Interaction between bone and glucose metabolism [Review]

Area of Science:

• Endocrinology
• Metabolic Bone Disease
• Diabetology

Background:

• Diabetes mellitus (DM) is linked to increased osteoporotic fracture risk, classifying osteoporosis as a diabetic complication.
• Advanced glycation end products (AGEs) and homocysteine impair osteoblast and osteocyte function, contributing to DM-induced bone fragility.
• Bone, as an endocrine organ, influences glucose metabolism via osteocalcin, though human intervention studies are needed.

Purpose of the Study:

• To explore the intricate relationship between bone and glucose metabolism in the context of diabetes.
• To investigate the role of cellular mechanisms, including adenosine monophosphate-activated protein kinase (AMPK), in diabetic bone fragility.
• To identify potential therapeutic targets for managing DM-induced bone fragility.

Main Methods:

• Review of existing literature on the association between bone metabolism and diabetes.
• Analysis of the impact of advanced glycation end products (AGEs) and homocysteine on bone cells.
• Examination of the role of osteocalcin in glucose homeostasis and the function of adenosine monophosphate-activated protein kinase (AMPK) in bone cells.

Main Results:

• Diabetes mellitus leads to bone fragility through impaired osteoblast and osteocyte function, exacerbated by AGEs and homocysteine.
• Osteocalcin, secreted by osteoblasts, may regulate glucose metabolism, but its clinical efficacy requires further investigation.
• Adenosine monophosphate-activated protein kinase (AMPK) activation influences osteoblast differentiation and osteocyte survival, suggesting its therapeutic potential.

Conclusions:

• Diabetic bone fragility is a significant complication involving metabolic dysregulation and cellular dysfunction.
• Adenosine monophosphate-activated protein kinase (AMPK) presents a promising therapeutic target for mitigating diabetic bone fragility by enhancing bone formation and osteocyte protection.
• Further research into osteocalcin's role and AMPK activation is crucial for developing effective treatments for diabetic bone disease.