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Tan MY, Zhu SX, Wang GP, Liu ZX. Impact of metabolic syndrome on bone mineral density in men over 50 and postmenopausal women according to U.S. survey results. Sci Rep 2024; 14:7005. [PMID: 38523143 PMCID: PMC10961310 DOI: 10.1038/s41598-024-57352-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 03/18/2024] [Indexed: 03/26/2024] Open
Abstract
Metabolic Syndrome (MetS) and bone mineral density (BMD) have shown a controversial link in some studies. This research aims to study their association in males over 50 and postmenopausal females using National Health and Nutrition Examination Survey (NHANES) data. Postmenopausal females and males over 50 were included in the study. MetS was defined by the National Cholesterol Education Program Adult Treatment Panel III guidelines. BMD values were measured at the thoracic spine, lumbar spine, and pelvis as the primary outcome. Weighted multivariate general linear models have been employed to explore the status of BMD in patients with MetS. Additionally, interaction tests and subgroup analyses were conducted. Utilizing the NHANES database from 2003 to 2006 and 2011-2018, we included 1924 participants, with 1029 males and 895 females. In postmenopausal women, after adjusting for covariates, we found a positive correlation between MetS and pelvic (β: 0.030 [95%CI 0.003, 0.06]) and thoracic (β: 0.030 [95%CI 0.01, 0.06]) BMD, though not for lumbar spine BMD (β: 0.020 [95%CI - 0.01, 0.05]). In males over 50 years old, MetS was positively correlated with BMD in both Model 1 (without adjusting for covariates) and Model 2 (considering age and ethnicity). Specifically, Model 2 revealed a positive correlation between MetS and BMD at the pelvis (β: 0.046 [95%CI 0.02, 0.07]), thoracic spine (β: 0.047 [95%CI 0.02, 0.07]), and lumbar spine (β: 0.040 [95%CI 0.02, 0.06]). Subgroup analysis demonstrated that the relationship between MetS and BMD remained consistent in all strata, underscoring the stability of the findings. In postmenopausal women, after adjusting for all covariates, a significant positive correlation was observed between MetS and BMD in the pelvis and thoracic spine, whereas this correlation was not significant for lumbar spine BMD. Conversely, in males, positive correlations between MetS and BMD at the lumbar spine, thoracic spine, and pelvis were identified in Model 2, which adjusted for age and ethnicity; however, these correlations disappeared after fully adjusting for all covariates. These findings highlight the potential moderating role of gender in the impact of MetS on BMD.
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Affiliation(s)
- Mo-Yao Tan
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Si-Xuan Zhu
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Gao-Peng Wang
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Zhong-Xing Liu
- Dujiangyan Traditional Chinese Medicine Hospital, Chengdu, Sichuan, China.
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2
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Guan J, Liu T, Chen H, Yang K. Association of type 2 Diabetes Mellitus and bone mineral density: a two-sample Mendelian randomization study. BMC Musculoskelet Disord 2024; 25:130. [PMID: 38347501 PMCID: PMC10860277 DOI: 10.1186/s12891-024-07195-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 01/10/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Observational studies have suggested that type 2 Diabetes Mellitus (DM2) is a potentially modifiable risk factor for lower BMD, but the causal relationship is unclear. This study aimed to examine whether the association of DM2 with lower BMD levels was causal by using Mendelian randomization (MR) analyses. METHODS We collected genome-wide association study data for DM2 and BMD of total body and different skeletal sites from the IEU database. Subsequently, we performed a two-sample Mendelian randomization analysis using the Two Sample MR package. RESULTS We identified a positive association between DM2 risk (61,714 DM2 cases and 596,424 controls) and total BMD, and other skeletal sites BMD, such as femoral neck BMD, ultra-distal forearm BMD and heel BMD. However, non-significant trends were observed for the effects of DM2 on lumbar-spine BMD. CONCLUSION In two-sample MR analyses, there was positive causal relationship between DM2 and BMD in both overall samples. In summary, while observational analyses consistently indicate a strong association between DM2 and low BMD, our MR analysis introduces a nuanced perspective. Contrary to the robust association observed in observational studies, our MR analysis suggests a significant link between DM2 and elevated BMD.
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Affiliation(s)
- Jianbin Guan
- Honghui-hospital, Xi'an Jiaotong University, Xi'an, 710054, China
- Shannxi Key Laboratory of Spine Bionic Treatment, Xi'an, China
| | - Tao Liu
- Honghui-hospital, Xi'an Jiaotong University, Xi'an, 710054, China
- Shannxi Key Laboratory of Spine Bionic Treatment, Xi'an, China
| | - Hao Chen
- Honghui-hospital, Xi'an Jiaotong University, Xi'an, 710054, China
- Shannxi Key Laboratory of Spine Bionic Treatment, Xi'an, China
| | - Kaitan Yang
- Honghui-hospital, Xi'an Jiaotong University, Xi'an, 710054, China.
- Shannxi Key Laboratory of Spine Bionic Treatment, Xi'an, China.
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Pan R, Zhang Y, Zhao Y. Trabecular bone score in type 1 diabetes: a meta-analysis of cross-sectional studies. J Orthop Surg Res 2023; 18:794. [PMID: 37875949 PMCID: PMC10594696 DOI: 10.1186/s13018-023-04289-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 10/15/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND Bone fragility is a recognized complication of type 1 diabetes (T1D). Thus, lower trabecular bone score (TBS) measurements in T1D patients can be predicted. However, the results of current studies on TBS in patients with T1D are inconsistent. In this context, the present study aimed to test the hypothesis that T1D is associated with lower TBS through a meta-analysis. METHODS An electronic search of the literature was conducted using PubMed, Embase and Web of science databases to identify studies related to TBS and T1D, supplemented by an additional manual check of the reference list of relevant original and review articles. All data was analyzed using a random effects model. Results were compared using standardized mean differences (SMD) and 95% confidence intervals (CI). P ≤ 0.05 was considered statistically significant. Review Manager 5.4 software and Stata 17.0 software were used for statistical analysis. RESULTS Seven cross-sectional studies involving 848 participants were included. TBS was lower in T1D patients than in healthy controls on random effects analysis, with no heterogeneity (SMD = - 0.39, 95% CI [- 0.53, - 0.24], P < 0.001; I2 = 0%). In addition, by subgroup analysis, T1D patients were strongly associated with reduced TBS in different regions and age groups, and the results were independent of covariate adjustment. CONCLUSION This study showed that TBS was lower in patients with T1D than in healthy individuals with normal blood glucose levels, suggesting that TBS may be a useful measure to assess fracture risk in T1D.
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Affiliation(s)
- Runzhou Pan
- Department of Endocrinology, Cangzhou Central Hospital, Cangzhou, Hebei Province, China
| | - Yan Zhang
- Department of Endocrinology, Cangzhou Central Hospital, Cangzhou, Hebei Province, China
| | - Yongcai Zhao
- Department of Endocrinology, Cangzhou Central Hospital, Cangzhou, Hebei Province, China.
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Pattayil S, Vadakkekuttical RJ, Radhakrishnan C, Kanakkath H, Hrishi TS. Proportional relationship between periodontal inflamed surface area, clinical attachment loss, and glycated hemoglobin level in patients with type 2 diabetes mellitus on insulin therapy and on oral antidiabetic therapy. J Periodontol 2023; 94:31-40. [PMID: 35716397 DOI: 10.1002/jper.22-0085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 06/07/2022] [Accepted: 06/10/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Treatment of diabetes includes oral antidiabetic drugs (OAD), insulin, or their combinations. Insulin can achieve faster glycemic control and have anabolic action on bone. This study was undertaken to assess the prevalence and severity of periodontitis, and to estimate the proportional relationship between periodontal inflamed surface area, clinical attachment loss, and glycated hemoglobin (HbA1c) level in patients with type 2 diabetes (T2DM) on OAD therapy and on insulin therapy. METHODS This cross-sectional study comprised 130 patients with T2DM on OAD therapy (OAD group) and 130 patients with T2DM on insulin therapy (INSULIN group). All patients were assessed for sociodemographic, behavioral characteristics, clinical history, periodontal parameters (bleeding on probing, probing depth, clinical attachment loss [Clinical AL], Oral Hygiene Index-simplified, plaque index, and periodontal inflamed surface area [PISA]), and biochemical variables (HbA1c, fasting plasma glucose, postprandial plasma glucose). RESULTS Prevalence, extent, and severity of periodontitis and PISA were lower in the INSULIN group as compared with the OAD group. A proportional relationship was observed between HbA1c and PISA and between HbA1c and Clinical AL. A unit increase in HbA1c is associated with an increase in PISA of 130.47 mm2 and an increase in Clinical AL of 0.182 mm. CONCLUSION A proportional relationship was observed between PISA, clinical attachment loss, and HbA1c level in patients with type 2 diabetes mellitus on insulin therapy and OAD therapy. Despite comparable oral hygiene status and glycemic control between the two groups, the periodontal parameters were lesser in the INSULIN group as compared with the OAD group.
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Affiliation(s)
- Simna Pattayil
- Department of Periodontics, Government Dental College, Affiliated to Kerala University of Health Sciences, Calicut, Kerala, India
| | - Rosamma Joseph Vadakkekuttical
- Department of Periodontics, Government Dental College, Affiliated to Kerala University of Health Sciences, Calicut, Kerala, India
| | - Chandni Radhakrishnan
- Department of Emergency Medicine, Government Medical College, Affiliated to Kerala University of Health Sciences, Calicut, Kerala, India
| | - Harikumar Kanakkath
- Department of Periodontics, Government Dental College, Affiliated to Kerala University of Health Sciences, Calicut, Kerala, India
| | - Thayyil Sivaraman Hrishi
- Department of Periodontics, Government Dental College, Affiliated to Kerala University of Health Sciences, Calicut, Kerala, India
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Samvelyan HJ, Mathers JC, Skerry TM. Feeding intervention potentiates the effect of mechanical loading to induce new bone formation in mice. FASEB J 2021; 35:e21792. [PMID: 34516688 DOI: 10.1096/fj.202100334rr] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 06/19/2021] [Accepted: 06/28/2021] [Indexed: 12/17/2022]
Abstract
The benefits of increased human lifespan depend upon duration of healthy, independent living; the healthspan. Bone-wasting disorders contribute significantly to loss of independence, frailty, and morbidity in older people. Therefore, there is an unmet need globally for lifestyle interventions to reduce the likelihood of bone fractures with age. Although many mechanisms are involved in disorders of bone loss, there is no single regulatory pathway and, therefore, there is no single treatment available to prevent their occurrence. Our aim in these studies was to determine whether fasting/feeding interventions alter the effect of mechanical loading on bone anabolic activities and increase bone mass. In young 17-week-old mice, 16-hour fasting period followed by reintroduction of food for 2 hours increased markedly the potency of mechanical loading, that mimics the effect of exercise, to induce new cortical bone formation. Consistent with this finding, fasting and re-feeding increased the response of bone to a loading stimulus that, alone, does not stimulate new bone formation in ad-lib fed mice. Older mice (20 months) experienced no potentiation of loading-induced bone formation with the same timing of feeding interventions. Interestingly, the pre-, prandial, and postprandial endocrine responses in older mice were different from those in young animals. The hormones that change in response to timing of feeding have osteogenic effects that interact with loading-mediated effects. Our findings indicate associations between timing of food ingestion and bone adaptation to loading. If translated to humans, such non-pharmacological lifestyle interventions may benefit skeletal health of humans throughout life-course and in older age.
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Affiliation(s)
- Hasmik Jasmine Samvelyan
- CIMA, MRC-Versus Arthritis Centre for Integrated Research into Musculoskeletal Ageing, The University of Sheffield, Sheffield, UK.,Department of Oncology and Metabolism, The Medical School, Mellanby Centre for Bone Research, The University of Sheffield, Sheffield, UK
| | - John Cummings Mathers
- CIMA, MRC-Versus Arthritis Centre for Integrated Research into Musculoskeletal Ageing, The University of Sheffield, Sheffield, UK.,Human Nutrition Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Timothy Michael Skerry
- CIMA, MRC-Versus Arthritis Centre for Integrated Research into Musculoskeletal Ageing, The University of Sheffield, Sheffield, UK.,Department of Oncology and Metabolism, The Medical School, Mellanby Centre for Bone Research, The University of Sheffield, Sheffield, UK
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Yousefzadeh N, Jeddi S, Kashfi K, Ghasemi A. Diabetoporosis: Role of nitric oxide. EXCLI JOURNAL 2021; 20:764-780. [PMID: 34121973 PMCID: PMC8192884 DOI: 10.17179/excli2021-3541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 03/31/2021] [Indexed: 11/29/2022]
Abstract
Diabetoporosis, diabetic-related decreased bone quality and quantity, is one of the leading causes of osteoporotic fractures in subjects with type 2 diabetes (T2D). This is associated with lower trabecular and cortical bone quality, lower bone turnover rates, lower rates of bone healing, and abnormal posttranslational modifications of collagen. Decreased nitric oxide (NO) bioavailability has been reported within the bones of T2D patients and can be considered as one of the primary mechanisms by which diabetoporosis is manifested. NO donors increase trabecular and cortical bone quality, increase the rate of bone formation, accelerate the bone healing process, delay osteoporosis, and decrease osteoporotic fractures in T2D patients, suggesting the potential therapeutic implication of NO-based interventions. NO is produced in the osteoblast and osteoclast cells by three isoforms of NO synthase (NOS) enzymes. In this review, the roles of NO in bone remodeling in the normal and diabetic states are discussed. Also, the favorable effects of low physiological levels of NO produced by endothelial NOS (eNOS) versus detrimental effects of high pathological levels of NO produced by inducible NOS (iNOS) in diabetoporosis are summarized. Available data indicates decreased bone NO bioavailability in T2D and decreased expression of eNOS, and increased expression and activity of iNOS. NO donors can be considered novel therapeutic agents in diabetoporosis.
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Affiliation(s)
- Nasibeh Yousefzadeh
- Endocrine Physiology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sajad Jeddi
- Endocrine Physiology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Khosrow Kashfi
- Department of Molecular, Cellular, and Biomedical Sciences, Sophie Davis School of Biomedical Education, City University of New York School of Medicine, NY, USA.,PhD Program in Biology, City University of New York Graduate Center, New York,NY, USA
| | - Asghar Ghasemi
- Endocrine Physiology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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7
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Yoon JH, Hong AR, Choi W, Park JY, Kim HK, Kang HC. Association of Triglyceride-Glucose Index with Bone Mineral Density in Non-diabetic Koreans: KNHANES 2008-2011. Calcif Tissue Int 2021; 108:176-187. [PMID: 33006085 DOI: 10.1007/s00223-020-00761-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 09/23/2020] [Indexed: 11/30/2022]
Abstract
The association of insulin resistance (IR), as indicated by the homeostasis model assessment of insulin resistance, with bone metabolism is yet to be clarified. We aimed to investigate the relationship of IR with bone mass by using the triglyceride-glucose (TyG) index as an alternative marker of IR. Data of 4810 non-diabetes individuals (2552 men aged ≥ 50 years and 2258 postmenopausal women) from the Korean National Health and Nutritional Examination Survey IV and V were analyzed. Bone mineral density (BMD) at the lumbar spine, femoral neck, total hip, and whole body were measured using dual-energy X-ray absorptiometry. After adjusting for confounding factors, there were inverse relationships of TyG index with femoral neck, total hip, and whole body BMD in men (β = - 0.085, P < 0.001 at femoral neck; β = - 0.046, P = 0.037 at total hip; β = - 0.098, P < 0.001 at whole body). However, in women, femoral neck and whole body BMD were negatively associated with the TyG index (β = - 0.071, P = 0.008 at femoral neck and β = - 0.065, P = 0.005 at whole body). The highest TyG index tertile exhibited reduced femoral neck BMD in both sexes (P = 0.003 in men and P = 0.013 in women) and reduced whole body BMD in men (P < 0.001) after adjusting for confounders. When the study subjects were divided into BMI (body mass index) < 23 kg/m2 and ≥ 23 kg/m2 groups, the TyG index was significantly associated with femoral neck BMD only in the women with BMI < 23 kg/m2 (P = 0.009). We observed a significant association between the highest TyG index tertile and low bone mass at the femoral neck in women with BMI < 23 kg/m2 (P = 0.003) that was not observed in women with BMI ≥ 23 kg/m2 and men. In conclusion, IR evaluated using the TyG index was inversely associated with femoral neck BMD in non-diabetic men aged ≥ 50 years and postmenopausal women. The negative influence of IR on femoral neck BMD was robust in the women with BMI < 23 kg/m2. This indicates a differential effect of IR on BMD according to skeletal site, sex, and BMI.
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Affiliation(s)
- Jee Hee Yoon
- Department of Internal Medicine, Chonnam National University Medical School, 160 Baekseo-ro, Dong-gu, Gwangju, 61469, Republic of Korea
| | - A Ram Hong
- Department of Internal Medicine, Chonnam National University Medical School, 160 Baekseo-ro, Dong-gu, Gwangju, 61469, Republic of Korea.
| | - Wonsuk Choi
- Department of Internal Medicine, Chonnam National University Medical School, 160 Baekseo-ro, Dong-gu, Gwangju, 61469, Republic of Korea
| | - Ji Yong Park
- Department of Internal Medicine, Chonnam National University Medical School, 160 Baekseo-ro, Dong-gu, Gwangju, 61469, Republic of Korea
| | - Hee Kyung Kim
- Department of Internal Medicine, Chonnam National University Medical School, 160 Baekseo-ro, Dong-gu, Gwangju, 61469, Republic of Korea
| | - Ho-Cheol Kang
- Department of Internal Medicine, Chonnam National University Medical School, 160 Baekseo-ro, Dong-gu, Gwangju, 61469, Republic of Korea
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Abstract
INTRODUCTION Preclinical, clinical, and population-based studies have provided evidence that anti-diabetic drugs affect bone metabolism and may affect the risk of fracture in diabetic patients. AREAS COVERED An overview of the skeletal effects of anti-diabetic drugs used in type 2 diabetes is provided. Searches on AdisInsight, PubMed, and Medline databases were conducted up to 1st July 2020. The latest evidence from randomized clinical trials and population-based studies on the skeletal safety of the most recent drugs (DPP-4i, GLP-1RA, and SGLT-2i) is provided. EXPERT OPINION Diabetic patients present with a higher risk of fracture for a given bone mineral density suggesting a role of bone quality in the etiology of diabetic fracture. Bone quality is difficult to assess in human clinical practice and the use of preclinical models provides valuable information on diabetic bone alterations. As several links have been established between bone and energy homeostasis, it is interesting to study the safety of anti-diabetic drugs on the skeleton. So far, evidence for the newest molecules suggests a neutral fracture risk, but further studies, especially in different types of patient populations (patients at risk or with history of cardiovascular disease, renal impairment, neuropathy) are required to fully appreciate this matter.
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Affiliation(s)
- Guillaume Mabilleau
- Groupe Etude Remodelage Osseux et biomatériaux, GEROM, UPRES EA 4658, UNIV Angers, SFR ICAT 4208, Institut de Biologie en Santé , Angers, France
- Service Commun d'Imagerie et Analyses Microscopiques, SCIAM, UNIV Angers, SFR ICAT 4208, Institut de Biologie en Santé , Angers, France
- Bone pathology unit, Angers University hospital , Angers Cedex, France
| | - Béatrice Bouvard
- Groupe Etude Remodelage Osseux et biomatériaux, GEROM, UPRES EA 4658, UNIV Angers, SFR ICAT 4208, Institut de Biologie en Santé , Angers, France
- Rheumatology department, Angers University Hospital , Angers Cedex, France
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Panach L, Pertusa C, Martínez-Rojas B, Acebrón Á, Mifsut D, Tarín JJ, Cano A, García-Pérez MÁ. Comparative transcriptome analysis identifies CARM1 and DNMT3A as genes associated with osteoporosis. Sci Rep 2020; 10:16298. [PMID: 33004909 PMCID: PMC7530982 DOI: 10.1038/s41598-020-72870-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 09/07/2020] [Indexed: 12/11/2022] Open
Abstract
To identify new candidate genes in osteoporosis, mainly involved in epigenetic mechanisms, we compared whole gene-expression in osteoblasts (OBs) obtained from women undergoing hip replacement surgery due to fragility fracture and severe osteoarthritis. Then, we analyzed the association of several SNPs with BMD in 1028 women. Microarray analysis yielded 2542 differentially expressed transcripts belonging to 1798 annotated genes, of which 45.6% (819) were overexpressed, and 54.4% (979) underexpressed (fold-change between - 7.45 and 4.0). Among the most represented pathways indicated by transcriptome analysis were chondrocyte development, positive regulation of bone mineralization, BMP signaling pathway, skeletal system development and Wnt signaling pathway. In the translational stage we genotyped 4 SNPs in DOT1L, HEY2, CARM1 and DNMT3A genes. Raw data analyzed against inheritance patterns showed a statistically significant association between a SNP of DNMT3A and femoral neck-(FN) sBMD and primarily a SNP of CARM1 was correlated with both FN and lumbar spine-(LS) sBMD. Most of these associations remained statistically significant after adjusting for confounders. In analysis with anthropometric and clinical variables, the SNP of CARM1 unexpectedly revealed a close association with BMI (p = 0.000082), insulin (p = 0.000085), and HOMA-IR (p = 0.000078). In conclusion, SNPs of the DNMT3A and CARM1 genes are associated with BMD, in the latter case probably owing to a strong correlation with obesity and fasting insulin levels.
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Affiliation(s)
- Layla Panach
- Research Unit, INCLIVA Health Research Institute, 46010, Valencia, Spain
| | - Clara Pertusa
- Research Unit, INCLIVA Health Research Institute, 46010, Valencia, Spain
| | | | - Álvaro Acebrón
- Orthopedic Surgery and Traumatology, Clinic Hospital, Institute of Health Research INCLIVA, 46010, Valencia, Spain
| | - Damián Mifsut
- Orthopedic Surgery and Traumatology, Clinic Hospital, Institute of Health Research INCLIVA, 46010, Valencia, Spain
| | - Juan J Tarín
- Department of Cellular Biology, Functional Biology and Physical Anthropology, University of Valencia, 46100, Burjassot, Spain
| | - Antonio Cano
- Department of Pediatrics, Obstetrics and Gynecology, University of Valencia, 46010, Valencia, Spain
| | - Miguel Ángel García-Pérez
- Research Unit, INCLIVA Health Research Institute, 46010, Valencia, Spain.
- Department of Genetics, University of Valencia, 46100, Burjassot, Spain.
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10
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Khorsand B, Acri TM, Do A, Femino JE, Petersen E, Fredericks DC, Salem AK. A Multi-Functional Implant Induces Bone Formation in a Diabetic Model. Adv Healthc Mater 2020; 9:e2000770. [PMID: 32815306 DOI: 10.1002/adhm.202000770] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 07/15/2020] [Indexed: 12/21/2022]
Abstract
Patients with diabetes mellitus (DM) have defective healing of bone fractures. It was previously shown that nonviral gene delivery of plasmid DNA (pDNA) that independently encodes bone morphogenetic protein-2 (BMP-2) and fibroblast growth factor-2 (FGF-2), acts synergistically to promote bone regeneration in a DM animal model. Additionally, both insulin (INS) and the hormonally active form of vitamin D3, 1α,25-dihydroxyvitamin D3 (1α,25(OH)2 D3 ) (VD3) have independently been shown to play key roles in regulating bone fracture healing in DM patients. However, these individual therapies fail to adequately stimulate bone regeneration, illustrating a need for novel treatment of bone fractures in diabetic patients. Here, the ability of local delivery of INS and VD3 along with BMP-2 and FGF-2 genes is investigated to promote bone formation ectopically in Type-2 diabetic rats. A composite consisting of VD3 and INS is developed that contains poly(lactic-co-glycolic acid) microparticles (MPs) embedded in a fibrin gel surrounded by a collagen matrix that is permeated with polyethylenimine (PEI)-(pBMP-2+pFGF-2) nanoplexes. Using a submuscular osteoinduction model, it is demonstrated that local delivery of INS, VD3, and PEI-(pBMP-2+pFGF-2) significantly improves bone generation compared to other treatments, thusimplicating this approach as a method to promote bone regeneration in DM patients with bone fractures.
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Affiliation(s)
- Behnoush Khorsand
- Department of Pharmaceutical Sciences and Experimental Therapeutics University of Iowa College of Pharmacy Iowa City IA 52242 USA
| | - Timothy M. Acri
- Department of Pharmaceutical Sciences and Experimental Therapeutics University of Iowa College of Pharmacy Iowa City IA 52242 USA
| | - Anh‐Vu Do
- Department of Pharmaceutical Sciences and Experimental Therapeutics University of Iowa College of Pharmacy Iowa City IA 52242 USA
| | - John E. Femino
- Department of Orthopedics and Rehabilitation University of Iowa Iowa City IA 52242 USA
| | - Emily Petersen
- Department of Orthopedics and Rehabilitation University of Iowa Iowa City IA 52242 USA
| | - Douglas C. Fredericks
- Department of Orthopedics and Rehabilitation University of Iowa Iowa City IA 52242 USA
| | - Aliasger K. Salem
- Department of Pharmaceutical Sciences and Experimental Therapeutics University of Iowa College of Pharmacy Iowa City IA 52242 USA
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Campillo-Sánchez F, Usategui-Martín R, Ruiz -de Temiño Á, Gil J, Ruiz-Mambrilla M, Fernández-Gómez JM, Dueñas-Laita A, Pérez-Castrillón JL. Relationship between Insulin Resistance (HOMA-IR), Trabecular Bone Score (TBS), and Three-Dimensional Dual-Energy X-ray Absorptiometry (3D-DXA) in Non-Diabetic Postmenopausal Women. J Clin Med 2020; 9:jcm9061732. [PMID: 32503328 PMCID: PMC7355807 DOI: 10.3390/jcm9061732] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 05/16/2020] [Accepted: 05/29/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Insulin may play a key role in bone metabolism, where the anabolic effect predominates. This study aims to analyze the relationship between insulin resistance and bone quality using the trabecular bone score (TBS) and three-dimensional dual-energy X-ray absorptiometry (3D-DXA) in non-diabetic postmenopausal women by determining cortical and trabecular compartments. METHODS A cross-sectional study was conducted in non-diabetic postmenopausal women with suspected or diagnosed osteoporosis. The inclusion criteria were no menstruation for more than 12 months and low bone mass or osteoporosis as defined by DXA. Glucose was calculated using a Hitachi 917 auto-analyzer. Insulin was determined using an enzyme-linked immunosorbent assay (EIA). Insulin resistance was estimated using a homeostasis model assessment of insulin resistance (HOMA-IR). DXA, 3D-DXA, and TBS were thus collected. Moreover, we examined bone parameters according to quartile of insulin, hemoglobin A1C (HbA1c), and HOMA-IR. RESULTS In this study, we included 381 postmenopausal women. Women located in quartile 4 (Q4) of HOMA-IR had higher values of volumetric bone mineral density (vBMD) but not TBS. The increase was higher in the trabecular compartment (16.4%) than in the cortical compartment (6.4%). Similar results were obtained for insulin. Analysis of the quartiles by HbA1c showed no differences in densitometry values, however women in Q4 had lower levels of TBS. After adjusting for BMI, statistical significance was maintained for TBS, insulin, HOMA-IR, and HbA1c. CONCLUSIONS In non-diabetic postmenopausal women there was a direct relationship between insulin resistance and vBMD, whose effect is directly related to greater weight. TBS had an inverse relationship with HbA1c, insulin, and insulin resistance unrelated to weight. This might be explained by the formation of advanced glycosylation products (AGEs) in the bone matrix, which reduces bone deformation capacity and resistance, as well as increases fragility.
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Affiliation(s)
| | - Ricardo Usategui-Martín
- IOBA, University of Valladolid, 47011 Valladolid, Spain
- Correspondence: (R.U.-M.); (J.L.P.-C.); Tel./Fax: +34-98-342-3184 (R.U.-M. & J.L.P.-C.)
| | - Ángela Ruiz -de Temiño
- Department Medicine, University of Valladolid, 47005 Valladolid, Spain; (Á.R.-d.T.); (M.R.-M.); (A.D.-L.)
| | - Judith Gil
- Hospital Nuestra Señora de Sonsoles, 05004 Avila, Spain;
| | - Marta Ruiz-Mambrilla
- Department Medicine, University of Valladolid, 47005 Valladolid, Spain; (Á.R.-d.T.); (M.R.-M.); (A.D.-L.)
| | | | - Antonio Dueñas-Laita
- Department Medicine, University of Valladolid, 47005 Valladolid, Spain; (Á.R.-d.T.); (M.R.-M.); (A.D.-L.)
- Department of Medicine, University of Valladolid Service of Clinical Toxicology, Río Hortega University Hospital, 47012 Valladolid, Spain
| | - José Luis Pérez-Castrillón
- Department Medicine, University of Valladolid, 47005 Valladolid, Spain; (Á.R.-d.T.); (M.R.-M.); (A.D.-L.)
- Department of Internal Medicine, Department of Medicine, University of Valladolid, Río Hortega University Hospital, 47012 Valladolid, Spain
- Correspondence: (R.U.-M.); (J.L.P.-C.); Tel./Fax: +34-98-342-3184 (R.U.-M. & J.L.P.-C.)
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Russo V, Chen R, Armamento-Villareal R. Hypogonadism, Type-2 Diabetes Mellitus, and Bone Health: A Narrative Review. Front Endocrinol (Lausanne) 2020; 11:607240. [PMID: 33537005 PMCID: PMC7848021 DOI: 10.3389/fendo.2020.607240] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 11/30/2020] [Indexed: 12/26/2022] Open
Abstract
One of the complications from chronic hyperglycemia and insulin resistance due to type 2 diabetes mellitus (T2DM) on the hypothalamic-pituitary-gonadal axis in men is the high prevalence of hypogonadotropic hypogonadism (HH). Both T2DM and hypogonadism are associated with impaired bone health and increased fracture risk but whether the combination results in even worse bone disease than either one alone is not well-studied. It is possible that having both conditions predisposes men to an even greater risk for fracture than either one alone. Given the common occurrence of HH or hypogonadism in general in T2DM, a significant number of men could be at risk. To date, there is very little information on the bone health men with both hypogonadism and T2DM. Insulin resistance, which is the primary defect in T2DM, is associated with low testosterone (T) levels in men and may play a role in the bidirectional relationship between these two conditions, which together may portend a worse outcome for bone. The present manuscript aims to review the available evidences on the effect of the combination of hypogonadism and T2DM on bone health and metabolic profile, highlights the possible metabolic role of the skeleton, and examines the pathways involved in the interplay between bone, insulin resistance, and gonadal steroids.
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Affiliation(s)
- Vittoria Russo
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Baylor College of Medicine, Houston, TX, United States
- Department of Medicine, Michael E. DeBakey VA Medical Center, Houston, TX, United States
| | - Rui Chen
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Baylor College of Medicine, Houston, TX, United States
- Department of Medicine, Michael E. DeBakey VA Medical Center, Houston, TX, United States
| | - Reina Armamento-Villareal
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Baylor College of Medicine, Houston, TX, United States
- Department of Medicine, Michael E. DeBakey VA Medical Center, Houston, TX, United States
- *Correspondence: Reina Armamento-Villareal,
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Abstract
PURPOSE OF REVIEW There is ample evidence that patients with type 2 diabetes (T2D) have increased risk of fracture even though they have normal or high bone mineral density. As a result, poor bone quality is suggested to contribute to skeletal fragility in this population. Thus, our goal was to conduct a comprehensive literature review to understand how bone quality components are altered in T2D and their effects on bone biomechanics and fracture risk. RECENT FINDINGS T2D does affect bone quality via alterations in bone microarchitecture, organic matrix, and cellular behavior. Further, studies indicate that bone biomechanical properties are generally deteriorated in T2D, but there are few reports in patients. Additional work is needed to better understand molecular and cellular mechanisms that contribute to skeletal fragility in T2D. This knowledge can contribute to the development of improved diagnostic tools and drug targets to for improved quality of life for those with T2D.
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Affiliation(s)
- Lamya Karim
- Department of Bioengineering, University of Massachusetts Dartmouth, 285 Old Westport Road, Dartmouth, MA, 02747, USA.
| | - Taraneh Rezaee
- Department of Bioengineering, University of Massachusetts Dartmouth, 285 Old Westport Road, Dartmouth, MA, 02747, USA
| | - Rachana Vaidya
- Department of Bioengineering, University of Massachusetts Dartmouth, 285 Old Westport Road, Dartmouth, MA, 02747, USA
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Napoli N, Conte C, Pedone C, Strotmeyer ES, Barbour KE, Black DM, Samelson EJ, Schwartz AV. Effect of Insulin Resistance on BMD and Fracture Risk in Older Adults. J Clin Endocrinol Metab 2019; 104:3303-3310. [PMID: 30802282 PMCID: PMC6584125 DOI: 10.1210/jc.2018-02539] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 02/20/2019] [Indexed: 02/06/2023]
Abstract
CONTEXT Adults with type 2 diabetes (T2D) have higher fracture risk compared with nondiabetics, despite having higher bone mineral density (BMD). Insulin resistance (IR) has been associated with increased BMD. It is not known if IR increases fracture risk. OBJECTIVE We investigated the relationship among IR HOMA-IR, BMD, and incident nonspine fractures in nondiabetic individuals. DESIGN Participants included 2398 community-dwelling, nondiabetic older adults (age 74 ± 3 years, 53% women, 38% black) in the Health, Aging and Body Composition Prospective Cohort Study [median follow-up: 12 (interquartile range: 6) years]. RESULTS The cut-off values for the HOMA-IR quartiles were 1.05, 1.54, and 2.33. Total hip BMD was 0.104 g/cm2 higher in the fourth vs the first HOMA-IR quartile (P < 0.001). This difference was attenuated after adjustment for BMI (adjusted mean difference 0.007 g/cm2; P = 0.371). In unadjusted models, fracture risk was lower in those with higher HOMA-IR [hazard ratio (HR) 0.86 (95% CI 0.73 to 1.01) and 0.65 (95% CI 0.47 to 0.89) for the third and fourth quartile, respectively, vs the first quartile]. However, after adjustment for BMD and BMI, fracture risk was significantly higher in the third quartile (HR 1.19, 95% CI 1.00 to 1.41) and tended to be increased in the fourth quartile (HR 1.12, 95% CI 0.87 to 1.46) vs the first quartile. CONCLUSIONS Greater IR is associated with higher BMD in nondiabetic older adults. In contrast to the relationship between T2D and fracture risk, we did not find consistent evidence that greater IR is associated with increased fracture risk after adjustment for BMI and BMD.
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Affiliation(s)
- Nicola Napoli
- Division of Endocrinology and Diabetes, University Campus Bio-Medico di Roma, Rome, Italy
- Division of Bone Mineral Diseases, Washington University in Saint Louis, Saint Louis, Missouri
| | - Caterina Conte
- Vita-Salute San Raffaele University, Milan, Italy
- Clinical Transplant Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Claudio Pedone
- Geriatric Unit, University Campus Bio-Medico di Roma, Rome, Italy
| | - Elsa S Strotmeyer
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Kamil E Barbour
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Dennis M Black
- Department of Medicine, University of California, San Francisco, San Francisco, California
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California
| | - Elizabeth J Samelson
- Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts
- Department of Medicine, Harvard Medical School, Boston, Massachusetts
- Division of Gerontology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Ann V Schwartz
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California
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15
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Kalaitzoglou E, Fowlkes JL, Popescu I, Thrailkill KM. Diabetes pharmacotherapy and effects on the musculoskeletal system. Diabetes Metab Res Rev 2019; 35:e3100. [PMID: 30467957 PMCID: PMC6358500 DOI: 10.1002/dmrr.3100] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 11/14/2018] [Accepted: 11/19/2018] [Indexed: 12/13/2022]
Abstract
Persons with type 1 or type 2 diabetes have a significantly higher fracture risk than age-matched persons without diabetes, attributed to disease-specific deficits in the microarchitecture and material properties of bone tissue. Therefore, independent effects of diabetes drugs on skeletal integrity are vitally important. Studies of incretin-based therapies have shown divergent effects of different agents on fracture risk, including detrimental, beneficial, and neutral effects. The sulfonylurea class of drugs, owing to its hypoglycemic potential, is thought to amplify the risk of fall-related fractures, particularly in the elderly. Other agents such as the biguanides may, in fact, be osteo-anabolic. In contrast, despite similarly expected anabolic properties of insulin, data suggests that insulin pharmacotherapy itself, particularly in type 2 diabetes, may be a risk factor for fracture, negatively associated with determinants of bone quality and bone strength. Finally, sodium-dependent glucose co-transporter 2 inhibitors have been associated with an increased risk of atypical fractures in select populations, and possibly with an increase in lower extremity amputation with specific SGLT2I drugs. The role of skeletal muscle, as a potential mediator and determinant of bone quality, is also a relevant area of exploration. Currently, data regarding the impact of glucose lowering medications on diabetes-related muscle atrophy is more limited, although preclinical studies suggest that various hypoglycemic agents may have either aggravating (sulfonylureas, glinides) or repairing (thiazolidinediones, biguanides, incretins) effects on skeletal muscle atrophy, thereby influencing bone quality. Hence, the therapeutic efficacy of each hypoglycemic agent must also be evaluated in light of its impact, alone or in combination, on musculoskeletal health, when determining an individualized treatment approach. Moreover, the effect of newer medications (potentially seeking expanded clinical indication into the pediatric age range) on the growing skeleton is largely unknown. Herein, we review the available literature regarding effects of diabetes pharmacotherapy, by drug class and/or by clinical indication, on the musculoskeletal health of persons with diabetes.
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Affiliation(s)
- Evangelia Kalaitzoglou
- University of Kentucky Barnstable Brown Diabetes Center Department of Pediatrics, University of Kentucky College of Medicine, Lexington, KY, USA
| | - John L Fowlkes
- University of Kentucky Barnstable Brown Diabetes Center Department of Pediatrics, University of Kentucky College of Medicine, Lexington, KY, USA
| | - Iuliana Popescu
- University of Kentucky Barnstable Brown Diabetes Center Department of Pediatrics, University of Kentucky College of Medicine, Lexington, KY, USA
| | - Kathryn M Thrailkill
- University of Kentucky Barnstable Brown Diabetes Center Department of Pediatrics, University of Kentucky College of Medicine, Lexington, KY, USA
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16
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Raj JP, Venkatachalam S, Shekoba M, Norris JJ, Amaravati RS. Conventional antidiabetic agents and bone health: A pilot case-control study. Perspect Clin Res 2019; 10:177-182. [PMID: 31649868 PMCID: PMC6801990 DOI: 10.4103/picr.picr_125_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Background and Objectives: The burden of noncommunicable diseases such as diabetes (type 2 diabetes mellitus [T2DM]) and osteoporosis is increasing with increasing longevity. Uncontrolled T2DM is an independent risk factor for osteoporosis explained by the insulin osteocalcin pathway. Due to limited information on the effect of various commonly used antidiabetic agents (ADA) on bone health, our study aims to analyze the association between the two. Methodology: This is a case–control study, with 100 cases of clinical osteoporosis and 100 age-, sex-, and dietary status-matched controls in whom osteoporosis was ruled out by dual-energy X-ray absorptiometry scan. Prescription details of T2DM, physical activity levels, and disease status were collected using a pretested questionnaire. Exposure to each ADA was compared using the Chi-squared test. Binary logistic regression was performed to adjust the two main confounders, namely glycemic control and physical activity levels, and adjusted risk estimates were calculated. Results: There were a total of 74 T2DM patients, of whom 45 (60.8%) were cases and 29 (39.2%) were controls. Sulfonylureas (adjusted odds ratio [aOR] = 0.164, P = 0.004) and insulin (aOR = 0.248, P = 0.042) showed a significant protective effect on bone health. Biguanides (OR = 1.994, P = 0.029) and thiazolidinediones (OR: 5.444, P = 0.033), which demonstrated that an increased risk of osteoporosis in univariate analysis became insignificant after multivariate analysis. Conclusion: Sulfonylureas and insulin through the insulin osteocalcin pathway show favorable effect on bone health, but the probability of increased fractures secondary to hypoglycemic falls should be borne in mind. We recommend larger prospective studies to confirm this association.
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Affiliation(s)
- Jeffrey Pradeep Raj
- Department of Pharmacology, St. John's Medical College, Bengaluru, Karnataka, India
| | | | - Mahesh Shekoba
- Department of Orthopaedics, St. John's Medical College, Bengaluru, Karnataka, India
| | | | - Rajkumar S Amaravati
- Department of Orthopaedics, St. John's Medical College, Bengaluru, Karnataka, India
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17
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Al-Osami MH, Hameed EK. Serum adiponectin level in osteoporotic postmenopausal women with type 2 diabetes mellitus. Diabetes Metab Syndr 2018; 12:939-942. [PMID: 29853264 DOI: 10.1016/j.dsx.2018.05.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 05/21/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND Diabetes Mellitus (DM) is a major health burden worldwide. Patients with type 2 DM has various complications, including impaired bone health. Adiponectin is novel adipocytokine that could influence bone metabolism. OBJECTIVE We investigated the relationships between serum adiponectin versus lumbar bone mineral density (BMD) in type 2 diabetic osteoporotic postmenopausal women. SUBJECTS AND METHODS This study is a case control study included 90 postmenopausal women; divided as (group A) composed of 30 type 2 diabetic osteoporotic postmenapausal,(group B) composed of 30 non diabetic osteoporotic postmenopausal and 30 apparently healthy non osteoporotic postmenopausal women as a control group. All participants underwent Dual Energy X-ray Absorptiometry to measure the lumbar Bone Mineral Density (BMD).Serum adiponectin was measured by ELISA Kits. SPSS was used to analyze the data. RESULTS Among the studied subjects, group B showed a significant negative correlation between serum adiponectin and lumbar BMD. The diabetic osteoporotic postmenapausal group (group B) showed the lowest concentration of serum adiponectin (μg/mL): 5.14 compared with 11.02 and 8.63 in group A, and the control, respectively. Lumbar BMD of group B was significantly higher than that of group A. CONCLUSIONS Serum adiponectin is associated with lumber BMD in diabetic osteoporotic postmenopausal women. These findings suggest that serum adiponectin was involved in bone metabolism in this group.
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Affiliation(s)
- Mohammed Hadi Al-Osami
- Rheumtology and Medical rehabilitation unit, department of Medicine, College of Medicine-University of Baghdad, Baghdad, Iraq
| | - Ekhlas Khalid Hameed
- The Clinical Biochemistry department, Al-Kindy college of Medicine, University of Baghdad, Baghdad, Iraq.
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18
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Abstract
Accumulating evidence has shown that the risk of osteoporotic fractures is increased in patients with diabetes mellitus (DM). Thus, DM-induced bone fragility has been recently recognized as a diabetic complication. Because the fracture risk is independent of the reduction in bone mineral density, deterioration of the bone quality may be the main cause of bone fragility. Although its mechanism remains poorly understood, accumulated collagen cross-links of advanced glycation end-products (AGEs) and dysfunctions of osteoblast and osteocyte may be involved. Previous studies have suggested that various diabetes-related factors, such as chronic hyperglycemia, insulin, insulin-like growth factor-I, AGEs, and homocysteine, are associated with the risk of bone fragility caused by impaired bone formation and bone remodeling. Furthermore, several anti-diabetic drugs are known to affect bone metabolism and fracture risk. We herein review the association between DM and fracture risk as well as the mechanism of DM-induced bone fragility based on recent evidence.
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Affiliation(s)
- Ippei Kanazawa
- Internal Medicine 1, Shimane University Faculty of Medicine, Japan
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19
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Carnagarin R, Elahy M, Dharmarajan AM, Dass CR. Insulin antagonises pigment epithelium-derived factor (PEDF)-induced modulation of lineage commitment of myocytes and heterotrophic ossification. Mol Cell Endocrinol 2018; 472:159-166. [PMID: 29258756 DOI: 10.1016/j.mce.2017.12.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 11/07/2017] [Accepted: 12/15/2017] [Indexed: 12/13/2022]
Abstract
Extensive bone defects arising as a result of trauma, infection and tumour resection and other bone pathologies necessitates the identification of effective strategies in the form of tissue engineering, gene therapy and osteoinductive agents to enhance the bone repair process. PEDF is a multifunctional glycoprotein which plays an important role in regulating osteoblastic differentiation and bone formation. PEDF treatment of mice and human skeletal myocytes at physiological concentration inhibited myogenic differentiation and activated Erk1/2 MAPK- dependent osteogenic transdifferentiation of myocytes. In mice, insulin, a promoter of bone regeneration, attenuated PEDF-induced expression of osteogenic markers such as osteocalcin, alkaline phosphatase and mineralisation for bone formation in the muscle and surrounding adipose tissue. These results provide new insights into the molecular aspects of the antagonising effect of insulin on PEDF-dependent modulation of the differentiation commitment of musculoskeletal environment into osteogenesis, and suggest that PEDF may be developed as an effective clinical therapy for bone regeneration as its heterotopic ossification can be controlled via co-administration of insulin.
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Affiliation(s)
- Revathy Carnagarin
- Curtin Health Innovation Research Institute, Bentley, 6102, Australia; School of Pharmacy, Curtin University, Bentley, 6102, Australia; School of Biomedical Sciences, Curtin University, Bentley, 6102, Australia; Stem Cell and Cancer Biology Laboratory, School of Biomedical Sciences, Curtin University, Bentley, 6102, Australia
| | - Mina Elahy
- Curtin Health Innovation Research Institute, Bentley, 6102, Australia; School of Biomedical Sciences, Curtin University, Bentley, 6102, Australia
| | - Arun M Dharmarajan
- Curtin Health Innovation Research Institute, Bentley, 6102, Australia; Stem Cell and Cancer Biology Laboratory, School of Biomedical Sciences, Curtin University, Bentley, 6102, Australia
| | - Crispin R Dass
- Curtin Health Innovation Research Institute, Bentley, 6102, Australia; School of Pharmacy, Curtin University, Bentley, 6102, Australia.
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20
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Wang X, Zhang G, Qi F, Cheng Y, Lu X, Wang L, Zhao J, Zhao B. Enhanced bone regeneration using an insulin-loaded nano-hydroxyapatite/collagen/PLGA composite scaffold. Int J Nanomedicine 2017; 13:117-127. [PMID: 29317820 PMCID: PMC5743129 DOI: 10.2147/ijn.s150818] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Insulin is widely considered as a classical hormone and drug in maintaining energy and glucose homeostasis. Recently, insulin has been increasingly recognized as an indispensable factor for osteogenesis and bone turnover, but its applications in bone regeneration have been restricted because of the short periods of activity and uncontrolled release. In this study, we incorporated insulin-loaded poly lactic-co-glycolic-acid (PLGA) nanospheres into nano-hydroxyapatite/collagen (nHAC) scaffolds and investigated the bioactivity of the composite scaffolds in vitro and in vivo. Bioactive insulin was successfully released from the nanospheres within the scaffold, and the release kinetics of insulin could be efficiently controlled by uniform-sized nanospheres. The physical characterizations of the composite scaffolds demonstrated that incorporation of nanospheres in nHAC scaffolds using this method did not significantly change the porosity, pore diameters, and compressive strengths of nHAC. In vitro, the insulin-loaded nHAC/PLGA composite scaffolds possessed favorable biological function for bone marrow mesenchymal stem cells adhesion and proliferation, as well as the differentiation into osteoblasts. In vivo, the optimized bone regenerative capability of this composite scaffold was confirmed in rabbit mandible critical size defects. These results demonstrated successful development of a functional insulin-PLGA-nHAC composite scaffold that enhances the bone regeneration capability of nHAC.
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Affiliation(s)
- Xing Wang
- Shanxi Medical University Stomatological Hospital, Taiyuan
| | - Guilan Zhang
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Feng Qi
- Department of Mechanical and Aerospace Engineering, University of Missouri, Columbia, MO, USA
| | - Yongfeng Cheng
- Shanxi Medical University Stomatological Hospital, Taiyuan
| | - Xuguang Lu
- Shanxi Medical University Stomatological Hospital, Taiyuan
| | - Lu Wang
- Shanxi Medical University Stomatological Hospital, Taiyuan
| | - Jing Zhao
- Shanxi Medical University Stomatological Hospital, Taiyuan
| | - Bin Zhao
- Shanxi Medical University Stomatological Hospital, Taiyuan
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21
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Abstract
Accumulating evidence has shown that bone and glucose metabolism are closely associated with each other. Since the risk of osteoporotic fractures is increased in patients with diabetes mellitus (DM), osteoporosis is recently recognized as one of diabetic complications, called DM-induced bone fragility. Previous studies showed that collagen cross-links of advanced glycation end products (AGEs) and dysfunctions of osteoblast and osteocyte are involved in DM-induced bone fragility. Circulating levels of AGEs and homocysteine are increased in patients with DM, and they directly impair the functions of osteoblast and osteocyte, resulting in decreased bone formation and bone remodeling. On the other hand, bone is recently recognized as an endocrine organ. Previous studies based on in vitro and animal studies showed that osteocalcin, which is specifically expressed in osteoblasts and secreted into the circulation, may regulate glucose homeostasis. Although several clinical studies reported the relationship between osteocalcin and glucose metabolism, further large-scale and intervention studies are necessary to confirm the beneficial effects of osteocalcin on glucose metabolism in human. It has been shown that adenosine monophosphate-activated protein kinase (AMPK), an intracellular energy sensor, is involved in bone metabolism. Adiponectin and metformin stimulate osteocalcin expression and the differentiation of osteoblasts via AMPK activation. Also, AMPK activation protects against oxidative stress-induced apoptosis of osteocytes. These findings suggest that AMPK in osteoblasts and osteocytes may be a therapeutic target for DM-induced bone fragility.
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Affiliation(s)
- Ippei Kanazawa
- Internal Medicine 1, Shimane University Faculty of Medicine, Izumo 693-8501, Japan
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Tangseefa P, Martin SK, Fitter S, Baldock PA, Proud CG, Zannettino ACW. Osteocalcin-dependent regulation of glucose metabolism and fertility: Skeletal implications for the development of insulin resistance. J Cell Physiol 2017; 233:3769-3783. [PMID: 28834550 DOI: 10.1002/jcp.26163] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Accepted: 08/22/2017] [Indexed: 01/22/2023]
Abstract
The skeleton has recently emerged as a critical insulin target tissue that regulates whole body glucose metabolism and male reproductive function. While our understanding of these new regulatory axes remains in its infancy, the bone-specific protein, osteocalcin, has been shown to be centrally involved. Undercarboxylated osteocalcin acts as a secretagogue in a feed-forward loop to stimulate pancreatic β-cell proliferation and insulin secretion, improve insulin sensitivity, and promote testosterone production. Importantly, dysregulation of insulin signaling in bone causes a reduction in serum osteocalcin levels that is associated with elevated blood glucose and reduced serum insulin levels, suggesting that the skeleton may play a significant role in the development of diet-induced insulin resistance. Insulin signaling is negatively regulated by the mammalian target of rapamycin complex 1 (mTORC1) which becomes hyper-activated in response to nutrient overload. Loss- and gain-of function models suggest that mTORC1 function in bone is essential for normal skeletal development; however, the role of this complex in the regulation of glucose metabolism remains to be determined. This review highlights our current understanding of the role played by osteocalcin in the skeletal regulation of glucose metabolism and fertility. In particular, it examines data emerging from transgenic mouse models which have revealed a pancreas-bone-testis regulatory axis and discusses recent human studies which seek to corroborate findings from mouse models with clinical observations. Moreover, we review recent studies which suggest dysregulation of insulin signaling in bone leads to the development of insulin resistance and discuss the potential role of mTORC1 signaling in this process.
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Affiliation(s)
- Pawanrat Tangseefa
- Faculty of Health and Medical Science, Myeloma Research Laboratory, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
- Cancer Theme, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Sally K Martin
- Faculty of Health and Medical Science, Myeloma Research Laboratory, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
- Cancer Theme, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Stephen Fitter
- Faculty of Health and Medical Science, Myeloma Research Laboratory, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
- Cancer Theme, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Paul A Baldock
- Skeletal Metabolism Group, Garvan Institute of Medical Research, Sydney, New South Wales, Australia
| | - Christopher G Proud
- Nutrition & Metabolism, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- School of Biological Sciences, University of Adelaide, Adelaide, South Australia, Australia
- Department of Biochemistry and Genetics, School of Medicine, Zhejiang University, Hangzhou, China
| | - Andrew C W Zannettino
- Faculty of Health and Medical Science, Myeloma Research Laboratory, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
- Cancer Theme, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
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Wongwitwichot P, Kaewsrichan J. Osteogenic differentiation of mesenchymal stem cells is impaired by bone morphogenetic protein 7. Adv Med Sci 2017; 62:266-272. [PMID: 28501726 DOI: 10.1016/j.advms.2016.12.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2016] [Revised: 11/06/2016] [Accepted: 12/11/2016] [Indexed: 10/19/2022]
Abstract
PURPOSE Mesenchymal stem cells (MSCs) are multipotent adult stem cells and present in practically all tissues but originally identified within the bone marrow (BM). The differentiation potential of these cells is generally impaired when culturing in vitro for cell expansion. The aim of this study is to speedily increase the numbers of bone marrow derived mesenchymal stem cells (BM-MSCs) with substantially maintaining their differentiation potential in vitro and improving bone formation in vivo. MATERIALS AND METHODS BM-MSCs isolated from rats were sequentially cultured in α-MEM containing basic fibroblast growth factor (FGF2) and/or insulin to stimulate proliferation and osteogenic commitment, and in the medium with the addition of bone morphogenetic protein 2 (BMP2) and/or bone morphogenetic protein 7 (BMP7) to arouse differentiation. The expression of genes markedly associating the commitment and differentiation were investigated in vitro using real-time PCR technique and mineralization assay, while the capacity of inducing bone formation by the established conditions was determined in vivo using a rat model. RESULTS The BM-MSCs greatly proliferated with active transcription of runx2 and osterix genes when induced by FGF2 and insulin. The in vitro mineralization was enhanced by BMP2, but the extent was diminished when BMP2 was replaced or supplemented by BMP7. Formation of new small blood vessels was notably detected when the cells were respectively challenged by FGF2 plus insulin and BMP2. CONCLUSION These data are valuable in choosing growth factors for proper bone repair. However, optimization of the established system would be essential when the cells of human source are applied.
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Papageorgiou M, Dolan E, Elliott-Sale KJ, Sale C. Reduced energy availability: implications for bone health in physically active populations. Eur J Nutr 2017; 57:847-859. [PMID: 28721562 PMCID: PMC5861178 DOI: 10.1007/s00394-017-1498-8] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 07/03/2017] [Indexed: 01/17/2023]
Abstract
Purpose The present review critically evaluates existing literature on the effects of short- and long-term low energy availability (EA) on bone metabolism and health in physically active individuals. Methods We reviewed the literature on the short-term effects of low EA on markers of bone metabolism and the long-term effects of low EA on outcomes relating to bone health (bone mass, microarchitecture and strength, bone metabolic markers and stress fracture injury risk) in physically active individuals. Results Available evidence indicates that short-term low EA may increase markers of bone resorption and decrease markers of bone formation in physically active women. Bone metabolic marker responses to low EA are less well known in physically active men. Cross-sectional studies investigating the effects of long-term low EA suggest that physically active individuals who have low EA present with lower bone mass, altered bone metabolism (favouring bone resorption), reduced bone strength and increased risk for stress fracture injuries. Conclusions Reduced EA has a negative influence on bone in both the short- and long-term, and every effort should be made to reduce its occurrence in physically active individuals. Future interventions are needed to explore the effects of long-term reduced EA on bone health outcomes, while short-term low EA studies are also required to give insight into the pathophysiology of bone alterations.
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Affiliation(s)
- Maria Papageorgiou
- Musculoskeletal Physiology Research Group, Sport, Health and Performance Enhancement Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, NG11 8NS UK
| | - Eimear Dolan
- Applied Physiology and Nutrition Research Group, University of Sao Paulo, São Paulo, Brazil
| | - Kirsty J. Elliott-Sale
- Musculoskeletal Physiology Research Group, Sport, Health and Performance Enhancement Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, NG11 8NS UK
| | - Craig Sale
- Musculoskeletal Physiology Research Group, Sport, Health and Performance Enhancement Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, NG11 8NS UK
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25
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Wang X, Wu X, Xing H, Zhang G, Shi Q, E L, Liu N, Yang T, Wang D, Qi F, Wang L, Liu H. Porous Nanohydroxyapatite/Collagen Scaffolds Loading Insulin PLGA Particles for Restoration of Critical Size Bone Defect. ACS APPLIED MATERIALS & INTERFACES 2017; 9:11380-11391. [PMID: 28256126 DOI: 10.1021/acsami.6b13566] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Insulin is considered to be a classical central regulator of energy homeostasis. Recently, the effect of insulin on bone has gained a lot of attention, but little attention has been paid to the application in bone tissue engineering. In this study, porous nanohydroxyapatite/collagen (nHAC) scaffolds incorporating poly lactic-co-glycolic acid (PLGA) particles were successfully developed as an insulin delivery platform for bone regeneration. Bioactive insulin was successfully released from the PLGA particles within the scaffold, and the size of the particles as well as the release kinetics of the insulin could be efficiently controlled through Shirasu porous glass premix membrane emulsification technology. It was indicated that the nHAC/PLGA composite scaffolds possessed favorable mechanical and structural properties for cell adhesion and proliferation, as well as the differentiation into osteoblasts. It was also demonstrated that the nHAC/PLGA scaffolds implanted into a rabbit critical-size mandible defect possessed tissue compatibility and higher bone restoration capacity compared with the defects that were filled with or without nHAC scaffolds. Furthermore, the in vivo results showed that the nHAC/PLGA scaffolds which incorporated insulin-loaded microspheres with a size of 1.61 μm significantly accelerated bone healing compared with two other composite scaffolds. Our study indicated that the local insulin released at the optimal time could substantially and reproducibly improve bone repair.
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Affiliation(s)
- Xing Wang
- Institute of Stomatology, Chinese PLA General Hospital , Beijing 100853, China
- Hospital of Stomatology, Shanxi Medical University , Taiyuan, 030001, China
| | - Xia Wu
- Institute of Stomatology, Chinese PLA General Hospital , Beijing 100853, China
| | - Helin Xing
- Institute of Stomatology, Chinese PLA General Hospital , Beijing 100853, China
| | - Guilan Zhang
- Institute of Stomatology, Chinese PLA General Hospital , Beijing 100853, China
| | - Quan Shi
- Institute of Stomatology, Chinese PLA General Hospital , Beijing 100853, China
| | - Lingling E
- Institute of Stomatology, Chinese PLA General Hospital , Beijing 100853, China
| | - Na Liu
- Institute of Stomatology, Chinese PLA General Hospital , Beijing 100853, China
| | - Tingyuan Yang
- National Key Laboratory of Biochemical Engineering, Institute of Process Engineering, Chinese Academy of Sciences , Beijing, 100190, China
| | - Dongsheng Wang
- Institute of Stomatology, Chinese PLA General Hospital , Beijing 100853, China
| | - Feng Qi
- National Key Laboratory of Biochemical Engineering, Institute of Process Engineering, Chinese Academy of Sciences , Beijing, 100190, China
| | - Lianyan Wang
- National Key Laboratory of Biochemical Engineering, Institute of Process Engineering, Chinese Academy of Sciences , Beijing, 100190, China
| | - Hongchen Liu
- Institute of Stomatology, Chinese PLA General Hospital , Beijing 100853, China
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26
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Abstract
The rising incidence of metabolic diseases worldwide has prompted renewed interest in the study of intermediary metabolism and cellular bioenergetics. The application of modern biochemical methods for quantitating fuel substrate metabolism with advanced mouse genetic approaches has greatly increased understanding of the mechanisms that integrate energy metabolism in the whole organism. Examination of the intermediary metabolism of skeletal cells has been sparked by a series of unanticipated observations in genetically modified mice that suggest the existence of novel endocrine pathways through which bone cells communicate their energy status to other centers of metabolic control. The recognition of this expanded role of the skeleton has in turn led to new lines of inquiry directed at defining the fuel requirements and bioenergetic properties of bone cells. This article provides a comprehensive review of historical and contemporary studies on the metabolic properties of bone cells and the mechanisms that control energy substrate utilization and bioenergetics. Special attention is devoted to identifying gaps in our current understanding of this new area of skeletal biology that will require additional research to better define the physiological significance of skeletal cell bioenergetics in human health and disease.
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Affiliation(s)
- Ryan C Riddle
- Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, Maryland; and The Baltimore Veterans Administration Medical Center, Baltimore, Maryland
| | - Thomas L Clemens
- Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, Maryland; and The Baltimore Veterans Administration Medical Center, Baltimore, Maryland
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27
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Palermo A, D'Onofrio L, Buzzetti R, Manfrini S, Napoli N. Pathophysiology of Bone Fragility in Patients with Diabetes. Calcif Tissue Int 2017; 100:122-132. [PMID: 28180919 DOI: 10.1007/s00223-016-0226-3] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 12/20/2016] [Indexed: 02/07/2023]
Abstract
It has been well established that bone fragility is one of the chronic complications of diabetes mellitus, and both type 1 and type 2 diabetes are risk factors for fragility fractures. Diabetes may negatively affect bone health by unbalancing several pathways: bone formation, bone resorption, collagen formation, inflammatory cytokine, muscular and incretin system, bone marrow adiposity and calcium metabolism. The purpose of this narrative review is to explore the current understanding of pathophysiological pathways underlying bone fragility in diabetics. In particular, the review will focus on the peculiar cellular and molecular system impairment that may lead to increased risk of fracture in type 1 and type 2 diabetes.
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Affiliation(s)
- Andrea Palermo
- Diabetes and Bone network, Department Endocrinology and Diabetes, University Campus Bio-Medico of Rome, Via Alvaro del Portillo, 21 - 00128, Rome, Italy
| | - Luca D'Onofrio
- Department of Experimental Medicine, Polo Pontino, Sapienza University of Rome, Rome, Italy
| | - Raffaella Buzzetti
- Department of Experimental Medicine, Polo Pontino, Sapienza University of Rome, Rome, Italy
| | - Silvia Manfrini
- Diabetes and Bone network, Department Endocrinology and Diabetes, University Campus Bio-Medico of Rome, Via Alvaro del Portillo, 21 - 00128, Rome, Italy
| | - Nicola Napoli
- Diabetes and Bone network, Department Endocrinology and Diabetes, University Campus Bio-Medico of Rome, Via Alvaro del Portillo, 21 - 00128, Rome, Italy.
- Division of Bone and Mineral Diseases, Washington University in St Louis, St Louis, USA.
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28
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Kalaitzoglou E, Popescu I, Bunn RC, Fowlkes JL, Thrailkill KM. Effects of Type 1 Diabetes on Osteoblasts, Osteocytes, and Osteoclasts. Curr Osteoporos Rep 2016; 14:310-319. [PMID: 27704393 PMCID: PMC5106298 DOI: 10.1007/s11914-016-0329-9] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
PURPOSE OF REVIEW To describe the effects of type 1 diabetes on bone cells. RECENT FINDINGS Type 1 diabetes (T1D) is associated with low bone mineral density, increased risk of fractures, and poor fracture healing. Its effects on the skeleton were primarily attributed to impaired bone formation, but recent data suggests that bone remodeling and resorption are also compromised. The hyperglycemic and inflammatory environment associated with T1D impacts osteoblasts, osteocytes, and osteoclasts. The mechanisms involved are complex; insulinopenia, pro-inflammatory cytokine production, and alterations in gene expression are a few of the contributing factors leading to poor osteoblast activity and survival and, therefore, poor bone formation. In addition, the observed sclerostin level increase accompanied by decreased osteocyte number and enhanced osteoclast activity in T1D results in uncoupling of bone remodeling. T1D negatively impacts osteoblasts and osteocytes, whereas its effects on osteoclasts are not well characterized, although the limited studies available indicate increased osteoclast activity, favoring bone resorption.
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Affiliation(s)
- Evangelia Kalaitzoglou
- UK Barnstable Brown Diabetes Center, University of Kentucky College of Medicine, 830 S. Limestone St., Lexington, KY, 40536, USA.
- Department of Pediatrics, University of Kentucky College of Medicine, Lexington, KY, 40536, USA.
| | - Iuliana Popescu
- UK Barnstable Brown Diabetes Center, University of Kentucky College of Medicine, 830 S. Limestone St., Lexington, KY, 40536, USA
| | - R Clay Bunn
- UK Barnstable Brown Diabetes Center, University of Kentucky College of Medicine, 830 S. Limestone St., Lexington, KY, 40536, USA
- Department of Pediatrics, University of Kentucky College of Medicine, Lexington, KY, 40536, USA
| | - John L Fowlkes
- UK Barnstable Brown Diabetes Center, University of Kentucky College of Medicine, 830 S. Limestone St., Lexington, KY, 40536, USA
- Department of Pediatrics, University of Kentucky College of Medicine, Lexington, KY, 40536, USA
| | - Kathryn M Thrailkill
- UK Barnstable Brown Diabetes Center, University of Kentucky College of Medicine, 830 S. Limestone St., Lexington, KY, 40536, USA
- Department of Pediatrics, University of Kentucky College of Medicine, Lexington, KY, 40536, USA
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29
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Ghodsi M, Larijani B, Keshtkar AA, Nasli-Esfahani E, Alatab S, Mohajeri-Tehrani MR. Mechanisms involved in altered bone metabolism in diabetes: a narrative review. J Diabetes Metab Disord 2016; 15:52. [PMID: 27891497 PMCID: PMC5111345 DOI: 10.1186/s40200-016-0275-1] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 11/01/2016] [Indexed: 02/08/2023]
Abstract
Many studies have shown that change in metabolism caused by diabetes can influence the bone metabolism in a way that quality and strength of bone is decreased. A 6 times and 2 times increased risk of fracture is reported in patients with type 1 and type 2 diabetes, respectively. There are several mechanisms by which diabetes can affect the bone. The fact that some of these mechanisms are acting in opposite ways opens the door for debate on pathways by which diabetes affects the bones. On the other hand, bone is not a simple organ that only get influence from other organs, but it is an endocrine organ that by secreting the agents such as osteocalcin, adiponectin and visfatin which can affect the insulin sensitivity and metabolism. In this paper we tried to briefly assess the latest finding in this matter.
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Affiliation(s)
- Maryam Ghodsi
- Diabetes Research Center (DRC), Endocrinology and Metabolism Research Institute (EMRI), Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center (EMRC), Endocrinology and Metabolism Resarch Institute (EMRI), Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Abbass Ali Keshtkar
- Department of Health Sciences Education Development, School of Public Health (SPH), Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Ensieh Nasli-Esfahani
- Diabetes Research Center (DRC), Endocrinology and Metabolism Research Institute (EMRI), Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Sudabeh Alatab
- Urology Research Center (URC), Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Mohammad Reza Mohajeri-Tehrani
- Endocrinology and Metabolism Research Center (EMRC), Endocrinology and Metabolism Resarch Institute (EMRI), Tehran University of Medical Sciences (TUMS), Tehran, Iran
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30
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Liu Q, Liu H, Yu X, Wang Y, Yang C, Xu H. Analysis of the Role of Insulin Signaling in Bone Turnover Induced by Fluoride. Biol Trace Elem Res 2016; 171:380-390. [PMID: 26521058 DOI: 10.1007/s12011-015-0555-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Accepted: 10/22/2015] [Indexed: 11/25/2022]
Abstract
The role of insulin signaling on the mechanism underlying fluoride induced osteopathology was studied. We analyzed the expression of genes related with bone turnover and insulin signaling in rats treated by varying dose of fluoride with or without streptozotocin (STZ) in vivo. Furthermore, insulin receptor (InR) expression in MC3T3-E1 cells (pre-osteoblast cell line) was interfered with small interfering RNA (siRNA), and genes related with osteoblastic and osteoclastic differentiation were investigated in cells exposed to fluoride in vitro for 2 days. The in vivo study indicated the possible role of insulin in bone lesion induced by excessive amount of fluoride. Fluoride activated the InR and Insulin-like growth factor 1 (IGF1) signaling, which were involved in the mechanism underlying fluoride induced bone turnover. The TGFβ1 and Wnt10/β-catenin pathway took part in the mechanism of bone lesion induced by fluoride, and insulin probably modulated the TGFβ1 and β-catenin to exert action on bone turnover during the development of bone lesion. The in vitro study showed the concomitant decrease of OPG, osterix and OCN with inhibition of InR expression in osteoblast, and three genes still was low in cells co-treated with fluoride and InR siRNA, which suggested that fluoride probably stimulated the expression of OPG, osterix and OCN through InR signaling. In conclusion, insulin played the important role in bone lesion induced by excessive amount of fluoride through mediating InR receptor signaling, and IGF1 signaling probably exerted action on bone turnover caused by overdose of fluoride.
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Affiliation(s)
- Qinyi Liu
- Department of Orthopedics, the Second Clinical Hospital, Jilin University, Changchun, 130041, China
| | - Hui Liu
- College of Basic Medical Sciences, Jilin University, Changchun, 130021, China
| | - Xiuhua Yu
- Department of Pediatrics, The First Clinical Hospital, Jilin University, Changchun, 130021, China
| | - Yan Wang
- School of Pharmaceutical Sciences, Jilin University, 1163 Xinmin Street, Changchun, 130021, People's Republic of China
| | - Chen Yang
- School of Pharmaceutical Sciences, Jilin University, 1163 Xinmin Street, Changchun, 130021, People's Republic of China
| | - Hui Xu
- School of Pharmaceutical Sciences, Jilin University, 1163 Xinmin Street, Changchun, 130021, People's Republic of China.
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31
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Malekzadeh BÖ, Ransjo M, Tengvall P, Mladenovic Z, Westerlund A. Insulin released from titanium discs with insulin coatings-Kinetics and biological activity. J Biomed Mater Res B Appl Biomater 2016; 105:1847-1854. [DOI: 10.1002/jbm.b.33717] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 05/04/2016] [Accepted: 05/09/2016] [Indexed: 02/01/2023]
Affiliation(s)
- B. Ö. Malekzadeh
- Department of Orthodontics; Institute of Odontology, Sahlgrenska Academy, University of Gothenburg; Gothenburg Sweden
- Department of Oral and Maxillofacial Surgery; Mölndal Hospital; Sweden
- Department of Biomaterials; Sahlgrenska Academy, University of Gothenburg; Gothenburg Sweden
| | - M. Ransjo
- Department of Orthodontics; Institute of Odontology, Sahlgrenska Academy, University of Gothenburg; Gothenburg Sweden
| | - P. Tengvall
- Department of Biomaterials; Sahlgrenska Academy, University of Gothenburg; Gothenburg Sweden
| | - Z. Mladenovic
- Department of Orthodontics; Institute of Odontology, Sahlgrenska Academy, University of Gothenburg; Gothenburg Sweden
| | - A. Westerlund
- Department of Orthodontics; Institute of Odontology, Sahlgrenska Academy, University of Gothenburg; Gothenburg Sweden
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32
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Potikanond S, Rattanachote P, Pintana H, Suntornsaratoon P, Charoenphandhu N, Chattipakorn N, Chattipakorn S. Obesity does not aggravate osteoporosis or osteoblastic insulin resistance in orchiectomized rats. J Endocrinol 2016; 228:85-95. [PMID: 26675491 DOI: 10.1530/joe-15-0333] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/13/2015] [Indexed: 01/03/2023]
Abstract
The present study aimed to test the hypothesis that testosterone deprivation impairs osteoblastic insulin signaling, decreases osteoblast survival, reduces bone density, and that obesity aggravates those deleterious effects in testosterone-deprived rats. Twenty four male Wistar rats underwent either a bilateral orchiectomy (O, n=12) or a sham operation (S, n=12). Then the rats in each group were further divided into two subgroups fed with either a normal diet (ND) or a high-fat diet (HF) for 12 weeks. At the end of the protocol, blood samples were collected to determine metabolic parameters and osteocalcin ratios. The tibiae were collected to determine bone mass using microcomputed tomography and for osteoblast isolation. The results showed that rats fed with HF (sham-operated HF-fed rats (HFS) and ORX HF-fed rats (HFO)) developed peripheral insulin resistance and had decreased trabecular bone density. In ND-fed rats, only the ORX ND-fed rats (NDO) group had decreased trabecular bone density. In addition, osteoblastic insulin resistance, as indicated by a decrease in tyrosine phosphorylation of the insulin receptor and Akt, were observed in all groups except the sham-operated ND-fed rats (NDS) rats. Those groups, again with the exception of the NDS rats, also had decreased osteoblastic survival. No differences in the levels of osteoblastic insulin resistance and osteoblastic survival were found among the NDO, HFS, and HFO groups. These findings suggest that either testosterone deprivation or obesity alone can impair osteoblastic insulin signaling and decrease osteoblastic survival leading to the development of osteoporosis. However, obesity does not aggravate those deleterious effects in the bone of testosterone-deprived rats.
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Affiliation(s)
- Saranyapin Potikanond
- Department of PharmacologyFaculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Pinyada Rattanachote
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Hiranya Pintana
- Center of Calcium and Bone Research (COCAB)Faculty of Science, Mahidol University, Bangkok, Thailand
| | | | - Narattaphol Charoenphandhu
- Cardiac Electrophysiology Unit Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Nipon Chattipakorn
- Center of Excellence in Cardiac Electrophysiology ResearchChiang Mai University, Chiang Mai, Thailand
| | - Siriporn Chattipakorn
- Department of Oral Biology and Diagnostic SciencesFaculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
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33
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Kanazawa I. Osteocalcin as a hormone regulating glucose metabolism. World J Diabetes 2015; 6:1345-1354. [PMID: 26722618 PMCID: PMC4689779 DOI: 10.4239/wjd.v6.i18.1345] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Revised: 10/23/2015] [Accepted: 12/02/2015] [Indexed: 02/05/2023] Open
Abstract
The number of patients with osteoporosis and diabetes is rapidly increasing all over the world. Bone is recently recognized as an endocrine organ. Accumulating evidence has shown that osteocalcin, which is specifically expressed in osteoblasts and secreted into the circulation, regulates glucose homeostasis by stimulating insulin expression in pancreas and adiponectin expression in adipocytes, resulting in improving glucose intolerance. On the other hand, insulin and adiponectin stimulate osteocalcin expression in osteoblasts, suggesting that positive feedforward loops exist among bone, pancreas, and adipose tissue. In addition, recent studies have shown that osteocalcin enhances insulin sensitivity and the differentiation in muscle, while secreted factors from muscle, myokines, regulate bone metabolism. These findings suggest that bone metabolism and glucose metabolism are associated with each other through the action of osteocalcin. In this review, I describe the role of osteocalcin in the interaction among bone, pancreas, brain, adipose tissue, and muscle.
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34
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Ivaska KK, Heliövaara MK, Ebeling P, Bucci M, Huovinen V, Väänänen HK, Nuutila P, Koistinen HA. The effects of acute hyperinsulinemia on bone metabolism. Endocr Connect 2015; 4:155-62. [PMID: 26047829 PMCID: PMC4496528 DOI: 10.1530/ec-15-0022] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Accepted: 06/05/2015] [Indexed: 12/20/2022]
Abstract
Insulin signaling in bone-forming osteoblasts stimulates bone formation and promotes the release of osteocalcin (OC) in mice. Only a few studies have assessed the direct effect of insulin on bone metabolism in humans. Here, we studied markers of bone metabolism in response to acute hyperinsulinemia in men and women. Thirty-three subjects from three separate cohorts (n=8, n=12 and n=13) participated in a euglycaemic hyperinsulinemic clamp study. Blood samples were collected before and at the end of infusions to determine the markers of bone formation (PINP, total OC, uncarboxylated form of OC (ucOC)) and resorption (CTX, TRAcP5b). During 4 h insulin infusion (40 mU/m(2) per min, low insulin), CTX level decreased by 11% (P<0.05). High insulin infusion rate (72 mU/m(2) per min) for 4 h resulted in more pronounced decrease (-32%, P<0.01) whereas shorter insulin exposure (40 mU/m(2) per min for 2 h) had no effect (P=0.61). Markers of osteoblast activity remained unchanged during 4 h insulin, but the ratio of uncarboxylated-to-total OC decreased in response to insulin (P<0.05 and P<0.01 for low and high insulin for 4 h respectively). During 2 h low insulin infusion, both total OC and ucOC decreased significantly (P<0.01 for both). In conclusion, insulin decreases bone resorption and circulating levels of total OC and ucOC. Insulin has direct effects on bone metabolism in humans and changes in the circulating levels of bone markers can be seen within a few hours after administration of insulin.
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Affiliation(s)
- Kaisa K Ivaska
- Department of Cell Biology and AnatomyInstitute of Biomedicine, University of Turku, FI-20520 Turku, FinlandDepartment of MedicineUniversity of Helsinki and Helsinki University Central Hospital, Helsinki, FinlandTurku PET CentreUniversity of Turku, Turku, FinlandDepartment of RadiologyUniversity of Turku, Turku, FinlandMedical Imaging Centre of Southwest FinlandTurku University Hospital, Turku, FinlandDepartment of EndocrinologyTurku University Hospital, Turku, FinlandAbdominal Center: EndocrinologyUniversity of Helsinki and Helsinki University Central Hospital, Helsinki, FinlandMinerva Foundation Institute for Medical ResearchHelsinki, Finland
| | - Maikki K Heliövaara
- Department of Cell Biology and AnatomyInstitute of Biomedicine, University of Turku, FI-20520 Turku, FinlandDepartment of MedicineUniversity of Helsinki and Helsinki University Central Hospital, Helsinki, FinlandTurku PET CentreUniversity of Turku, Turku, FinlandDepartment of RadiologyUniversity of Turku, Turku, FinlandMedical Imaging Centre of Southwest FinlandTurku University Hospital, Turku, FinlandDepartment of EndocrinologyTurku University Hospital, Turku, FinlandAbdominal Center: EndocrinologyUniversity of Helsinki and Helsinki University Central Hospital, Helsinki, FinlandMinerva Foundation Institute for Medical ResearchHelsinki, Finland
| | - Pertti Ebeling
- Department of Cell Biology and AnatomyInstitute of Biomedicine, University of Turku, FI-20520 Turku, FinlandDepartment of MedicineUniversity of Helsinki and Helsinki University Central Hospital, Helsinki, FinlandTurku PET CentreUniversity of Turku, Turku, FinlandDepartment of RadiologyUniversity of Turku, Turku, FinlandMedical Imaging Centre of Southwest FinlandTurku University Hospital, Turku, FinlandDepartment of EndocrinologyTurku University Hospital, Turku, FinlandAbdominal Center: EndocrinologyUniversity of Helsinki and Helsinki University Central Hospital, Helsinki, FinlandMinerva Foundation Institute for Medical ResearchHelsinki, Finland
| | - Marco Bucci
- Department of Cell Biology and AnatomyInstitute of Biomedicine, University of Turku, FI-20520 Turku, FinlandDepartment of MedicineUniversity of Helsinki and Helsinki University Central Hospital, Helsinki, FinlandTurku PET CentreUniversity of Turku, Turku, FinlandDepartment of RadiologyUniversity of Turku, Turku, FinlandMedical Imaging Centre of Southwest FinlandTurku University Hospital, Turku, FinlandDepartment of EndocrinologyTurku University Hospital, Turku, FinlandAbdominal Center: EndocrinologyUniversity of Helsinki and Helsinki University Central Hospital, Helsinki, FinlandMinerva Foundation Institute for Medical ResearchHelsinki, Finland
| | - Ville Huovinen
- Department of Cell Biology and AnatomyInstitute of Biomedicine, University of Turku, FI-20520 Turku, FinlandDepartment of MedicineUniversity of Helsinki and Helsinki University Central Hospital, Helsinki, FinlandTurku PET CentreUniversity of Turku, Turku, FinlandDepartment of RadiologyUniversity of Turku, Turku, FinlandMedical Imaging Centre of Southwest FinlandTurku University Hospital, Turku, FinlandDepartment of EndocrinologyTurku University Hospital, Turku, FinlandAbdominal Center: EndocrinologyUniversity of Helsinki and Helsinki University Central Hospital, Helsinki, FinlandMinerva Foundation Institute for Medical ResearchHelsinki, Finland Department of Cell Biology and AnatomyInstitute of Biomedicine, University of Turku, FI-20520 Turku, FinlandDepartment of MedicineUniversity of Helsinki and Helsinki University Central Hospital, Helsinki, FinlandTurku PET CentreUniversity of Turku, Turku, FinlandDepartment of RadiologyUniversity of Turku, Turku, FinlandMedical Imaging Centre of Southwest FinlandTurku University Hospital, Turku, FinlandDepartment of EndocrinologyTurku University Hospital, Turku, FinlandAbdominal Center: EndocrinologyUniversity of Helsinki and Helsinki University Central Hospital, Helsinki, FinlandMinerva Foundation Institute for Medical ResearchHelsinki, Finland Department of Cell Biology and AnatomyInstitute of Biomedicine, University of Turku, FI-20520 Turku, FinlandDepartment of MedicineUniversity of Helsinki and Helsinki University Central Hospital, Helsinki, FinlandTurku PET CentreUniversity of Turku, Turku, FinlandDepartment of RadiologyUniversity of Turku, Turku, FinlandMedical Imaging Centre of Southwest FinlandTurku University Hospital, Turku, FinlandDepartment of EndocrinologyTurku University Hospital, Turku, FinlandAbdominal Center: EndocrinologyUniversity of Helsinki and Helsinki University Central Hospital, Helsinki, FinlandMinerva Foundation Institute for Medical ResearchHelsinki, Finland
| | - H Kalervo Väänänen
- Department of Cell Biology and AnatomyInstitute of Biomedicine, University of Turku, FI-20520 Turku, FinlandDepartment of MedicineUniversity of Helsinki and Helsinki University Central Hospital, Helsinki, FinlandTurku PET CentreUniversity of Turku, Turku, FinlandDepartment of RadiologyUniversity of Turku, Turku, FinlandMedical Imaging Centre of Southwest FinlandTurku University Hospital, Turku, FinlandDepartment of EndocrinologyTurku University Hospital, Turku, FinlandAbdominal Center: EndocrinologyUniversity of Helsinki and Helsinki University Central Hospital, Helsinki, FinlandMinerva Foundation Institute for Medical ResearchHelsinki, Finland
| | - Pirjo Nuutila
- Department of Cell Biology and AnatomyInstitute of Biomedicine, University of Turku, FI-20520 Turku, FinlandDepartment of MedicineUniversity of Helsinki and Helsinki University Central Hospital, Helsinki, FinlandTurku PET CentreUniversity of Turku, Turku, FinlandDepartment of RadiologyUniversity of Turku, Turku, FinlandMedical Imaging Centre of Southwest FinlandTurku University Hospital, Turku, FinlandDepartment of EndocrinologyTurku University Hospital, Turku, FinlandAbdominal Center: EndocrinologyUniversity of Helsinki and Helsinki University Central Hospital, Helsinki, FinlandMinerva Foundation Institute for Medical ResearchHelsinki, Finland Department of Cell Biology and AnatomyInstitute of Biomedicine, University of Turku, FI-20520 Turku, FinlandDepartment of MedicineUniversity of Helsinki and Helsinki University Central Hospital, Helsinki, FinlandTurku PET CentreUniversity of Turku, Turku, FinlandDepartment of RadiologyUniversity of Turku, Turku, FinlandMedical Imaging Centre of Southwest FinlandTurku University Hospital, Turku, FinlandDepartment of EndocrinologyTurku University Hospital, Turku, FinlandAbdominal Center: EndocrinologyUniversity of Helsinki and Helsinki University Central Hospital, Helsinki, FinlandMinerva Foundation Institute for Medical ResearchHelsinki, Finland
| | - Heikki A Koistinen
- Department of Cell Biology and AnatomyInstitute of Biomedicine, University of Turku, FI-20520 Turku, FinlandDepartment of MedicineUniversity of Helsinki and Helsinki University Central Hospital, Helsinki, FinlandTurku PET CentreUniversity of Turku, Turku, FinlandDepartment of RadiologyUniversity of Turku, Turku, FinlandMedical Imaging Centre of Southwest FinlandTurku University Hospital, Turku, FinlandDepartment of EndocrinologyTurku University Hospital, Turku, FinlandAbdominal Center: EndocrinologyUniversity of Helsinki and Helsinki University Central Hospital, Helsinki, FinlandMinerva Foundation Institute for Medical ResearchHelsinki, Finland Department of Cell Biology and AnatomyInstitute of Biomedicine, University of Turku, FI-20520 Turku, FinlandDepartment of MedicineUniversity of Helsinki and Helsinki University Central Hospital, Helsinki, FinlandTurku PET CentreUniversity of Turku, Turku, FinlandDepartment of RadiologyUniversity of Turku, Turku, FinlandMedical Imaging Centre of Southwest FinlandTurku University Hospital, Turku, FinlandDepartment of EndocrinologyTurku University Hospital, Turku, FinlandAbdominal Center: EndocrinologyUniversity of Helsinki and Helsinki University Central Hospital, Helsinki, FinlandMinerva Foundation Institute for Medical ResearchHelsinki, Finland
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Davenport C, Mahmood WA, Forde H, Ashley DT, Agha A, McDermott J, Sreenan S, Thompson CJ, McGrath F, McAdam B, Cummins PM, Smith D. The effects of insulin and liraglutide on osteoprotegerin and vascular calcification in vitro and in patients with type 2 diabetes. Eur J Endocrinol 2015; 173:53-61. [PMID: 26036811 DOI: 10.1530/eje-14-1137] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Vascular calcification (VC) is inhibited by the glycoprotein osteoprotegerin (OPG). It is unclear whether treatments for type 2 diabetes are capable of promoting or inhibiting VC. The present study examined the effects of insulin and liraglutide on i) the production of OPG and ii) the emergence of VC, both in vitro in human aortic smooth muscle cells (HASMCs) and in vivo in type 2 diabetes. DESIGN/METHODS HASMCs were exposed to insulin glargine or liraglutide, after which OPG production, alkaline phosphatase (ALP) activity and levels of Runx2, ALP and bone sialoprotein (BSP) mRNA were measured. A prospective, nonrandomised human subject study was also conducted, in which OPG levels and coronary artery calcification (CAC) were measured in a type 2 diabetes population before and 16 months after the commencement of either insulin or liraglutide treatment and in a control group that took oral hypoglycemics only. RESULTS Exposure to insulin glargine, but not liraglutide, was associated with significantly decreased OPG production (11 913±1409 pg/10(4) cells vs 282±13 pg/10(4) cells, control vs 10 nmol/l insulin, P<0.0001), increased ALP activity (0.82±0.06 IU/10(4) cells vs 2.40±0.16 IU/10(4) cells, control vs 10 nmol/l insulin, P<0.0001) and increased osteogenic gene expression by HASMCs. In the clinical study (n=101), insulin treatment was associated with a significant reduction in OPG levels and, despite not achieving full statistical significance, a trend towards increased CAC in patients. CONCLUSION Exogenous insulin down-regulated OPG in vitro and in vivo and promoted VC in vitro. Although neither insulin nor liraglutide significantly affected CAC in the present pilot study, these data support the establishment of randomised trials to investigate medications and VC in diabetes.
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Affiliation(s)
- Colin Davenport
- Department of Academic EndocrinologyDiabetes Day Centre, Beaumont Hospital, County Dublin, Dublin 9, IrelandDepartment of Diabetes and EndocrinologyConnolly Hospital, Blanchardstown, County Dublin, Dublin 9, IrelandDepartments of RadiologyCardiologyBeaumont Hospital, County Dublin, Dublin 9, IrelandSchool of BiotechnologyCentre for Preventive Medicine, Dublin City University, County Dublin, Dublin 9, Ireland
| | - Wan A Mahmood
- Department of Academic EndocrinologyDiabetes Day Centre, Beaumont Hospital, County Dublin, Dublin 9, IrelandDepartment of Diabetes and EndocrinologyConnolly Hospital, Blanchardstown, County Dublin, Dublin 9, IrelandDepartments of RadiologyCardiologyBeaumont Hospital, County Dublin, Dublin 9, IrelandSchool of BiotechnologyCentre for Preventive Medicine, Dublin City University, County Dublin, Dublin 9, Ireland
| | - Hannah Forde
- Department of Academic EndocrinologyDiabetes Day Centre, Beaumont Hospital, County Dublin, Dublin 9, IrelandDepartment of Diabetes and EndocrinologyConnolly Hospital, Blanchardstown, County Dublin, Dublin 9, IrelandDepartments of RadiologyCardiologyBeaumont Hospital, County Dublin, Dublin 9, IrelandSchool of BiotechnologyCentre for Preventive Medicine, Dublin City University, County Dublin, Dublin 9, Ireland
| | - David T Ashley
- Department of Academic EndocrinologyDiabetes Day Centre, Beaumont Hospital, County Dublin, Dublin 9, IrelandDepartment of Diabetes and EndocrinologyConnolly Hospital, Blanchardstown, County Dublin, Dublin 9, IrelandDepartments of RadiologyCardiologyBeaumont Hospital, County Dublin, Dublin 9, IrelandSchool of BiotechnologyCentre for Preventive Medicine, Dublin City University, County Dublin, Dublin 9, Ireland
| | - Amar Agha
- Department of Academic EndocrinologyDiabetes Day Centre, Beaumont Hospital, County Dublin, Dublin 9, IrelandDepartment of Diabetes and EndocrinologyConnolly Hospital, Blanchardstown, County Dublin, Dublin 9, IrelandDepartments of RadiologyCardiologyBeaumont Hospital, County Dublin, Dublin 9, IrelandSchool of BiotechnologyCentre for Preventive Medicine, Dublin City University, County Dublin, Dublin 9, Ireland
| | - John McDermott
- Department of Academic EndocrinologyDiabetes Day Centre, Beaumont Hospital, County Dublin, Dublin 9, IrelandDepartment of Diabetes and EndocrinologyConnolly Hospital, Blanchardstown, County Dublin, Dublin 9, IrelandDepartments of RadiologyCardiologyBeaumont Hospital, County Dublin, Dublin 9, IrelandSchool of BiotechnologyCentre for Preventive Medicine, Dublin City University, County Dublin, Dublin 9, Ireland
| | - Seamus Sreenan
- Department of Academic EndocrinologyDiabetes Day Centre, Beaumont Hospital, County Dublin, Dublin 9, IrelandDepartment of Diabetes and EndocrinologyConnolly Hospital, Blanchardstown, County Dublin, Dublin 9, IrelandDepartments of RadiologyCardiologyBeaumont Hospital, County Dublin, Dublin 9, IrelandSchool of BiotechnologyCentre for Preventive Medicine, Dublin City University, County Dublin, Dublin 9, Ireland
| | - Christopher J Thompson
- Department of Academic EndocrinologyDiabetes Day Centre, Beaumont Hospital, County Dublin, Dublin 9, IrelandDepartment of Diabetes and EndocrinologyConnolly Hospital, Blanchardstown, County Dublin, Dublin 9, IrelandDepartments of RadiologyCardiologyBeaumont Hospital, County Dublin, Dublin 9, IrelandSchool of BiotechnologyCentre for Preventive Medicine, Dublin City University, County Dublin, Dublin 9, Ireland
| | - Frank McGrath
- Department of Academic EndocrinologyDiabetes Day Centre, Beaumont Hospital, County Dublin, Dublin 9, IrelandDepartment of Diabetes and EndocrinologyConnolly Hospital, Blanchardstown, County Dublin, Dublin 9, IrelandDepartments of RadiologyCardiologyBeaumont Hospital, County Dublin, Dublin 9, IrelandSchool of BiotechnologyCentre for Preventive Medicine, Dublin City University, County Dublin, Dublin 9, Ireland
| | - Brendan McAdam
- Department of Academic EndocrinologyDiabetes Day Centre, Beaumont Hospital, County Dublin, Dublin 9, IrelandDepartment of Diabetes and EndocrinologyConnolly Hospital, Blanchardstown, County Dublin, Dublin 9, IrelandDepartments of RadiologyCardiologyBeaumont Hospital, County Dublin, Dublin 9, IrelandSchool of BiotechnologyCentre for Preventive Medicine, Dublin City University, County Dublin, Dublin 9, Ireland
| | - Philip M Cummins
- Department of Academic EndocrinologyDiabetes Day Centre, Beaumont Hospital, County Dublin, Dublin 9, IrelandDepartment of Diabetes and EndocrinologyConnolly Hospital, Blanchardstown, County Dublin, Dublin 9, IrelandDepartments of RadiologyCardiologyBeaumont Hospital, County Dublin, Dublin 9, IrelandSchool of BiotechnologyCentre for Preventive Medicine, Dublin City University, County Dublin, Dublin 9, Ireland
| | - Diarmuid Smith
- Department of Academic EndocrinologyDiabetes Day Centre, Beaumont Hospital, County Dublin, Dublin 9, IrelandDepartment of Diabetes and EndocrinologyConnolly Hospital, Blanchardstown, County Dublin, Dublin 9, IrelandDepartments of RadiologyCardiologyBeaumont Hospital, County Dublin, Dublin 9, IrelandSchool of BiotechnologyCentre for Preventive Medicine, Dublin City University, County Dublin, Dublin 9, Ireland
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Abstract
Recent developments in endocrinology, made possible by the combination of mouse genetics, integrative physiology and clinical observations have resulted in rapid and unanticipated advances in the field of skeletal biology. Indeed, the skeleton, classically viewed as a structural scaffold necessary for mobility, and regulator of calcium-phosphorus homoeostasis and maintenance of the haematopoietic niche has now been identified as an important regulator of male fertility and whole-body glucose metabolism, in addition to the classical insulin target tissues. These seminal findings confirm bone to be a true endocrine organ. This review is intended to detail the key events commencing from the elucidation of osteocalcin (OC) in bone metabolism to identification of new and emerging candidates that may regulate energy metabolism independently of OC.
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Affiliation(s)
- K J Oldknow
- Developmental BiologyThe Roslin Institute, Edinburgh, UK
| | - V E MacRae
- Developmental BiologyThe Roslin Institute, Edinburgh, UK
| | - C Farquharson
- Developmental BiologyThe Roslin Institute, Edinburgh, UK
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37
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Abstract
Diabetes and osteoporosis are both common diseases with increasing prevalences in the aging population. There is increasing evidence corroborating an association between diabetes mellitus and bone. This review will discuss the disease complications of diabetes on the skeleton, highlighting findings from epidemiological, molecular, and imaging studies in animal models and humans. Compared to control subjects, decreased bone mineral density (BMD) has been observed in type 1 diabetes mellitus, while on average, higher BMD has been found in type 2 diabetes; nonetheless, patients with both types of diabetes are seemingly at increased risk of fractures. Conventional diagnostics such as DXA measurements and the current fracture risk assessment tool (FRAX) risk prediction algorithm for estimating risk of osteoporotic fractures are not sufficient in the case of diabetes. A deterioration in bone microarchitecture and an inefficient distribution of bone mass with insufficiency of repair and adaptation mechanisms appear to be factors of relevance. A highly complex and heterogeneous molecular pathophysiology underlies diabetes-related bone disease, involving hormonal, immune, and perhaps genetic pathways. The detrimental effects of chronically elevated glucose levels on bone should be added to the more well-known complications of diabetes.
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Affiliation(s)
- Ling Oei
- Department of Internal Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Netherlands Genomics Initiative (NGI)-sponsored Netherlands Consortium for Healthy Aging (NCHA), Rotterdam, The Netherlands
- Department of Internal Medicine, IJsselland Hospital, Capelle aan den IJssel, The Netherlands
| | - Fernando Rivadeneira
- Department of Internal Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Netherlands Genomics Initiative (NGI)-sponsored Netherlands Consortium for Healthy Aging (NCHA), Rotterdam, The Netherlands
| | - M. Carola Zillikens
- Department of Internal Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Netherlands Genomics Initiative (NGI)-sponsored Netherlands Consortium for Healthy Aging (NCHA), Rotterdam, The Netherlands
| | - Edwin H. G. Oei
- Department of Radiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
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38
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Wauquier F, Léotoing L, Philippe C, Spilmont M, Coxam V, Wittrant Y. Pros and cons of fatty acids in bone biology. Prog Lipid Res 2015; 58:121-45. [PMID: 25835096 DOI: 10.1016/j.plipres.2015.03.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Revised: 03/06/2015] [Accepted: 03/23/2015] [Indexed: 12/12/2022]
Abstract
Despite the growing interest in deciphering the causes and consequences of obesity-related disorders, the mechanisms linking fat intake to bone behaviour remain unclear. Since bone fractures are widely associated with increased morbidity and mortality, most notably in elderly and obese people, bone health has become a major social and economic issue. Consistently, public health system guidelines have encouraged low-fat diets in order to reduce associated complications. However, from a bone point of view, mechanisms linking fat intake to bone alteration remain quite controversial. Thus, after more than a decade of dedicated studies, this timely review offers a comprehensive overview of the relationships between bone and fatty acids. Using clinical evidences as a starting-point to more complex molecular elucidation, this work highlights the complexity of the system and reveals that bone alteration that cannot be solved simply by taking ω-3 pills. Fatty acid effects on bone metabolism can be both direct and indirect and require integrated investigations. Furthermore, even at the level of a single cell, one fatty acid is able to trigger several different independent pathways (receptors, metabolites…) which may all have a say in the final cellular metabolic response.
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Affiliation(s)
- Fabien Wauquier
- INRA, UMR 1019, UNH, CRNH Auvergne, F-63009 Clermont-Ferrand, France; Clermont Université, Université d'Auvergne, Unité de Nutrition Humaine, BP 10448, F-63000 Clermont-Ferrand, France; Equipe Alimentation, Squelette et Métabolismes, France
| | - Laurent Léotoing
- INRA, UMR 1019, UNH, CRNH Auvergne, F-63009 Clermont-Ferrand, France; Clermont Université, Université d'Auvergne, Unité de Nutrition Humaine, BP 10448, F-63000 Clermont-Ferrand, France; Equipe Alimentation, Squelette et Métabolismes, France
| | - Claire Philippe
- INRA, UMR 1019, UNH, CRNH Auvergne, F-63009 Clermont-Ferrand, France; Clermont Université, Université d'Auvergne, Unité de Nutrition Humaine, BP 10448, F-63000 Clermont-Ferrand, France; Equipe Alimentation, Squelette et Métabolismes, France
| | - Mélanie Spilmont
- INRA, UMR 1019, UNH, CRNH Auvergne, F-63009 Clermont-Ferrand, France; Clermont Université, Université d'Auvergne, Unité de Nutrition Humaine, BP 10448, F-63000 Clermont-Ferrand, France; Equipe Alimentation, Squelette et Métabolismes, France
| | - Véronique Coxam
- INRA, UMR 1019, UNH, CRNH Auvergne, F-63009 Clermont-Ferrand, France; Clermont Université, Université d'Auvergne, Unité de Nutrition Humaine, BP 10448, F-63000 Clermont-Ferrand, France; Equipe Alimentation, Squelette et Métabolismes, France
| | - Yohann Wittrant
- INRA, UMR 1019, UNH, CRNH Auvergne, F-63009 Clermont-Ferrand, France; Clermont Université, Université d'Auvergne, Unité de Nutrition Humaine, BP 10448, F-63000 Clermont-Ferrand, France; Equipe Alimentation, Squelette et Métabolismes, France.
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39
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Faienza MF, Luce V, Ventura A, Colaianni G, Colucci S, Cavallo L, Grano M, Brunetti G. Skeleton and glucose metabolism: a bone-pancreas loop. Int J Endocrinol 2015; 2015:758148. [PMID: 25873957 PMCID: PMC4383460 DOI: 10.1155/2015/758148] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Revised: 11/11/2014] [Accepted: 12/02/2014] [Indexed: 02/06/2023] Open
Abstract
Bone has been considered a structure essential for mobility, calcium homeostasis, and hematopoietic function. Recent advances in bone biology have highlighted the importance of skeleton as an endocrine organ which regulates some metabolic pathways, in particular, insulin signaling and glucose tolerance. This review will point out the role of bone as an endocrine "gland" and, specifically, of bone-specific proteins, as the osteocalcin (Ocn), and proteins involved in bone remodeling, as osteoprotegerin, in the regulation of insulin function and glucose metabolism.
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Affiliation(s)
- Maria Felicia Faienza
- Section of Pediatrics, Department of Biomedical Sciences and Human Oncology, University of Bari “A. Moro”, 70124 Bari, Italy
| | - Vincenza Luce
- Section of Pediatrics, Department of Biomedical Sciences and Human Oncology, University of Bari “A. Moro”, 70124 Bari, Italy
| | - Annamaria Ventura
- Section of Pediatrics, Department of Biomedical Sciences and Human Oncology, University of Bari “A. Moro”, 70124 Bari, Italy
| | - Graziana Colaianni
- Section of Human Anatomy and Histology, Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari, 70124 Bari, Italy
| | - Silvia Colucci
- Section of Human Anatomy and Histology, Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari, 70124 Bari, Italy
| | - Luciano Cavallo
- Section of Pediatrics, Department of Biomedical Sciences and Human Oncology, University of Bari “A. Moro”, 70124 Bari, Italy
| | - Maria Grano
- Section of Human Anatomy and Histology, Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari, 70124 Bari, Italy
| | - Giacomina Brunetti
- Section of Human Anatomy and Histology, Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari, 70124 Bari, Italy
- *Giacomina Brunetti:
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40
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Turner RT, Philbrick KA, Wong CP, Olson DA, Branscum AJ, Iwaniec UT. Morbid obesity attenuates the skeletal abnormalities associated with leptin deficiency in mice. J Endocrinol 2014; 223:M1-15. [PMID: 24990938 PMCID: PMC4161659 DOI: 10.1530/joe-14-0224] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Leptin-deficient ob/ob mice are morbidly obese and exhibit low total bone mass and mild osteopetrosis. In order to disassociate the skeletal effects of leptin deficiency from those associated with morbid obesity, we evaluated bone mass, architecture, gene expression, and indices of bone turnover in WT mice, ob/ob mice allowed to feed ad libitum (ob/ob), and ob/ob mice pair-fed equivalent to WT mice (pair-fed ob/ob). Mice were maintained at 32 °C (thermoneutral) from 6 to 18 weeks of age to minimize differences in resting energy expenditure. ob/ob mice were heavier, had more abdominal white adipose tissue (WAT), and were hyperglycemic compared with WT mice. Femur length, bone mineral content (BMC) and bone mineral density, and midshaft femur cortical thickness were lower in ob/ob mice than in WT mice. Cancellous bone volume (BV) fraction was higher but indices of bone formation and resorption were lower in ob/ob mice compared with WT mice; reduced bone resorption in ob/ob mice resulted in pathological retention of calcified cartilage. Pair-fed ob/ob mice were lighter and had lower WAT, uterine weight, and serum glucose than ob/ob mice. Similarly, femoral length, BMC, and cortical thickness were lower in pair-fed ob/ob mice compared with ob/ob mice, as were indices of cancellous bone formation and resorption. In contrast, bone marrow adiposity, calcified cartilage, and cancellous BV fraction were higher at one or more cancellous sites in pair-fed ob/ob mice compared with ob/ob mice. These findings indicate that the skeletal abnormalities caused by leptin deficiency are markedly attenuated in morbidly obese ob/ob mice.
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Affiliation(s)
- Russell T Turner
- Skeletal Biology LaboratorySchool of Biological and Population Health SciencesCenter for Healthy Aging ResearchBiostatisticsSchool of Biological and Population Health Sciences, Oregon State University, Corvallis, Oregon 97331, USA Skeletal Biology LaboratorySchool of Biological and Population Health SciencesCenter for Healthy Aging ResearchBiostatisticsSchool of Biological and Population Health Sciences, Oregon State University, Corvallis, Oregon 97331, USA
| | - Kenneth A Philbrick
- Skeletal Biology LaboratorySchool of Biological and Population Health SciencesCenter for Healthy Aging ResearchBiostatisticsSchool of Biological and Population Health Sciences, Oregon State University, Corvallis, Oregon 97331, USA
| | - Carmen P Wong
- Skeletal Biology LaboratorySchool of Biological and Population Health SciencesCenter for Healthy Aging ResearchBiostatisticsSchool of Biological and Population Health Sciences, Oregon State University, Corvallis, Oregon 97331, USA
| | - Dawn A Olson
- Skeletal Biology LaboratorySchool of Biological and Population Health SciencesCenter for Healthy Aging ResearchBiostatisticsSchool of Biological and Population Health Sciences, Oregon State University, Corvallis, Oregon 97331, USA
| | - Adam J Branscum
- Skeletal Biology LaboratorySchool of Biological and Population Health SciencesCenter for Healthy Aging ResearchBiostatisticsSchool of Biological and Population Health Sciences, Oregon State University, Corvallis, Oregon 97331, USA
| | - Urszula T Iwaniec
- Skeletal Biology LaboratorySchool of Biological and Population Health SciencesCenter for Healthy Aging ResearchBiostatisticsSchool of Biological and Population Health Sciences, Oregon State University, Corvallis, Oregon 97331, USA Skeletal Biology LaboratorySchool of Biological and Population Health SciencesCenter for Healthy Aging ResearchBiostatisticsSchool of Biological and Population Health Sciences, Oregon State University, Corvallis, Oregon 97331, USA
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41
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Zhang J, Zhao Y, Hou X, Chen B, Xiao Z, Han J, Shi C, Liu J, Miao Q, Dai J. The inhibition effects of insulin on BMP2-induced muscle heterotopic ossification. Biomaterials 2014; 35:9322-31. [PMID: 25132600 DOI: 10.1016/j.biomaterials.2014.07.056] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Accepted: 07/25/2014] [Indexed: 01/09/2023]
Abstract
Bone morphogenetic proteins (BMPs) play an important role in regulating osteoblastic differentiation and bone formation. But the diffuse of BMPs into muscle tissues around bone injury sites often leads to heterotopic ossification, which has been regarded as one of major side-effects of BMP implementation in bone defect patients. It raises great demands for exploring effective methods that preventing BMP-induced heterotopic ossification while not interrupting the osteoinductive activity of BMPs for in situ bone defect repair. Here we found insulin, a positive regulator for bone regeneration, inhibited BMP2-induced muscle heterotopic ossification by suppressing the expression of bone transcription factor Osterix. By analyzing downstream molecules of insulin pathway, we found AKT/mTOR/GSK3 signaling was responsible for the inhibition of insulin on BMP2-induced ossification, and GSK3 inhibitor SB216763 attenuated BMP2-induced muscle heterotopic ossification. The data might shed light on developing effective clinical therapy for inhibiting muscle heterotopic ossification when BMPs were used bone defect repair.
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Affiliation(s)
- Jing Zhang
- Institute of Combined Injury, State Key Laboratory of Trauma, Burns and Combined Injury, Chongqing Engineering Research Center for Nanomedicine, College of Preventive Medicine, Third Military Medical University, 30 Gaotanyan Road, 400038, Chongqing, China
| | - Yannan Zhao
- Institute of Combined Injury, State Key Laboratory of Trauma, Burns and Combined Injury, Chongqing Engineering Research Center for Nanomedicine, College of Preventive Medicine, Third Military Medical University, 30 Gaotanyan Road, 400038, Chongqing, China; State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing 100101, China
| | - Xianglin Hou
- Institute of Combined Injury, State Key Laboratory of Trauma, Burns and Combined Injury, Chongqing Engineering Research Center for Nanomedicine, College of Preventive Medicine, Third Military Medical University, 30 Gaotanyan Road, 400038, Chongqing, China; State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing 100101, China
| | - Bing Chen
- Institute of Combined Injury, State Key Laboratory of Trauma, Burns and Combined Injury, Chongqing Engineering Research Center for Nanomedicine, College of Preventive Medicine, Third Military Medical University, 30 Gaotanyan Road, 400038, Chongqing, China; State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing 100101, China
| | - Zhifeng Xiao
- Institute of Combined Injury, State Key Laboratory of Trauma, Burns and Combined Injury, Chongqing Engineering Research Center for Nanomedicine, College of Preventive Medicine, Third Military Medical University, 30 Gaotanyan Road, 400038, Chongqing, China; State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing 100101, China
| | - Jin Han
- State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing 100101, China
| | - Chunying Shi
- State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing 100101, China
| | - Jianzhou Liu
- Department of Cardiac Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Beijing, China
| | - Qi Miao
- Department of Cardiac Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Beijing, China
| | - Jianwu Dai
- Institute of Combined Injury, State Key Laboratory of Trauma, Burns and Combined Injury, Chongqing Engineering Research Center for Nanomedicine, College of Preventive Medicine, Third Military Medical University, 30 Gaotanyan Road, 400038, Chongqing, China; State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing 100101, China.
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42
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Choi YJ, Kim DJ, Lee Y, Chung YS. Insulin is inversely associated with bone mass, especially in the insulin-resistant population: the Korea and US National Health and Nutrition Examination Surveys. J Clin Endocrinol Metab 2014; 99:1433-41. [PMID: 24483156 DOI: 10.1210/jc.2013-3346] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
BACKGROUND Insulin is an important osteotropic hormone but may be negatively associated with bone mass after adjustment for body mass index in adolescent populations. However, the association between insulin and bone mass in adults remains unclear. OBJECTIVE The objective of the study was to investigate whether insulin was associated with bone mass in adults and, if so, whether the association was positive or negative. DESIGN This study had a cross-sectional design, using data from the Fourth Korea National Health and Nutrition Examination Survey (KNHANES) 2008-2009 and the US National Health and Nutrition Examination Survey (NHANES) 1999-2006. SETTING The setting for the study was the Korean and US population. PARTICIPANTS A total of 7271 KNHANES and 3399 NHANES participants were included. MAIN OUTCOME MEASURES Anthropometric parameters and bone mass data, fasting glucose and insulin, height, weight, and markers related to insulin resistance were measured. RESULTS After adjusting for confounding factors, there was an inverse relationship between insulin and total body bone mineral content in the KNHANES and NHANES subjects. In a stratified analysis, an association between insulin and bone mass was apparent, especially in the highest homeostatic model of assessment of insulin resistance quartile in the Korean subjects. However, this association was seen only in men in the US subjects. CONCLUSIONS There is an inverse relationship between insulin and total body bone mineral content after adjustment for confounding factors in Korean and US subjects, especially in the insulin-resistant population. This strongly suggests that the adverse influence of insulin on bone mass likely reflects the effects of other factors associated with insulin resistance rather than being a direct action of insulin itself.
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Affiliation(s)
- Yong Jun Choi
- Departments of Endocrinology and Metabolism (Y.J.C., D.J.K., Y.-S.C.) and Preventive Medicine and Public Health (Y.L.) and Institute on Aging (D.J.K., Y.L., Y.-S.C.), Ajou University School of Medicine, Suwon 443-380, South Korea
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Naot D, Cornish J. Cytokines and Hormones That Contribute to the Positive Association between Fat and Bone. Front Endocrinol (Lausanne) 2014; 5:70. [PMID: 24847313 PMCID: PMC4023068 DOI: 10.3389/fendo.2014.00070] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Accepted: 04/27/2014] [Indexed: 01/20/2023] Open
Abstract
The positive association between body weight and bone density has been established in numerous laboratory and clinical studies. Apart from the direct effect of soft tissue mass on bone through skeletal loading, a number of cytokines and hormones contribute to the positive association between adipose and bone tissue, acting either locally in sites where cells of the two tissues are adjacent to each other or systemically through the circulation. The current review describes the effects of such local and systemic factors on bone physiology. One class of factors are the adipocyte-secreted peptides (adipokines), which affect bone turnover through a combination of direct effects in bone cells and indirect mechanisms mediated by the central nervous system. Another source of hormones that contribute to the coupling between fat and bone tissue are beta cells of the pancreas. Insulin, amylin, and preptin are co-secreted from pancreatic beta cells in response to increased glucose levels after feeding, and are also found in high circulating levels in obesity. A number of peptide hormones secreted from the gastrointestinal tract in response to feeding affect both fat and bone cells and thus can also act as mediators of the association between the two tissues. The current review focuses on results of laboratory studies investigating possible mechanism involved in the positive association between fat mass and bone mass.
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Affiliation(s)
- Dorit Naot
- Department of Medicine, University of Auckland, Auckland, New Zealand
- *Correspondence: Dorit Naot, Department of Medicine, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand e-mail:
| | - Jillian Cornish
- Department of Medicine, University of Auckland, Auckland, New Zealand
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Abstract
Insulin and its downstream signaling pathway are indispensable for postnatal bone growth and turnover by having influence on both osteoblast and osteoclast development. Insulin signaling regulates both bone formation by osteoblasts and bone resorption by osteoclasts; however, the regulation occurs mainly through the insulin signaling pathway within osteoblasts. An impairment of osteoblastic insulin signaling leads to an impaired bone quality by affecting osteoblast proliferation, differentiation and survival. The insulin signaling pathway and MAPK and PI3K/Akt pathways play pivotal roles in the differentiation, function and survival of bone cells. Current evidence suggests that osteoblastic insulin signaling not only modulates bone growth and turnover but is also required for energy metabolism. Several mice models with impaired insulin signaling exhibited both bone and metabolic phenotypes, including symptoms of low bone mass, obesity, glucose intolerance and insulin resistance. In this review, we discuss the key findings that suggest a pivotal role of osteoblastic insulin signaling in both bone and energy metabolism.
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Thrailkill K, Bunn RC, Lumpkin C, Wahl E, Cockrell G, Morris L, Kahn CR, Fowlkes J, Nyman JS. Loss of insulin receptor in osteoprogenitor cells impairs structural strength of bone. J Diabetes Res 2014; 2014:703589. [PMID: 24963495 PMCID: PMC4052184 DOI: 10.1155/2014/703589] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Accepted: 04/30/2014] [Indexed: 12/11/2022] Open
Abstract
Type 1 diabetes mellitus (T1D) is associated with decreased bone mineral density, a deficit in bone structure, and subsequently an increased risk of fragility fracture. These clinical observations, paralleled by animal models of T1D, suggest that the insulinopenia of T1D has a deleterious effect on bone. To further examine the action of insulin signaling on bone development, we generated mice with an osteoprogenitor-selective (osterix-Cre) ablation of the insulin receptor (IR), designated OIRKO. OIRKO mice exhibited an 80% decrease in IR in osteoblasts. Prenatal elimination of IR did not affect fetal survival or gross morphology. However, loss of IR in mouse osteoblasts resulted in a postnatal growth-constricted phenotype. By 10-12 weeks of age, femurs of OIRKO mice were more slender, with a thinner diaphyseal cortex and, consequently, a decrease in whole bone strength when subjected to bending. In male mice alone, decreased metaphyseal trabecular bone, with thinner and more rodlike trabeculae, was also observed. OIRKO mice did not, however, exhibit abnormal glucose tolerance. The skeletal phenotype of the OIRKO mouse appeared more severe than that of previously reported bone-specific IR knockdown models, and confirms that insulin receptor expression in osteoblasts is critically important for proper bone development and maintenance of structural integrity.
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Affiliation(s)
- Kathryn Thrailkill
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Arkansas Children's Hospital, 1 Children's Way, Slot 512-6, Little Rock, AR 72202, USA
- *Kathryn Thrailkill:
| | - R. Clay Bunn
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Charles Lumpkin
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Arkansas Children's Hospital Research Institute, Little Rock, AR, USA
| | - Elizabeth Wahl
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Arkansas Children's Hospital Research Institute, Little Rock, AR, USA
| | - Gael Cockrell
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Lindsey Morris
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Division of Diabetes, Endocrinology & Metabolism, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - C. Ronald Kahn
- Joslin Diabetes Center and Harvard Medical School, Boston, MA, USA
| | - John Fowlkes
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Jeffry S. Nyman
- VA Tennessee Valley Health Care System, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Orthopaedic Surgery & Rehabilitation, Vanderbilt University Medical Center, Nashville, TN, USA
- Center for Bone Biology, Vanderbilt University Medical Center, Nashville, TN, USA
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Tamura Y, Kawao N, Okada K, Yano M, Okumoto K, Matsuo O, Kaji H. Plasminogen activator inhibitor-1 is involved in streptozotocin-induced bone loss in female mice. Diabetes 2013; 62:3170-9. [PMID: 23715621 PMCID: PMC3749344 DOI: 10.2337/db12-1552] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
In diabetic patients, the risk of fracture is high because of impaired bone formation. However, the details of the mechanisms in the development of diabetic osteoporosis remain unclear. In the current study, we investigated the role of plasminogen activator inhibitor (PAI)-1 in the pathogenesis of type 1 diabetic osteoporosis by using PAI-1-deficient mice. Quantitative computed tomography analysis showed that PAI-1 deficiency protected against streptozotocin-induced bone loss in female mice but not in male mice. PAI-1 deficiency blunted the changes in the levels of Runx2, osterix, and alkaline phosphatase in tibia as well as serum osteocalcin levels suppressed by the diabetic state in female mice only. Furthermore, the osteoclast levels in tibia, suppressed in diabetes, were also blunted by PAI-1 deficiency in female mice. Streptozotocin markedly elevated the levels of PAI-1 mRNA in liver in female mice only. In vitro study demonstrated that treatment with active PAI-1 suppressed the levels of osteogenic genes and mineralization in primary osteoblasts from female mouse calvaria. In conclusion, the current study indicates that PAI-1 is involved in the pathogenesis of type 1 diabetic osteoporosis in females. The expression of PAI-1 in the liver and the sensitivity of bone cells to PAI-1 may be an underlying mechanism.
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Affiliation(s)
- Yukinori Tamura
- Department of Physiology and Regenerative Medicine, Kinki University Faculty of Medicine, Osaka, Japan
| | - Naoyuki Kawao
- Department of Physiology and Regenerative Medicine, Kinki University Faculty of Medicine, Osaka, Japan
| | - Kiyotaka Okada
- Department of Physiology and Regenerative Medicine, Kinki University Faculty of Medicine, Osaka, Japan
| | - Masato Yano
- Department of Physiology and Regenerative Medicine, Kinki University Faculty of Medicine, Osaka, Japan
| | - Katsumi Okumoto
- Life Science Research Institute, Kinki University, Osaka, Japan
| | - Osamu Matsuo
- Department of Physiology and Regenerative Medicine, Kinki University Faculty of Medicine, Osaka, Japan
| | - Hiroshi Kaji
- Department of Physiology and Regenerative Medicine, Kinki University Faculty of Medicine, Osaka, Japan
- Corresponding author: Hiroshi Kaji,
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Wattanachanya L, Lu WD, Kundu RK, Wang L, Abbott MJ, O'Carroll D, Quertermous T, Nissenson RA. Increased bone mass in mice lacking the adipokine apelin. Endocrinology 2013; 154:2069-80. [PMID: 23584856 PMCID: PMC3740482 DOI: 10.1210/en.2012-2034] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Adipose tissue plays an important role in skeletal homeostasis, and there is interest in identifying adipokines that influence bone mass. One such adipokine may be apelin, a ligand for the Gi-G protein-coupled receptor APJ, which has been reported to enhance mitogenesis and suppress apoptosis in MC3T3-E1 cells and primary human osteoblasts (OBs). However, it is unclear whether apelin plays a physiological role in regulating skeletal homeostasis in vivo. In this study, we compared the skeletal phenotypes of apelin knockout (APKO) and wild-type mice and investigated the direct effects of apelin on bone cells in vitro. The increased fractional cancellous bone volume at the distal femur was observed in APKO mice of both genders at 12 weeks of age and persisted until the age of 20. Cortical bone perimeter at the femoral midshaft was significantly increased in males and females at both time points. Dynamic histomorphometry revealed that APKO mice had increased rates of bone formation and mineral apposition, with evidences of accelerated OB proliferation and differentiation, without significant alteration in osteoclast activity. An in vitro study showed that apelin increased proliferation of primary mouse OBs as well as suppressed apoptosis in a dose-dependent manner with the maximum effect at 5nM. However, it had no effect on the formation of mineralized nodules. We did not observed significantly altered in osteoclast parameters in vitro. Taken together, the increased bone mass in mice lacking apelin suggested complex direct and paracrine/endocrine effects of apelin on bone, possibly via modulating insulin sensitivity. These results indicate that apelin functions as a physiologically significant antianabolic factor in bone in vivo.
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Affiliation(s)
- Lalita Wattanachanya
- Veterans Affairs Medical Center (111 N), 4150 Clement Street, San Francisco, California 94121, USA
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Pramojanee SN, Phimphilai M, Kumphune S, Chattipakorn N, Chattipakorn SC. Decreased jaw bone density and osteoblastic insulin signaling in a model of obesity. J Dent Res 2013; 92:560-5. [PMID: 23569161 DOI: 10.1177/0022034513485600] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Previous studies have demonstrated that decreased bone mass results from either the impairment of osteoblastic insulin signaling or obesity. Our previous study revealed that 12-week high-fat-diet (HFD) consumption caused obesity as well as peripheral and brain insulin resistance. However, the osteoblastic insulin resistance induced by HFD has not been elucidated. Therefore, we hypothesized that 12-week HFD rats exhibited not only peripheral insulin resistance but also osteoblastic insulin resistance, which leads to decreased jawbone quality. We found that the jawbones of rats fed a 12-week HFD exhibited increased osteoporosis. The osteoblastic cells isolated from HFD-fed rats exhibited the impairment of osteoblastic insulin signaling as well as reduction of cell proliferation and survival. In conclusion, this study demonstrated that insulin resistance induced by 12-week HFD impaired osteoblastic insulin signaling, osteoblast proliferation, and osteoblast survival and resulted in osteoporosis in the jawbone.
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Affiliation(s)
- S N Pramojanee
- Department of Oral Biology and Diagnostic Science, Faculty of Dentistry
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Patti A, Gennari L, Merlotti D, Dotta F, Nuti R. Endocrine actions of osteocalcin. Int J Endocrinol 2013; 2013:846480. [PMID: 23737779 PMCID: PMC3657394 DOI: 10.1155/2013/846480] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2012] [Revised: 04/01/2013] [Accepted: 04/02/2013] [Indexed: 12/22/2022] Open
Abstract
Osteocalcin is the most abundant noncollagenous protein of bone matrix. Once transcribed, this protein undergoes posttranslational modifications within osteoblastic cells before its secretion, including the carboxylation of three glutamic residues in glutamic acid, which is essential for hydroxyapatite binding and deposition in the extracellular matrix of bone. Recent provocative data from experimental observations in mice showed that the circulating undercarboxylated fraction of osteocalcin increases insulin secretion and sensitivity, lowers blood glucose, and decreases visceral fat in both genders, while it enhances testosterone production by the testes in males. Moreover, both total and undercarboxylated osteocalcins increase following physical activity with potential positive effects on glucose tolerance. Despite that these evidences have been only in part confirmed in humans, further prospective investigations are needed to definitively establish the endocrine role of osteocalcin both in the general population and cohorts of patients with diabetes or other metabolic disorders.
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Affiliation(s)
- Aurora Patti
- Department of Clinical, Surgical and Neurological Sciences, University of Siena, 53100 Siena, Italy
- *Aurora Patti:
| | - Luigi Gennari
- Department of Clinical, Surgical and Neurological Sciences, University of Siena, 53100 Siena, Italy
| | - Daniela Merlotti
- Department of Clinical, Surgical and Neurological Sciences, University of Siena, 53100 Siena, Italy
| | - Francesco Dotta
- Department of Clinical, Surgical and Neurological Sciences, University of Siena, 53100 Siena, Italy
| | - Ranuccio Nuti
- Department of Clinical, Surgical and Neurological Sciences, University of Siena, 53100 Siena, Italy
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Sustained local delivery of insulin for potential improvement of peri-implant bone formation in diabetes. SCIENCE CHINA-LIFE SCIENCES 2012; 55:948-57. [DOI: 10.1007/s11427-012-4392-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2012] [Accepted: 06/05/2012] [Indexed: 10/27/2022]
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