Bone quality in type 2 diabetes mellitus

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Type 2 diabetes mellitus (T2DM) is an enormous, and growing, public health problem. While patients with T2DM are at significant risk for premature morbidity and mortality due to macrovascular disease, retinopathy, nephropathy, and neuropathy, it is also clear that T2DM patients are at increased risk for fragility fractures. As efforts to understand the underlying pathogenesis of skeletal abnormalities in T2DM have primarily focused on rodent models, major gaps in our understanding of diabetic bone disease in humans remain. Nonetheless, mounting evidence now suggests that fragility fractures in T2DM may result from compromised bone “quality” (i.e., altered bone material properties and/or bone microarchitecture) rather than reduced bone mineral density. Consistent with this, recent work has demonstrated, using in vivo microindentation technology, that bone material properties are compromised in patients with T2DM compared to nondiabetic controls, and that, in patients with T2DM, poor chronic glycemic control is associated with worse bone material properties. Thus, our current understanding of the pathogenesis of skeletal fragility in diabetes suggests that poor glucose control in patients with T2DM leads to increases in advanced glycation end products (AGEs) that have negative effects on osteoblasts, which in turn causes a reduction in bone formation. This defect in bone formation subsequently results in low bone turnover in T2DM patients, which prolongs the lifespan of type I collagen in bone, thereby leaving it particularly vulnerable to damage from increased AGEs. Ultimately, this creates a “vicious cycle” that may contribute to reduced bone qulity and increased fracture risk in patients with T2DM.

Original languageEnglish (US)
Title of host publicationDiabetic Bone Disease: Basic and Translational Research and Clinical Applications
PublisherSpringer International Publishing
Pages211-224
Number of pages14
ISBN (Print)9783319164021, 9783319164014
DOIs
StatePublished - Jan 1 2016

Fingerprint

Type 2 Diabetes Mellitus
Bone and Bones
Osteogenesis
Advanced Glycosylation End Products
Premature Mortality
Bone Remodeling
Bone Diseases
Collagen Type I
Osteoblasts
Bone Density
Rodentia
Public Health
Technology
Morbidity
Glucose

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Farr, J., & Khosla, S. (2016). Bone quality in type 2 diabetes mellitus. In Diabetic Bone Disease: Basic and Translational Research and Clinical Applications (pp. 211-224). Springer International Publishing. https://doi.org/10.1007/978-3-319-16402-1_10

Bone quality in type 2 diabetes mellitus. / Farr, Joshua; Khosla, Sundeep.

Diabetic Bone Disease: Basic and Translational Research and Clinical Applications. Springer International Publishing, 2016. p. 211-224.

Research output: Chapter in Book/Report/Conference proceedingChapter

Farr, J & Khosla, S 2016, Bone quality in type 2 diabetes mellitus. in Diabetic Bone Disease: Basic and Translational Research and Clinical Applications. Springer International Publishing, pp. 211-224. https://doi.org/10.1007/978-3-319-16402-1_10
Farr J, Khosla S. Bone quality in type 2 diabetes mellitus. In Diabetic Bone Disease: Basic and Translational Research and Clinical Applications. Springer International Publishing. 2016. p. 211-224 https://doi.org/10.1007/978-3-319-16402-1_10
Farr, Joshua ; Khosla, Sundeep. / Bone quality in type 2 diabetes mellitus. Diabetic Bone Disease: Basic and Translational Research and Clinical Applications. Springer International Publishing, 2016. pp. 211-224
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