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Bone quality in diabetes.
1Department of Orthopaedic Surgery, Jikei University School of Medicine , Tokyo , Japan.
Frontiers in Endocrinology
|June 21, 2013
Summary
Diabetes elevates fracture risk by reducing bone quality, not just bone mineral density (BMD). This review explores how diabetes impacts collagen cross-linking and advanced glycation end-products (AGEs), affecting bone strength.
Area of Science:
- Endocrinology
- Orthopedics
- Biochemistry
Background:
- Diabetes mellitus is linked to increased fracture risk.
- Type 1 and Type 2 diabetes present differing effects on bone mineral density (BMD).
- Bone strength depends on both density and quality, with diabetes potentially impairing quality.
Purpose of the Study:
- To review the mechanisms by which diabetes negatively affects bone quality.
- To elucidate the role of collagen cross-linking in diabetes-related bone fragility.
- To discuss the impact of hyperglycemia and oxidative stress on bone matrix properties.
Main Methods:
- Literature review focusing on diabetes, bone quality, and collagen cross-linking.
- Analysis of biochemical pathways affecting bone matrix integrity.
- Examination of the role of advanced glycation end-products (AGEs) in bone.
Main Results:
- Diabetes reduces bone quality independently of BMD.
- Collagen cross-linking is significantly altered in diabetic bone.
- Both enzymatic and non-enzymatic collagen cross-links are affected, with an increase in detrimental AGEs.
Conclusions:
- Diabetes impairs bone strength primarily through reduced bone quality.
- Altered collagen cross-linking, including AGE accumulation, is a key mechanism.
- Understanding these mechanisms is crucial for managing fracture risk in diabetic patients.
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