation, and worsened cancellous bone microarchitecture (for example, the femoral metaphyseal BV/TV decreased by 17.3% and 18.1%, respectively, in relation to the NOVX controls) and strength (the maximum load in the proximal tibial metaphysis decreased by 35.4% and 48.1%, respectively, in relation to the NOVX controls). Only in the diabetic rats, profound increases in some cytokine levels were noted. In conclusion, the changes induced by DM in female rats were only slightly intensified by estrogen deficiency. Despite similar effects on bone microstructure and strength, the influence of DM on the skeletal system was based on more profound systemic homeostasis changes than those induced by estrogen deficiency.

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Type 2 Diabetes Mellitus Increases the Risk to Hip Fracture in Postmenopausal Osteoporosis by Deteriorating the Trabecular Bone Microarchitecture and Bone Mass

Cited by 29 publications

References 41 publications

The Future of Metformin in the Prevention of Diabetes-Related Osteoporosis

The Future of Metformin in the Prevention of Diabetes-Related Osteoporosis

Association of circulating B-type natriuretic peptide with osteoporosis in a Chinese type 2 diabetic population

Negligible Effect of Estrogen Deficiency on Development of Skeletal Changes Induced by Type 1 Diabetes in Experimental Rat Models

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