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Veneri F, Filippini T, Consolo U, Vinceti M, Generali L. Ozone therapy in dentistry: An overview of the biological mechanisms involved (Review). Biomed Rep 2024; 21:115. [PMID: 38912169 PMCID: PMC11190636 DOI: 10.3892/br.2024.1803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 04/03/2024] [Indexed: 06/25/2024] Open
Abstract
At low medically-relevant concentrations, ozone serves as an oxidant with a wide spectrum of antimicrobial activity and the ability to promote healing and reduce inflammation. Despite providing therapeutic benefits in a range of diseases, certain adverse effects and contraindications of ozone treatment must be considered. These are primarily related to toxicity from inhalation and systemic types of administration and can be avoided by following relevant guidelines and recommendations. Ozone therapy has been implemented in a number of fields of dentistry and the most commonly used formulations for the oral cavity are gaseous ozone, ozonized water and ozonized oil. The biological mechanisms underlying the molecular effects of ozone have been increasingly reported, but currently remain largely unknown. The aim of the present review was to provide an overview of the mechanisms involved in ozone interaction with dental tissues. The present review focused on relevant evidence regarding the effect of ozone on dental tissues, including periodontal structures, dental cells, enamel and dentine, considering in vitro studies in addition to animal and human studies. A variety of biological mechanisms acting through multiple biochemical target pathways were reported to be responsible for the therapeutic effects of ozone. The main beneficial effects of ozone occurred in the following domains: antimicrobial activity, remineralization and microstructural changes of hard dental tissues, immunomodulation and biostimulation of dental and periodontal cells. Additional research could provide further insights into the use of ozone, increase its use for broader clinical applications and assist in the selection of targeted protocols.
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Affiliation(s)
- Federica Veneri
- Unit of Dentistry and Oral-Maxillo-Facial Surgery, Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance, University of Modena and Reggio Emilia, I-41124 Modena, Italy
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, I-41125 Modena, Italy
| | - Tommaso Filippini
- Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, I-41125 Modena, Italy
- School of Public Health, University of California Berkeley, Berkeley, CA 94704, USA
| | - Ugo Consolo
- Unit of Dentistry and Oral-Maxillo-Facial Surgery, Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance, University of Modena and Reggio Emilia, I-41124 Modena, Italy
| | - Marco Vinceti
- Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, I-41125 Modena, Italy
- Department of Epidemiology, Boston University School of Public Health, Boston, MA 02118, USA
| | - Luigi Generali
- Unit of Dentistry and Oral-Maxillo-Facial Surgery, Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance, University of Modena and Reggio Emilia, I-41124 Modena, Italy
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2
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Jalava N, Arponen M, Widjaja N, Heino TJ, Ivaska KK. Short- and long-term exposure to high glucose induces unique transcriptional changes in osteoblasts in vitro. Biol Open 2024; 13:bio060239. [PMID: 38809145 PMCID: PMC11128269 DOI: 10.1242/bio.060239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 04/22/2024] [Indexed: 05/16/2024] Open
Abstract
Bone is increasingly recognized as a target for diabetic complications. In order to evaluate the direct effects of high glucose on bone, we investigated the global transcriptional changes induced by hyperglycemia in osteoblasts in vitro. Rat bone marrow-derived mesenchymal stromal cells were differentiated into osteoblasts for 10 days, and prior to analysis, they were exposed to hyperglycemia (25 mM) for the short-term (1 or 3 days) or long-term (10 days). Genes and pathways regulated by hyperglycemia were identified using mRNA sequencing and verified with qPCR. Genes upregulated by 1-day hyperglycemia were, for example, related to extracellular matrix organization, collagen synthesis and bone formation. This stimulatory effect was attenuated by 3 days. Long-term exposure impaired osteoblast viability, and downregulated, for example, extracellular matrix organization and lysosomal pathways, and increased intracellular oxidative stress. Interestingly, transcriptional changes by different exposure times were mostly unique and only 89 common genes responding to glucose were identified. In conclusion, short-term hyperglycemia had a stimulatory effect on osteoblasts and bone formation, whereas long-term hyperglycemia had a negative effect on intracellular redox balance, osteoblast viability and function.
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Affiliation(s)
- Niki Jalava
- Institute of Biomedicine, Faculty of Medicine, University of Turku, Turku 20520, Finland
| | - Milja Arponen
- Institute of Biomedicine, Faculty of Medicine, University of Turku, Turku 20520, Finland
| | - Nicko Widjaja
- Institute of Biomedicine, Faculty of Medicine, University of Turku, Turku 20520, Finland
| | - Terhi J. Heino
- Institute of Biomedicine, Faculty of Medicine, University of Turku, Turku 20520, Finland
| | - Kaisa K. Ivaska
- Institute of Biomedicine, Faculty of Medicine, University of Turku, Turku 20520, Finland
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3
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Zhou XC, Ni GX. O-linked β-N-acetylglucosaminylation may be a key regulatory factor in promoting osteogenic differentiation of bone marrow mesenchymal stromal cells. World J Stem Cells 2024; 16:228-231. [PMID: 38577231 PMCID: PMC10989286 DOI: 10.4252/wjsc.v16.i3.228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/02/2024] [Accepted: 02/29/2024] [Indexed: 03/25/2024] Open
Abstract
Cumulative evidence suggests that O-linked β-N-acetylglucosaminylation (O-GlcNAcylation) plays an important regulatory role in pathophysiological processes. Although the regulatory mechanisms of O-GlcNAcylation in tumors have been gradually elucidated, the potential mechanisms of O-GlcNAcylation in bone metabolism, particularly, in the osteogenic differentiation of bone marrow mesenchymal stromal cells (BMSCs) remains unexplored. In this study, the literature related to O-GlcNAcylation and BMSC osteogenic differentiation was reviewed, assuming that it could trigger more scholars to focus on research related to O-GlcNAcylation and bone metabolism and provide insights into the development of novel therapeutic targets for bone metabolism disorders such as osteoporosis.
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Affiliation(s)
- Xu-Chang Zhou
- School of Sport Medicine and Rehabilitation, Beijing Sport University, Beijing 100084, China
| | - Guo-Xin Ni
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Xiamen University, Xiamen 361003, Fujian Province, China.
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4
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Le T, Salas Sanchez A, Nashawi D, Kulkarni S, Prisby RD. Diabetes and the Microvasculature of the Bone and Marrow. Curr Osteoporos Rep 2024; 22:11-27. [PMID: 38198033 DOI: 10.1007/s11914-023-00841-3] [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] [Accepted: 12/04/2023] [Indexed: 01/11/2024]
Abstract
PURPOSE OF REVIEW The purpose of this review is to highlight the evidence of microvascular dysfunction in bone and marrow and its relation to poor skeletal outcomes in diabetes mellitus. RECENT FINDINGS Diabetes mellitus is characterized by chronic hyperglycemia, which may lead to microangiopathy and macroangiopathy. Micro- and macroangiopathy have been diagnosed in Type 1 and Type 2 diabetes, coinciding with osteopenia, osteoporosis, enhanced fracture risk and delayed fracture healing. Microangiopathy has been reported in the skeleton, correlating with reduced blood flow and perfusion, vasomotor dysfunction, microvascular rarefaction, reduced angiogenic capabilities, and augmented vascular permeability. Microangiopathy within the skeleton may be detrimental to bone and manifest as, among other clinical abnormalities, reduced mass, enhanced fracture risk, and delayed fracture healing. More investigations are required to elucidate the various mechanisms by which diabetic microvascular dysfunction impacts the skeleton.
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Affiliation(s)
- Teresa Le
- Bone Vascular and Microcirculation Laboratory, Department of Kinesiology, University of Texas at Arlington, Arlington, TX, 76019, USA
| | - Amanda Salas Sanchez
- Bone Vascular and Microcirculation Laboratory, Department of Kinesiology, University of Texas at Arlington, Arlington, TX, 76019, USA
| | - Danyah Nashawi
- Bone Vascular and Microcirculation Laboratory, Department of Kinesiology, University of Texas at Arlington, Arlington, TX, 76019, USA
| | - Sunidhi Kulkarni
- Bone Vascular and Microcirculation Laboratory, Department of Kinesiology, University of Texas at Arlington, Arlington, TX, 76019, USA
| | - Rhonda D Prisby
- Bone Vascular and Microcirculation Laboratory, Department of Kinesiology, University of Texas at Arlington, Arlington, TX, 76019, USA.
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5
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Iyer S, Adams DJ. Bone and the Unfolded Protein Response: In Sickness and in Health. Calcif Tissue Int 2023; 113:96-109. [PMID: 37243756 PMCID: PMC10326125 DOI: 10.1007/s00223-023-01096-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 05/08/2023] [Indexed: 05/29/2023]
Abstract
Differentiation and optimal function of osteoblasts and osteoclasts are contingent on synthesis and maintenance of a healthy proteome. Impaired and/or altered secretory capacity of these skeletal cells is a primary driver of most skeletal diseases. The endoplasmic reticulum (ER) orchestrates the folding and maturation of membrane as well as secreted proteins at high rates within a calcium rich and oxidative organellar niche. Three ER membrane proteins monitor fidelity of protein processing in the ER and initiate an intricate signaling cascade known as the Unfolded Protein Response (UPR) to remediate accumulation of misfolded proteins in its lumen, a condition referred to as ER stress. The UPR aids in fine-tuning, expanding and/or modifying the cellular proteome, especially in specialized secretory cells, to match everchanging physiologic cues and metabolic demands. Sustained activation of the UPR due to chronic ER stress, however, is known to hasten cell death and drive pathophysiology of several diseases. A growing body of evidence suggests that ER stress and an aberrant UPR may contribute to poor skeletal health and the development of osteoporosis. Small molecule therapeutics that target distinct components of the UPR may therefore have implications for developing novel treatment modalities relevant to the skeleton. This review summarizes the complexity of UPR actions in bone cells in the context of skeletal physiology and osteoporotic bone loss, and highlights the need for future mechanistic studies to develop novel UPR therapeutics that mitigate adverse skeletal outcomes.
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Affiliation(s)
- Srividhya Iyer
- Department of Orthopedics, University of Colorado Anschutz Medical Campus, 12800 E 19th Ave, Mailstop:8343, Aurora, CO, 80045, USA.
| | - Douglas J Adams
- Department of Orthopedics, University of Colorado Anschutz Medical Campus, 12800 E 19th Ave, Mailstop:8343, Aurora, CO, 80045, USA
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6
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Nasser MI, Stidsen JV, Højlund K, Nielsen JS, Eastell R, Frost M. Low Bone Turnover Associates With Lower Insulin Sensitivity in Newly Diagnosed Drug-Naïve Persons With Type 2 Diabetes. J Clin Endocrinol Metab 2023; 108:e371-e379. [PMID: 36718513 PMCID: PMC10271224 DOI: 10.1210/clinem/dgad043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 12/29/2022] [Accepted: 01/24/2023] [Indexed: 02/01/2023]
Abstract
CONTEXT Bone turnover markers (BTMs) are lower in type 2 diabetes mellitus (T2D). The relationships between bone turnover, β-cell function, and insulin sensitivity in T2D are uncertain. OBJECTIVE To investigate if fasting levels of BTMs in persons with T2D are associated with β-cell function or insulin sensitivity. METHODS We defined three T2D phenotypes, the insulinopenic (low β-cell function, high insulin sensitivity), the classical (low β-cell function, low insulin sensitivity), and the hyperinsulinemic (high β-cell function, low insulin sensitivity) phenotypes, in the Danish Centre for Strategic Research T2D cohort using the homeostatic model assessment. We selected age- and gender-matched subgroups to represent the three T2D phenotypes, yielding 326 glucose-lowering treatment-naïve persons with T2D. Median values of BTMs between the three T2D phenotypes were compared. Regression models were applied to assess the association between BTMs, β-cell function, and insulin sensitivity adjusted for potential confounders. RESULTS Median serum levels of procollagen type I N-terminal propeptide, C-terminal telopeptide of type I collagen, and osteocalcin were higher in the insulinopenic phenotype (52.3 μg/L, IQR 41.6, 63.3; 259.4 ng/L, IQR 163.4, 347.7; and 18.0 μg/L, IQR 14.4, 25.2, respectively) compared with the classical (41.4, IQR 31.0, 51.4; 150.4 IQR 103.5, 265.1; 13.1, IQR 10.0, 17.6, respectively) and the hyperinsulinemic (43.7, IQR 32.3, 57.3; 163.3, IQR 98.9, 273.1; 15.7 IQR 10.2, 20.8, respectively) phenotypes (all P < .01). These differences persisted after adjustment for age, sex, waist to hip ratio, or fasting plasma glucose (P < .01). CONCLUSION BTMs are lower in newly diagnosed persons with T2D characterized by low insulin sensitivity.
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Affiliation(s)
- Mohamad I Nasser
- Department of Endocrinology and Metabolism, Molecular Endocrinology Laboratory (KMEB), Odense University Hospital, Odense 5000, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense 5000, Denmark
- Steno Diabetes Center Odense, Odense University Hospital, Odense 5000, Denmark
| | - Jacob V Stidsen
- Steno Diabetes Center Odense, Odense University Hospital, Odense 5000, Denmark
| | - Kurt Højlund
- Department of Clinical Research, University of Southern Denmark, Odense 5000, Denmark
- Steno Diabetes Center Odense, Odense University Hospital, Odense 5000, Denmark
| | - Jens Steen Nielsen
- Department of Clinical Research, University of Southern Denmark, Odense 5000, Denmark
- Steno Diabetes Center Odense, Odense University Hospital, Odense 5000, Denmark
| | - Richard Eastell
- Academic Unit of Bone Metabolism, University of Sheffield, Sheffield S10, UK
- Mellanby Centre for Musculoskeletal Research, University of Sheffield, Sheffield S10, UK
| | - Morten Frost
- Department of Endocrinology and Metabolism, Molecular Endocrinology Laboratory (KMEB), Odense University Hospital, Odense 5000, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense 5000, Denmark
- Steno Diabetes Center Odense, Odense University Hospital, Odense 5000, Denmark
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7
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Sheu A, Greenfield JR, White CP, Center JR. Contributors to impaired bone health in type 2 diabetes. Trends Endocrinol Metab 2023; 34:34-48. [PMID: 36435679 DOI: 10.1016/j.tem.2022.11.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/30/2022] [Accepted: 11/04/2022] [Indexed: 11/27/2022]
Abstract
Type 2 diabetes (T2D) is associated with numerous complications, including increased risk of fragility fractures, despite seemingly protective factors [e.g., normal bone mineral density and increased body mass index(BMI)]. However, fracture risk in T2D is underestimated by current fracture risk calculators. Importantly, post-fracture mortality is worse in T2D following any fracture, highlighting the importance of identifying high-risk patients that may benefit from targeted management. Several diabetes-related factors are associated with increased fracture risk, including exogenous insulin therapy, vascular complications, and poor glycaemic control, although detailed comprehensive studies to identify the independent contributions of these factors are lacking. The underlying pathophysiological mechanisms are complex and multifactorial, with different factors contributing during the course of T2D disease. These include obesity, hyperinsulinaemia, hyperglycaemia, accumulation of advanced glycation end products, and vascular supply affecting bone-cell function and survival and bone-matrix composition. This review summarises the current understanding of the contributors to impaired bone health in T2D, and proposes an updated approach to managing these patients.
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Affiliation(s)
- Angela Sheu
- Bone Biology Division, Garvan Institute of Medical Research, Sydney, Australia; Clinical School, St Vincent's Hospital, Faculty of Medicine, University of New South Wales Sydney, Sydney, Australia; Department of Endocrinology and Diabetes, St Vincent's Hospital, Sydney, Australia.
| | - Jerry R Greenfield
- Clinical School, St Vincent's Hospital, Faculty of Medicine, University of New South Wales Sydney, Sydney, Australia; Department of Endocrinology and Diabetes, St Vincent's Hospital, Sydney, Australia; Diabetes and Metabolism, Garvan Institute of Medical Research, Sydney, Australia
| | - Christopher P White
- Clinical School, Prince of Wales Hospital, Faculty of Medicine, University of New South Wales Sydney, Sydney, Australia; Department of Endocrinology and Metabolism, Prince of Wales Hospital, Sydney, Australia
| | - Jacqueline R Center
- Bone Biology Division, Garvan Institute of Medical Research, Sydney, Australia; Clinical School, St Vincent's Hospital, Faculty of Medicine, University of New South Wales Sydney, Sydney, Australia; Department of Endocrinology and Diabetes, St Vincent's Hospital, Sydney, Australia
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8
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Entz L, Falgayrac G, Chauveau C, Pasquier G, Lucas S. The extracellular matrix of human bone marrow adipocytes and glucose concentration differentially alter mineralization quality without impairing osteoblastogenesis. Bone Rep 2022; 17:101622. [PMID: 36187598 PMCID: PMC9519944 DOI: 10.1016/j.bonr.2022.101622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 09/09/2022] [Accepted: 09/19/2022] [Indexed: 11/18/2022] Open
Abstract
Bone marrow adipocytes (BMAds) accrue in various states of osteoporosis and interfere with bone remodeling through the secretion of various factors. However, involvement of the extracellular matrix (ECM) produced by BMAds in the impairment of bone marrow mesenchymal stromal cell (BM-MSC) osteoblastogenesis has received little attention. In type 2 diabetes (T2D), skeletal fragility is associated with several changes in bone quality that are incompletely understood, and BMAd quantity increases in relationship to poor glycemic control. Considering their altered phenotype in this pathophysiological context, we aimed to determine the contribution of the ECM of mature BMAds to osteoblastogenesis and mineralization quality in the context of chronic hyperglycemia. Human BM-MSCs were differentiated for 21 days in adipogenic medium containing either a normoglycemic (LG, 5.5 mM) or a high glucose concentration (HG, 25 mM). The ECM laid down by BMAds were devitalized through cell removal to examine their impact on the proliferation and differentiation of BM-MSCs toward osteoblastogenesis in LG and HG conditions. Compared to control plates, both adipocyte ECMs promoted cell adhesion and proliferation. As shown by the unmodified RUNX2 and osteocalcin mRNA levels, BM-MSC commitment in osteoblastogenesis was hampered by neither the hyperglycemic condition nor the adipocyte matrices. However, adipocyte ECMs or HG condition altered the mineralization phase with perturbed expression levels of type 1 collagen, MGP and osteopontin. Despite higher ALP activity, mineralization levels per cell were decreased for osteoblasts grown on adipocyte ECMs compared to controls. Raman spectrometry revealed that culturing on adipocyte matrices specifically prevents type-B carbonate substitution and favors collagen crosslinking, in contrast to exposure to HG concentration alone. Moreover, the mineral to organic ratio was disrupted according to the presence of adipocyte ECM and the glucose concentration used for adipocyte or osteoblast culture. HG concentration and adipocyte ECM lead to different defects in mineralization quality, recapitulating contradictory changes reported in T2D osteoporosis. Our study shows that ECMs from BMAds do not impair osteoblastogenesis but alter both the quantity and quality of mineralization partly in a glucose concentration-dependent manner. This finding sheds light on the involvement of BMAds, which should be considered in the compromised bone quality of T2D and osteoporosis patients more generally. Glucose level alters the Extracellular Matrix composition of Bone Marrow adipocytes. Osteoblastogenesis on adipocyte ECMs is unaltered but produced less mineral amount. The quality of the mineral is altered differently by adipocyte ECMs or glucose levels. The presence of BM adipocytes should be valued in damaged osteoporosis bone quality.
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Key Words
- AGEs, Advanced glycation end-products
- BM-MSC, Bone marrow mesenchymal stromal cell
- BMAd, Bone marrow adipocyte
- ECM, Extracellular matrix
- ECMBMAd HG, Extracellular matrix obtained from BMAds cultured in HG concentration
- ECMBMAd LG, Extracellular matrix obtained from BMAds cultured in LG concentration
- ECMBMAd, Extracellular matrix obtained from BMAds
- Extracellular matrix
- GAG, glycosaminoglycan
- HA, hydroxyapatite
- HG, High glucose
- Hyperglycemia
- LG, Low glucose
- LGM, Low glucose and mannitol
- Marrow adipocytes
- Osteoblast
- Osteoporosis
- Skeletal mesenchymal stromal cells
- T2D, Type 2 diabetes
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Weber DR, Long F, Zemel BS, Kindler JM. Glycemic Control and Bone in Diabetes. Curr Osteoporos Rep 2022; 20:379-388. [PMID: 36214991 PMCID: PMC9549036 DOI: 10.1007/s11914-022-00747-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/30/2022] [Indexed: 01/30/2023]
Abstract
PURPOSE OF REVIEW This review summarizes recent developments on the effects of glycemic control and diabetes on bone health. We discuss the foundational cellular mechanisms through which diabetes and impaired glucose control impact bone biology, and how these processes contribute to bone fragility in diabetes. RECENT FINDINGS Glucose is important for osteoblast differentiation and energy consumption of mature osteoblasts. The role of insulin is less clear, but insulin receptor deletion in mouse osteoblasts reduces bone formation. Epidemiologically, type 1 (T1D) and type 2 diabetes (T2D) associate with increased fracture risk, which is greater among people with T1D. Accumulation of cortical bone micro-pores, micro-vascular complications, and AGEs likely contribute to diabetes-related bone fragility. The effects of youth-onset T2D on peak bone mass attainment and subsequent skeletal fragility are of particular concern. Further research is needed to understand the effects of hyperglycemia on skeletal health through the lifecycle, including the related factors of inflammation and microvascular damage.
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Affiliation(s)
- David R Weber
- Division of Endocrinology and Diabetes, Department of Pediatrics, The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia,, PA, USA
| | - Fanxin Long
- Department of Orthopedic Surgery, The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Babette S Zemel
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
- Division of GI, Hepatology & Nutrition, Roberts Center for Pediatric Research, 2716 South Street, 14th Floor/Room 14471, Philadelphia, PA, 19146, USA.
| | - Joseph M Kindler
- Department of Nutritional Sciences, University of Georgia, Athens, GA, USA
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10
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Ucer Ozgurel S, Swallow EA, Metzger CE, Allen MR. Femoral Skeletal Perfusion is Reduced in Male Mice with Type 1 Diabetes. Calcif Tissue Int 2022; 111:323-330. [PMID: 35704049 DOI: 10.1007/s00223-022-00992-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 05/13/2022] [Indexed: 11/02/2022]
Abstract
The bone vasculature and blood flow are critical for bone modeling, remodeling, and regeneration. Vascular complications are one of the major health concerns of people with type 1 diabetes (T1D). Moreover, people with T1D have lower bone mineral density and increased bone fragility. The goal of this study was to understand whether bone perfusion was altered in a mouse model of T1D and how this related to changes in bone mass. T1D was induced via the administration of streptozotocin in 12-week-old C57BL/6NHsd male mice. The assessment of bone perfusion utilized the injection of fluorescent microspheres with assessment of levels in the bone. Femoral blood flow and VEGF-A expression in the cortical bone shafts were lower in the T1D mice, compared to healthy controls, in this pattern followed that of changes in bone mass. These data demonstrate a possible association between reduced skeletal perfusion and reduced bone mass in the setting of T1D.
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Affiliation(s)
- Serra Ucer Ozgurel
- Department of Anatomy, Cell Biology, and Physiology, School of Medicine, Indiana University, Indianapolis, IN, USA.
- Department of Nutritional Sciences, University of Texas at Austin, Austin, TX, USA.
| | - Elizabeth A Swallow
- Department of Anatomy, Cell Biology, and Physiology, School of Medicine, Indiana University, Indianapolis, IN, USA
| | - Corinne E Metzger
- Department of Anatomy, Cell Biology, and Physiology, School of Medicine, Indiana University, Indianapolis, IN, USA
| | - Matthew R Allen
- Department of Anatomy, Cell Biology, and Physiology, School of Medicine, Indiana University, Indianapolis, IN, USA
- Richard L. Roudebush Veterans Affairs Medical Center, Indianapolis, IN, USA
- Department of Medicine - Division of Nephrology, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Biomedical Engineering, Indiana University Purdue University of Indianapolis, Indianapolis, IN, USA
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11
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Zheng F, Zhang F, Wang F. Inhibition of miR‑98‑5p promotes high glucose‑induced suppression of preosteoblast proliferation and differentiation via the activation of the PI3K/AKT/GSK3β signaling pathway by targeting BMP2. Mol Med Rep 2022; 26:292. [PMID: 35904181 PMCID: PMC9366150 DOI: 10.3892/mmr.2022.12808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 09/14/2021] [Indexed: 12/04/2022] Open
Abstract
Osteoporosis (OP) is a bone metabolic disease, in which low bone mass and the microarchitectural deterioration of bone tissue contribute to the fragility of bones and increase the risk of fracture. The aim of the present study was to determine the role of microRNA (miR)-98-5p in high glucose (HG)-induced preosteoblasts. HG was used to induce preosteoblasts treated in a differentiation medium to establish an in vitro OP model. Next, miR-98-5p expression was determined using reverse transcription-quantitative PCR. Following the transfection of an miR-98-5p inhibitor into HG-treated osteoblasts, cell viability was assessed using a Cell Counting Kit-8 assay, while alkaline phosphatase (ALP) activity, differentiation ability and the expression of differentiation-regulated genes osteocalcin and osteopontin were measured using the corresponding ALP, Alizarin red staining, reverse transcription-quantitative PCR and western blotting assays. The association between miR-98-5p and the PI3K/AKT/GSK3β signaling pathway was determined using western blotting. Next, the binding relationship between miR-98-5p and bone morphogenetic protein 2 (BMP2) was predicted and verified, and the role of BMP2 in the regulation of the PI3K/AKT/GSK3β signaling pathway was explored using western blotting. The results revealed that miR-98-5p expression was upregulated in HG-induced osteoblasts, and the inhibition of miR-98-5p resulted in enhanced cell viability, alkaline phosphatase activity and differentiation in osteoblasts following HG induction. It was also discovered that miR-98-5p inhibition activated PI3K/AKT/GSK3β signaling, while knockdown of BMP2, which binds to miR-98-5p, enhanced the activation of this signaling pathway and the differentiation ability of osteoblasts. In conclusion, the findings of the present study suggested that the inhibition of miR-98-5p expression may activate PI3K/AKT/GSK3β signaling to promote HG-induced suppression of preosteoblast viability and differentiation by targeting BMP2, which provides a novel insight into future potential molecular markers for OP treatment.
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Affiliation(s)
- Feng Zheng
- Department of Orthopedics, Qinghai Provincial People's Hospital, Xining, Qinghai 810007, P.R. China
| | - Fucai Zhang
- Department of Orthopedics, Qinghai Provincial People's Hospital, Xining, Qinghai 810007, P.R. China
| | - Furong Wang
- Department of Orthopedics, Qinghai Provincial People's Hospital, Xining, Qinghai 810007, P.R. China
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12
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Hypoxia mimetics restore bone biomineralisation in hyperglycaemic environments. Sci Rep 2022; 12:13944. [PMID: 35977987 PMCID: PMC9385857 DOI: 10.1038/s41598-022-18067-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 08/04/2022] [Indexed: 11/08/2022] Open
Abstract
Diabetic patients have an increased risk of fracture and an increased occurrence of impaired fracture healing. Diabetic and hyperglycaemic conditions have been shown to impair the cellular response to hypoxia, via an inhibited hypoxia inducible factor (HIF)-1α pathway. We investigated, using an in vitro hyperglycaemia bone tissue engineering model (and a multidisciplinary bone characterisation approach), the differing effects of glucose levels, hypoxia and chemicals known to stabilise HIF-1α (CoCl2 and DMOG) on bone formation. Hypoxia (1% O2) inhibited bone nodule formation and resulted in discrete biomineralisation as opposed to the mineralised extracellular collagen fibres found in normoxia (20% O2). Unlike hypoxia, the use of hypoxia mimetics did not prevent nodule formation in normal glucose level. Hyperglycaemic conditions (25 mM and 50 mM glucose) inhibited biomineralisation. Interestingly, both hypoxia mimetics (CoCl2 and DMOG) partly restored hyperglycaemia inhibited bone nodule formation. These results highlight the difference in osteoblast responses between hypoxia mimetics and actual hypoxia and suggests a role of HIF-1α stabilisation in bone biomineralisation that extends that of promoting neovascularisation, or other system effects associated with hypoxia and bone regeneration in vivo. This study demonstrates that targeting the HIF pathway may represent a promising strategy for bone regeneration in diabetic patients.
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Rubin MR, de Boer IH, Backlund JYC, Arends V, Gubitosi-Klug R, Wallia A, Sinha Gregory N, Barnie A, Burghardt AJ, Lachin JM, Braffett BH, Schwartz AV. Biochemical Markers of Bone Turnover in Older Adults With Type 1 Diabetes. J Clin Endocrinol Metab 2022; 107:e2405-e2416. [PMID: 35188961 PMCID: PMC9113800 DOI: 10.1210/clinem/dgac099] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT Type 1 diabetes (T1D) is characterized by high fracture risk, yet little is known regarding diabetes-related mechanisms or risk factors. OBJECTIVE Determine whether glycemic control, advanced glycation end products (AGEs), and microvascular complications are associated with bone turnover markers among older T1D adults. DESIGN Cross-sectional. SETTING Epidemiology of Diabetes Interventions and Complications study (6 of 27 clinical centers). PARTICIPANTS 232 T1D participants followed for >30 years. EXPOSURES Glycemic control ascertained as concurrent and cumulative hemoglobin A1c (HbA1c); kidney function, by estimated glomerular filtration rates (eGFR); and AGEs, by skin intrinsic fluorescence. MAIN OUTCOME MEASURES Serum procollagen 1 intact N-terminal propeptide (PINP), bone-specific alkaline phosphatase (bone ALP), serum C-telopeptide (sCTX), tartrate-resistant acid phosphatase 5b (TRACP5b), and sclerostin. RESULTS Mean age was 59.6 ± 6.8 years, and 48% were female. In models with HbA1c, eGFR, and AGEs, adjusted for age and sex, higher concurrent HbA1c was associated with lower PINP [β -3.4 pg/mL (95% CI -6.1, -0.7), P = 0.015 for each 1% higher HbA1c]. Lower eGFR was associated with higher PINP [6.9 pg/mL (95% CI 3.8, 10.0), P < 0.0001 for each -20 mL/min/1.73 m2 eGFR], bone ALP [1.0 U/L (95% CI 0.2, 1.9), P = 0.011], sCTX [53.6 pg/mL (95% CI 32.6, 74.6), P < 0.0001], and TRACP5b [0.3 U/L (95% CI 0.1, 0.4), P = 0.002]. However, AGEs were not associated with any bone turnover markers in adjusted models. HbA1c, eGFR, and AGEs were not associated with sclerostin levels. CONCLUSIONS Among older adults with T1D, poor glycemic control is a risk factor for reduced bone formation, while reduced kidney function is a risk factor for increased bone resorption and formation.
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Affiliation(s)
| | - Ian H de Boer
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Jye-Yu C Backlund
- The Biostatistics Center, George Washington University, Rockville, MD,USA
| | - Valerie Arends
- Departement of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA
| | - Rose Gubitosi-Klug
- Case Western Reserve/Rainbow Babies and Children’s Hospital, Cleveland, OH, USA
| | - Amisha Wallia
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | | | - Andrew J Burghardt
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - John M Lachin
- The Biostatistics Center, George Washington University, Rockville, MD,USA
| | - Barbara H Braffett
- The Biostatistics Center, George Washington University, Rockville, MD,USA
| | - Ann V Schwartz
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
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Araújo R, Martin V, Ferreira R, Fernandes MH, Gomes PS. A new ex vivo model of the bone tissue response to the hyperglycemic environment - The embryonic chicken femur organotypic culture in high glucose conditions. Bone 2022; 158:116355. [PMID: 35151894 DOI: 10.1016/j.bone.2022.116355] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 02/01/2022] [Accepted: 02/07/2022] [Indexed: 11/02/2022]
Abstract
Diabetes mellitus (DM) embrace a group of chronic metabolic conditions with a high morbidity, causing deleterious effects in different tissues and organs, including bone. Hyperglycemia seems to be one of the most contributing etiological factors of bone-related alterations, altering metabolic functionality and inducing morphological adaptations. Despite the established models for the assessment of bone functionality in hyperglycemic conditions, in vitro studies present a limited representativeness given the imperfect cell-cell and cell-matrix interactions, and restricted three-dimensional spatial arrangement; while in vivo studies raise ethical issues and offer limited mechanistic characterization, given the modulatory influence of many systemic factors and/or regulatory systems. Accordingly, the aim of this study is to establish and characterize an innovative ex vivo model of the bone tissue response to hyperglycemia, reaching hand of the organotypic culture of embryonic chicken femurs in high glucose conditions, showcasing the integrative responsiveness of the model regarding hyperglycemia-induced alterations. A thorough assessment of the cellular and tissue functionality was further conducted. Results show that, in high glucose conditions, femurs presented an increased cell proliferation and enhanced collagen production, despite the altered protein synthesis, substantiated by the increased carbonyl content. Gene expression analysis evidenced that high glucose levels induced the expression of pro-inflammatory and early osteogenic markers, further impairing the expression of late osteogenic markers. Furthermore, the tissue morphological organization and matrix mineralization were significantly altered by high glucose levels, as evidenced by histological, histochemical and microtomographic evaluations. Attained data is coherent with acknowledged hyperglycemia-induced bone tissue alterations, validating the models' effectiveness, and evidencing its integrative responsiveness regarding cell proliferation, gene and protein expression, and tissue morpho-functional organization. The assessed ex vivo model conjoins the capability to access both cellular and tissue outcomes in the absence of a systemic modulatory influence, outreaching the functionality of current experimental in vitro and in vivo models of the diabetic bone condition.
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Affiliation(s)
- Rita Araújo
- Laboratory for Bone Metabolism and Regeneration, Faculty of Dental Medicine, University of Porto, Porto, Portugal; REQUIMTE/LAQV, University of Porto, Porto, Portugal
| | - Victor Martin
- Laboratory for Bone Metabolism and Regeneration, Faculty of Dental Medicine, University of Porto, Porto, Portugal; REQUIMTE/LAQV, University of Porto, Porto, Portugal
| | - Rita Ferreira
- Department of Chemistry, University of Aveiro, Portugal; REQUIMTE/LAQV, University of Aveiro, Aveiro, Portugal
| | - Maria Helena Fernandes
- Laboratory for Bone Metabolism and Regeneration, Faculty of Dental Medicine, University of Porto, Porto, Portugal; REQUIMTE/LAQV, University of Porto, Porto, Portugal
| | - Pedro Sousa Gomes
- Laboratory for Bone Metabolism and Regeneration, Faculty of Dental Medicine, University of Porto, Porto, Portugal; REQUIMTE/LAQV, University of Porto, Porto, Portugal.
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15
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Wang JJ, Xue Q, Wang YJ, Zhang M, Chen YJ, Zhang Q. Engineered Chimeric Peptides with IGF-1 and Titanium-Binding Functions to Enhance Osteogenic Differentiation In Vitro under T2DM Condition. MATERIALS 2022; 15:ma15093134. [PMID: 35591468 PMCID: PMC9105221 DOI: 10.3390/ma15093134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 03/30/2022] [Accepted: 04/24/2022] [Indexed: 02/06/2023]
Abstract
Due to the complexity of the biomolecules and titanium (Ti) combination, it is a challenge to modify the implant surface with biological cytokines. The study proposed a new method for immobilizing cytokines on implant surface to solve the problem of low osseointegration under type 2 diabetes mellitus (T2DM) condition. This new modified protein that connected Ti-binding artificial aptamer minTBP-1 with Insulin-like growth factor I (IGF-I), had a special strong affinity with Ti and a therapeutic effect on diabetic bone loss. According to the copies of minTBP-1, three proteins were prepared, namely minTBP-1-IGF-1, 2minTBP-1-IGF-1 and 3minTBP-1-IGF-1. Compared with the other modified proteins, 3minTBP-1-IGF-1 adsorbed most on the Ti surface. Additionally, this biointerface demonstrated the most uniform state and the strongest hydrophilicity. In vitro results showed that the 3minTBP-1-IGF-1 significantly increased the adhesion, proliferation, and mineralization activity of osteoblasts under T2DM conditions when compared with the control group and the other modified IGF-1s groups. Real-time PCR assay results confirmed that 3minTBP-1-IGF-1 could effectively promote the expression of osteogenic genes, that is, ALP, BMP-2, OCN, OPG, and Runx2. All these data indicated that the 3minTBP-1-IGF-1 had the most efficacious effect in promoting osteoblasts osteogenesis in diabetic conditions, and may be a promising option for further clinical use.
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Affiliation(s)
| | | | | | - Min Zhang
- Correspondence: (M.Z.); (Y.-J.C.); (Q.Z.)
| | | | - Qian Zhang
- Correspondence: (M.Z.); (Y.-J.C.); (Q.Z.)
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16
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Effects of Type 2 Diabetes Mellitus on Osteoclast Differentiation, Activity, and Cortical Bone Formation in POSTmenopausal MRONJ Patients. J Clin Med 2022; 11:jcm11092377. [PMID: 35566506 PMCID: PMC9102751 DOI: 10.3390/jcm11092377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 04/20/2022] [Accepted: 04/21/2022] [Indexed: 01/22/2023] Open
Abstract
Osteoporosis is a common metabolic bone disease in patients with diabetes, which can develop simultaneously with type 2 diabetes (T2D) in postmenopausal women. Bisphosphonate (BP) is administered to patients with both conditions and may cause medication-related osteonecrosis of the jaw (MRONJ). It affects the differentiation and function of osteoclasts as well as the thickness of the cortical bone through bone mineralization. Therefore, this study aimed to investigate the effects of T2D on osteoclast differentiation and activity as well as cortical bone formation in postmenopausal patients with MRONJ. Tissue samples were collected from 10 patients diagnosed with T2D and stage III MRONJ in the experimental group and from 10 patients without T2D in the control group. A histological examination was conducted, and the expression of dendritic cell-specific transmembrane protein (DC-STAMP) and tartrate-resistant acid phosphatase (TRAP) was assessed. Cortical bone formation was analyzed using CBCT images. The number of TRAP-positive osteoclasts and DC-STAMP-positive mononuclear cells was significantly less in the experimental group (p < 0.05). Furthermore, the thickness and ratio of cortical bone were significantly greater in the experimental group (p < 0.05). In conclusion, T2D decreased the differentiation and function of osteoclasts and increased cortical bone formation in postmenopausal patients with MRONJ.
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Liu C, Liu Y, Yu Y, Zhao Y, Zhang D, Yu A. Identification of Up-Regulated ANXA3 Resulting in Fracture Non-Union in Patients With T2DM. Front Endocrinol (Lausanne) 2022; 13:890941. [PMID: 35813617 PMCID: PMC9263855 DOI: 10.3389/fendo.2022.890941] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 05/23/2022] [Indexed: 11/22/2022] Open
Abstract
Diabetes mellitus is a metabolic disorder that increases fracture risk and interferes with bone formation and impairs fracture healing. Genomic studies on diabetes and fracture healing are lacking. We used a weighted co-expression network analysis (WGCNA) method to identify susceptibility modules and hub genes associated with T2DM and fracture healing. First, we downloaded the GSE95849, GSE93213, GSE93215, and GSE142786 data from the Gene Expression Omnibus (GEO) website, analyzed differential expression genes and constructed a WGCNA network. Second, we screened out 30 hub genes, which were found to be enriched in neutrophil activation, translational initiation, RAGE receptor binding, propanoate metabolism, and other pathways through Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and gene set enrichment analysis (GSEA) analyses. Third, we searched for genes related to bone metabolism and fracture healing in the published genome-wide single nucleotide polymorphism (SNP) data, built a protein-protein interaction (PPI) network with hub genes, and found that they were associated with metabolic process, blood vessel development, and extracellular matrix organization. ANXA3 was identified as the biomarker based on gene expression and correlation analysis. And the AUC value of it was 0.947. Fourth, we explored that ANXA3 was associated with neutrophils in fracture healing process by single-cell RNA sequencing analysis. Finally, we collected clinical patient samples and verified the expression of ANXA3 by qRT-PCR in patents with T2DM and fracture non-union. In conclusion, this is the first genomics study on the effect of T2DM on fracture healing. Our study identified some characteristic modules and hub genes in the etiology of T2DM-associated fracture non-union, which may help to further investigate the molecular mechanisms. Up-regulated ANXA3 potentially contributed to fracture non-union in T2DM by mediating neutrophils. It can be a prognostic biomarker and potential therapeutic target.
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Affiliation(s)
| | | | | | | | | | - Aixi Yu
- *Correspondence: Dong Zhang, ; Aixi Yu,
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18
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Huang R, Wang H, Shen Z, Cai T, Zhou Y, Wang Y, Xia W, Ding B, Yan R, Li H, Wu J, Ma J. Increased Glycemic Variability Evaluated by Continuous Glucose Monitoring is Associated with Osteoporosis in Type 2 Diabetic Patients. Front Endocrinol (Lausanne) 2022; 13:861131. [PMID: 35733774 PMCID: PMC9207512 DOI: 10.3389/fendo.2022.861131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 05/04/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Subjects with type 2 diabetes mellitus (T2DM) are susceptible to osteoporosis. This study was conducted to evaluate the association between glycemic variability evaluated by continuous glucose monitoring (CGM) and osteoporosis in type 2 diabetic patient. METHODS A total of 362 type 2 diabetic subjects who underwent bone mineral density (BMD) measurement and were monitored by a CGM system from Jan 2019 to May 2020 were enrolled in this cross-sectional study. Glycemic variability was calculated with the Easy GV software, including 24-hour mean blood glucose (24-h MBG), the standard deviation of 24-h MBG (SDBG), coefficient of variation (CV), mean amplitude of glycemic excursions (MAGE), and time in range between 3.9 and 10.0 mmol/L (TIR). Other potential influence factors for osteoporosis were also examined. RESULTS Based on the T-scores of BMD measurement, there were 190 patients with normal bone mass, 132 patients with osteopenia and 40 patients with osteoporosis. T2DM patients with osteoporosis showed a higher 24-h MBG, SDBG, CV, and MAGE, but a lower TIR (all p < 0.05). Multivariate logistic regression analysis revealed that age, female gender, body mass index (BMI), low-density lipoprotein cholesterol (LDL-C), serum uric acid (SUA) and MAGE independently contribute to osteoporosis, and corresponding odds ratio [95% confidence interval (CI)] was 1.129 (1.072-1.190), 4.215 (1.613-11.012), 0.801 (0.712-0.901), 2.743 (1.385-5.431), 0.993 (0.988-0.999), and 1.380 (1.026-1.857), respectively. Further receiver operating characteristic analysis with Youden index indicated that the area under the curve and its 95% CI were 0.673 and 0.604-0.742, with the optimal cut-off value of MAGE predicting osteoporosis being 4.31 mmol/L. CONCLUSION In addition to conventional influence factors including age, female gender, BMI, LDL-C and SUA, increased glycemic variability assessed by MAGE is associated with osteoporosis in type 2 diabetic patients.
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Li H, Wen Y, Liu P, Zhang L, Zhang X, Liu Y, Ma B, Kuang H, Wang J, Song L. Characteristics of bone metabolism in postmenopausal women with newly diagnosed type 2 diabetes mellitus. Clin Endocrinol (Oxf) 2021; 95:430-438. [PMID: 34008210 DOI: 10.1111/cen.14501] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 05/09/2021] [Accepted: 05/12/2021] [Indexed: 01/08/2023]
Abstract
OBJECTIVE The characteristics of bone metabolism in T2DM are still controversial. This study aims to recognize bone turnover features in patients with newly diagnosed T2DM who have never been treated with anti-diabetic drugs and further explore the possible factors contributing to their impaired bone turnover. MATERIALS AND METHODS An analytic sample of 88 patients with newly diagnosed T2DM and 152 non-diabetic control individuals were studied. All the participants were postmenopausal women. Demographics variables and clinical history were recorded. We measured lipid profile, glucose metabolism, bone turnover markers indices as well as their related hormones, serum calcium and phosphorus. Bone mineral density was detected by dual-energy X-ray absorptiometry. We compared the differences in bone turnover markers and their regulating hormones between two groups and further analysed the factors related to bone turnover in T2DM. RESULTS Compared with the control group, patients with T2DM had a higher level of bone alkaline phosphatase (BALP), lower levels of procollagen type I intact N-terminal (P1NP), osteocalcin (OC) and parathyroid hormone (PTH). Multiple linear regression analysis showed that in patients with T2DM, HbA1c was negatively correlated with P1NP and OC. For patients without diabetes, HbA1c was negatively related to BALP and OC. CONCLUSIONS Patients with newly diagnosed T2DM may have impaired osteoblastic maturation and bone formation, which may be mainly attributed to hyperglycaemia.
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Affiliation(s)
- Huijuan Li
- Department of Endocrinology, Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yuhua Wen
- Department of Endocrinology, Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Peipei Liu
- Department of Endocrinology, Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Liya Zhang
- Department of Endocrinology, Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xiaoya Zhang
- Department of Endocrinology, Tongji Hospital, Tongji University School of Medicine, Shanghai, China
- Institute of Osteoporosis and Metabolic Bone Diseases, Tongji University School of Medicine, Shanghai, China
| | - Yichen Liu
- Department of Endocrinology, Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Bin Ma
- Division of Spine, Department of Orthopedics, Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Haidong Kuang
- Yichuan Community Health Service Center, Shanghai, China
| | - Jianxin Wang
- Yichuan Community Health Service Center, Shanghai, China
| | - Lige Song
- Department of Endocrinology, Tongji Hospital, Tongji University School of Medicine, Shanghai, China
- Institute of Osteoporosis and Metabolic Bone Diseases, Tongji University School of Medicine, Shanghai, China
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Undenatured Type II Collagen Relieves Bone Impairment through Improving Inflammation and Oxidative Stress in Ageing db/db Mice. Molecules 2021; 26:molecules26164942. [PMID: 34443530 PMCID: PMC8400234 DOI: 10.3390/molecules26164942] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 08/03/2021] [Accepted: 08/09/2021] [Indexed: 12/26/2022] Open
Abstract
Ageing-related bone impairment due to exposure to hyperglycemic environment is scarcely researched. The aim was to confirm the improvement effects of undenatured type II collagen (UC II) on bone impairment in ageing db/db mice, and the ageing model was established by normal feeding for 48-week-old. Then, the ageing db/db mice were randomly assigned to UC II intervention, the ageing model, and the chondroitin sulfate + glucosamine hydrochloride control groups. After 12 weeks of treatment, femoral microarchitecture and biomechanical parameters were observed, biomarkers including bone metabolism, inflammatory cytokines, and oxidative stress were measured, and the gastrocnemius function and expressions of interleukin (IL) 1β, receptor activator of nuclear factor (NF)-κB ligand (RANKL), and tartrate-resistant acid phosphatase (TRAP) were analyzed. The results showed that the mice in the UC II intervention group showed significantly superior bone and gastrocnemius properties than those in the ageing model group, including bone mineral density (287.65 ± 72.77 vs. 186.97 ± 32.2 mg/cm3), gastrocnemius index (0.46 ± 0.07 vs. 0.18 ± 0.01%), muscle fiber diameter (0.0415 ± 0.005 vs. 0.0330 ± 0.002 mm), and cross-sectional area (0.0011 ± 0.00007 vs. 0.00038 ± 0.00004 mm2). The UC II intervention elevated bone mineralization and formation and decreased bone resorption, inflammatory cytokines, and the oxidative stress. In addition, lower protein expression of IL-1β, RANKL, and TRAP in the UC II intervention group was observed. These findings suggested that UC II improved bones impaired by T2DM during ageing, and the likely mechanism was partly due to inhibition of inflammation and oxidative stress.
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Ekeuku SO, Chong PN, Chan HK, Mohamed N, Froemming GR, Okechukwu PN. Spirulina supplementation improves bone structural strength and stiffness in streptozocin-induced diabetic rats. J Tradit Complement Med 2021; 12:225-234. [PMID: 35493310 PMCID: PMC9039118 DOI: 10.1016/j.jtcme.2021.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 07/29/2021] [Accepted: 07/30/2021] [Indexed: 11/26/2022] Open
Abstract
Spirulina (blue-green algae) contains a wide range of nutrients with medicinal properties which include β-carotene, chromium, and moderate amounts of vitamins B12. This study aims to determine the preventive effect of spirulina against bone fragility linked to type 2 diabetes mellitus. Thirty Sprague-Dawley rats were divided into five groups (n = 6) and diabetes was induced using streptozocin. Rats with a plasma glucose level of 10 mmol/L and above were orally treated for twelve weeks with either a single dose of spirulina, metformin, or a combined dose of spirulina + metformin per day. After the treatment, blood and bones were taken for biochemical analysis, three-dimensional imaging, 3-point biomechanical analysis, histology imaging and gene expression using qPCR. Results showed that diabetes induction and treatment with metformin caused destruction in the trabecular microarchitecture of the femur bone, reduction in serum bone marker and expression of bone formation marker genes in the experimental rats. Spirulina supplementation showed improved trabecular microarchitecture with a denser trabecular network, increased 25-OH vitamin D levels, and lowered the level of phosphate and calcium in the serum. Biomechanical tests revealed increased maximum force, stress strain, young modulus and histology images showed improvement in regular mesh and an increase in osteoblasts and osteocytes. There was an increase in the expression of bone formation marker osteocalcin. The results suggest that spirulina supplementation was more effective at improving bone structural strength and stiffness in diabetic rats compared to metformin. Spirulina may be able to prevent T2DM-related brittle bone, lowering the risk of fracture.
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Chiodini I, Gaudio A, Palermo A, Napoli N, Vescini F, Falchetti A, Merlotti D, Eller-Vainicher C, Carnevale V, Scillitani A, Pugliese G, Rendina D, Salcuni A, Bertoldo F, Gonnelli S, Nuti R, Toscano V, Triggiani V, Cenci S, Gennari L. Management of bone fragility in type 2 diabetes: Perspective from an interdisciplinary expert panel. Nutr Metab Cardiovasc Dis 2021; 31:2210-2233. [PMID: 34059385 DOI: 10.1016/j.numecd.2021.04.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 04/11/2021] [Accepted: 04/15/2021] [Indexed: 12/22/2022]
Abstract
AIM Bone fragility is increasingly recognized as a relevant complication of type 2 diabetes (T2D) and diabetic patients with fragility fractures have higher mortality rates than non diabetic individuals or diabetic patients without fractures. However, current diagnostic approaches for fracture risk stratification, such as bone mineral density measurement or the use of risk assessment algorithms, largely underestimate fracture risk in T2D patients. A multidisciplinary expert panel was established in order to in order to formulate clinical consensus recommendations on bone health assessment and management of fracture risk in patients with T2D. DATA SYNTHESIS The following key questions were addressed: a) which are the risk factors for bone fragility in T2D?, b) which diagnostic procedures can be currently used to stratify fracture risk in T2D patients?, c) which are the effects of antidiabetic treatments on bone?, and d) how to prevent and treat bone fragility in T2D patients? Based on the available data members of this panel suggest that the stratification of fracture risk in patients with diabetes should firstly rely on the presence of a previous fragility fracture and on the individual risk profile, with the inclusion of T2D-specific risk factors (namely T2D duration above 10 yrs, presence of chronic T2D complications, use of insulin or thiazolidinediones and persistent HbA1c levels above 8% for at least 1 year). Two independent diagnostic approaches were then suggested in the presence or the absence of a prevalent fragility fracture, respectively. CONCLUSIONS Clinical trials in T2D patients at risk for fragility fractures are needed to determine the efficacy and safety of available antiresorptive and anabolic agents in this specific setting.
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Affiliation(s)
- Iacopo Chiodini
- Unit for Bone Metabolism Diseases and Diabetes and Lab of Endocrine and Metabolic Research, IRCCS Istituto Auxologico Italiano, Milan, Italy; Department of Medical Science and Community Health, University of Milan, Milan, Italy
| | - Agostino Gaudio
- Department of Clinical and Experimental Medicine, University of Catania, University Hospital "G. Rodolico" Catania, Italy
| | - Andrea Palermo
- Department of Endocrinology and Diabetes, University Campus Bio-Medico, Rome, Italy
| | - Nicola Napoli
- Department of Endocrinology and Diabetes, University Campus Bio-Medico, Rome, Italy
| | - Fabio Vescini
- Endocrinology and Metabolism Unit, University-Hospital S. M. Misericordia of Udine, Italy
| | - Alberto Falchetti
- Unit for Bone Metabolism Diseases and Diabetes and Lab of Endocrine and Metabolic Research, IRCCS Istituto Auxologico Italiano, Milan, Italy; EndOsMet, Villa Donatello Private Hospital, Florence, Italy
| | - Daniela Merlotti
- Department of Medicine, Surgery and Neurosciences, University of Siena, Policlinico Le Scotte, Siena, Italy; Division of Genetics and Cell Biology, San Raffaele Scientific Institute, Milan, Italy
| | | | - Vincenzo Carnevale
- Unit of Internal Medicine, "Casa Sollievo della Sofferenza" Hospital, IRCCS, San Giovanni Rotondo, (FG), Italy
| | - Alfredo Scillitani
- Unit of Endocrinology, "Casa Sollievo della Sofferenza" Hospital, IRCCS, San Giovanni Rotondo, (FG), Italy
| | - Giuseppe Pugliese
- Department of Clinical and Molecular Medicine, "La Sapienza" University, and Diabetes Unit, Sant'Andrea University Hospital, Rome, Italy
| | - Domenico Rendina
- Department of Clinical Medicine and Surgery, "Federico II" University of Naples, Naples, Italy
| | - Antonio Salcuni
- Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Francesco Bertoldo
- Department of Medicine, University of Verona, Policlinico GB Rossi, Verona, Italy
| | - Stefano Gonnelli
- Department of Medicine, Surgery and Neurosciences, University of Siena, Policlinico Le Scotte, Siena, Italy
| | - Ranuccio Nuti
- Department of Medicine, Surgery and Neurosciences, University of Siena, Policlinico Le Scotte, Siena, Italy
| | - Vincenzo Toscano
- Department of Clinical and Molecular Medicine, "La Sapienza" University, Rome, Italy
| | - Vincenzo Triggiani
- Interdisciplinary Department of Medicine, Section of Internal Medicine, Geriatrics, Endocrinology and Rare Diseases. University of Bari "Aldo Moro", Bari, Italy
| | - Simone Cenci
- Division of Genetics and Cell Biology, San Raffaele Scientific Institute, Milan, Italy
| | - Luigi Gennari
- Department of Medicine, Surgery and Neurosciences, University of Siena, Policlinico Le Scotte, Siena, Italy.
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Brunetti G, D'Amato G, De Santis S, Grano M, Faienza MF. Mechanisms of altered bone remodeling in children with type 1 diabetes. World J Diabetes 2021; 12:997-1009. [PMID: 34326950 PMCID: PMC8311475 DOI: 10.4239/wjd.v12.i7.997] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 03/17/2021] [Accepted: 05/22/2021] [Indexed: 02/06/2023] Open
Abstract
Bone loss associated with type 1 diabetes mellitus (T1DM) begins at the onset of the disease, already in childhood, determining a lower bone mass peak and hence a greater risk of osteoporosis and fractures later in life. The mechanisms underlying diabetic bone fragility are not yet completely understood. Hyperglycemia and insulin deficiency can affect the bone cells functions, as well as the bone marrow fat, thus impairing the bone strength, geometry, and microarchitecture. Several factors, like insulin and growth hormone/insulin-like growth factor 1, can control bone marrow mesenchymal stem cell commitment, and the receptor activator of nuclear factor-κB ligand/osteoprotegerin and Wnt-b catenin pathways can impair bone turnover. Some myokines may have a key role in regulating metabolic control and improving bone mass in T1DM subjects. The aim of this review is to provide an overview of the current knowledge of the mechanisms underlying altered bone remodeling in children affected by T1DM.
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Affiliation(s)
- Giacomina Brunetti
- Department of Biosciences, Biotechnologies and Biopharmaceutics, University "A. Moro" of Bari, Bari 70125, Italy
| | - Gabriele D'Amato
- Department of Women’s and Children’s Health, ASL Bari, Neonatal Intensive Care Unit, Di Venere Hospital, Bari 70124, Italy
| | - Stefania De Santis
- Department of Pharmacy-Drug Science, University of Bari Aldo Moro, Bari 70126, Italy
| | - Maria Grano
- Department of Emergency and Organ Transplantation, Univ Bari, Bari 70124, Italy
| | - Maria Felicia Faienza
- Department of Biomedical Sciences and Human Oncology, Pediatric Unit, University "A.Moro", Bari 70124, Italy
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Kitaura H, Ogawa S, Ohori F, Noguchi T, Marahleh A, Nara Y, Pramusita A, Kinjo R, Ma J, Kanou K, Mizoguchi I. Effects of Incretin-Related Diabetes Drugs on Bone Formation and Bone Resorption. Int J Mol Sci 2021; 22:ijms22126578. [PMID: 34205264 PMCID: PMC8234693 DOI: 10.3390/ijms22126578] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 06/14/2021] [Accepted: 06/15/2021] [Indexed: 12/12/2022] Open
Abstract
Patients with type 2 diabetes have an increased risk of fracture compared to the general population. Glucose absorption is accelerated by incretin hormones, which induce insulin secretion from the pancreas. The level of the incretin hormone, glucagon-like peptide-1 (GLP-1), shows an immediate postprandial increase, and the circulating level of intact GLP-1 is reduced rapidly by dipeptidyl peptidase-4 (DPP-4)-mediated inactivation. Therefore, GLP-1 receptor agonists and DPP-4 inhibitors are effective in the treatment of type 2 diabetes. However, these incretin-related diabetic agents have been reported to affect bone metabolism, including bone formation and resorption. These agents enhance the expression of bone markers, and have been applied to improve bone quality and bone density. In addition, they have been reported to suppress chronic inflammation and reduce the levels of inflammatory cytokine expression. Previously, we reported that these incretin-related agents inhibited both the expression of inflammatory cytokines and inflammation-induced bone resorption. This review presents an overview of current knowledge regarding the effects of incretin-related diabetes drugs on osteoblast differentiation and bone formation as well as osteoclast differentiation and bone resorption. The mechanisms by which incretin-related diabetes drugs regulate bone formation and bone resorption are also discussed.
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Vilaca T, Paggiosi M, Walsh JS, Selvarajah D, Eastell R. The Effects of Type 1 Diabetes and Diabetic Peripheral Neuropathy on the Musculoskeletal System: A Case-Control Study. J Bone Miner Res 2021; 36:1048-1059. [PMID: 33825260 DOI: 10.1002/jbmr.4271] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 02/05/2021] [Accepted: 02/10/2021] [Indexed: 12/22/2022]
Abstract
Fracture risk is increased in type 1 diabetes (T1D). Diabetic neuropathy might contribute to this increased risk directly through effects on bone turnover and indirectly through effects on balance, muscle strength, and gait. We compared patients with T1D with (T1DN+, n = 20) and without (T1DN-, n = 20) distal symmetric sensorimotor polyneuropathy and controls (n = 20). We assessed areal bone mineral density (aBMD) and appendicular muscle mass by dual-energy X-ray absorptiometry, microarchitecture by high-resolution peripheral quantitative tomography at the standard ultra-distal site and at an exploratory 14% bone length site at the tibia and radius, bone turnover markers, and muscle strength, gait, and balance by Short Physical Performance Battery (SPPB). At the standard ultra-distal site, tibial cortical porosity was 56% higher in T1DN+ compared with T1DN- (p = .009) and correlated positively with the severity of neuropathy (Toronto Clinical Neuropathy Score; r = 0.347, p = .028) and negatively with nerve conduction amplitude and velocity (r = -0.386, p = .015 and r = -0.358, p = .025, respectively). Similar negative correlations were also observed at the radius (r = -0.484, p = .006 and r = -0.446, p = .012, respectively). At the exploratory 14% offset site (less distal), we found higher trabecular volumetric BMD (tibia 25%, p = .024; radius 46%, p = .017), trabecular bone volume (tibia 25%, p = .023; radius 46%, p = .017), and trabecular number (tibia 22%, p = .014; radius 30%, p = .010) in T1DN- compared with controls. Both CTX and PINP were lower in participants with TD1 compared with controls. No difference was found in aBMD and appendicular muscle mass. T1DN+ had worse performance in the SPPB compared with T1DN- and control. In summary, neuropathy was associated with cortical porosity and worse performance in physical tests. Our findings suggest that bone structure does not fully explain the rate of fractures in T1D. We conclude that the increase in the risk of fractures in T1D is multifactorial with both skeletal and non-skeletal contributions. © 2021 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Tatiane Vilaca
- Academic Unit of Bone Metabolism, University of Sheffield, Sheffield, UK
| | - Margaret Paggiosi
- Academic Unit of Bone Metabolism, University of Sheffield, Sheffield, UK
| | - Jennifer S Walsh
- Academic Unit of Bone Metabolism, University of Sheffield, Sheffield, UK
| | - Dinesh Selvarajah
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | - Richard Eastell
- Academic Unit of Bone Metabolism, University of Sheffield, Sheffield, UK
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Zhou H, Li C, Song W, Wei M, Cui Y, Huang Q, Wang Q. Increasing fasting glucose and fasting insulin associated with elevated bone mineral density-evidence from cross-sectional and MR studies. Osteoporos Int 2021; 32:1153-1164. [PMID: 33409590 DOI: 10.1007/s00198-020-05762-w] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 11/23/2020] [Indexed: 01/09/2023]
Abstract
UNLABELLED We performed a cross-sectional study using the National Health Examination and Nutrition Survey (NHANES) data and a Mendelian randomisation (MR) study using the GWAS summary statistics from European populations. The T2D-related indices (fasting plasma glucose (FPG), fasting insulin (FI), and insulin resistance (IR)) were found to associate with elevated bone mineral density (BMD). INTRODUCTION The known associations amongst FPG, FI, IR, and BMD remain inconsistent. This study aims to explore the abovementioned associations by using cross-sectional and MR designs. METHODS Data from adults aged ≥ 20 years (n = 7170) in four rounds of the U.S. NHANES (2005-2010 and 2013-2014) were analysed in this cross-sectional study. Multiple linear and logistic regression models were used for statistical analyses. A two-sample MR study was performed using the genome-wide association study summary statistics obtained from the Meta-analyses of Glucose and Insulin-related traits Consortium (n = 108,557) and Genetic Factors for Osteoporosis Consortium (n = 32,735) to examine the causality of the FI-BMD association. RESULTS Multiple linear regression revealed that FPG was positively associated with the BMDs at the hip, femur neck, and 1st lumbar spine (L1). Multiple logistic regressions revealed that FPG levels were associated with elevated BMDs at the hip and L1, and FI and IR levels were associated with elevated BMD at the hip. Patients with type 2 diabetes had higher hip BMD than those without diabetes. In the MR study, the lumbar spine BMD increased by 0.49 g/cm2 (95% confidence interval: 0.01, 0.97) in response to per unit increase in log-transformed FI. CONCLUSION Findings from our cross-sectional and MR studies revealed the associations between the studied diabetic indices and BMD measurements in the US and European adults.
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Affiliation(s)
- H Zhou
- MOE Key Laboratory of Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - C Li
- MOE Key Laboratory of Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - W Song
- MOE Key Laboratory of Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - M Wei
- MOE Key Laboratory of Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Y Cui
- MOE Key Laboratory of Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Q Huang
- Department of Rehabilitation Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
| | - Q Wang
- MOE Key Laboratory of Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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Zhu Q, Xu J, Zhou M, Lian X, Xu J, Shi J. Association between type 1 diabetes mellitus and reduced bone mineral density in children: a meta-analysis. Osteoporos Int 2021; 32:1143-1152. [PMID: 33404757 DOI: 10.1007/s00198-020-05715-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 10/23/2020] [Indexed: 12/16/2022]
Abstract
UNLABELLED In this meta-analysis, we analyzed 9 cross-sectional studies for an association between type 1 diabetes mellitus (T1DM) and bone mineral density (BMD) in children. We found that BMD Z-scores were significantly reduced in children with T1DM. INTRODUCTION Recent cross-sectional studies have examined how T1DM influences bone health in children and adolescents, but the relationship between T1DM and BMD remains unclear due to conflicting reports. METHODS In this meta-analysis, we systematically searched PubMed, Cochrane library, and Web of Science databases (for publications through March 12, 2020), and calculated weight mean difference (WMD) along with 95% confidence intervals (CI) using a random-effects model. Heterogeneity was evaluated using the I2 method. The Newcastle-Ottawa Scale was used to assess the quality of the included studies. RESULTS Data were analyzed from 9 eligible studies, including a total of 1522 children and adolescents. These data were tested for an association between T1DM and BMD. This analysis found a significant decrease in BMD Z-score in the whole body (pooled WMD, - 0.47, 95% CI, - 0.92 to - 0.02, I2 = 80.2%) and lumbar spine (pooled WMD, - 0.41, 95% CI, - 0.69 to - 0.12, I2 = 80.3%) in children and adolescents with T1DM, which was consistent in published studies from Asia and South America, but inconsistent in the North America and Europe. Importantly, the differences in BMD Z-scores were independent of age, level of glucose control (HbA1c), and prepubertal stage. Sensitivity analyses did not modify these findings. Funnel plot and the Egger test did not reveal significant publication bias. CONCLUSION This meta-analysis suggests that T1DM may play a role in decreasing BMD Z-scores in the whole body and lumbar spine in children.
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Affiliation(s)
- Q Zhu
- Department of Translational Medicine Platform, Affiliated Hospital of Hangzhou Normal University, No. 126 Wenzhou Road, Gongshu District, Zhejiang Province, 310000, Hangzhou, China
| | - J Xu
- Medical College of Hangzhou Normal University, No.2318 Yuhangtang Road, Yuhang District, Zhejiang Province, 311121, Hangzhou, China
| | - M Zhou
- Department of Neurology, Affiliated Hospital of Hangzhou Normal University, No. 126 Wenzhou Road, Gongshu District, Zhejiang Province, 310000, Hangzhou, China
| | - X Lian
- Metabolic Disease Center and Department of Orthopedics, Affiliated Hospital of Hangzhou Normal University, No. 126 Wenzhou Road, Gongshu District, Zhejiang Province, 310000, Hangzhou, China
| | - J Xu
- Department of Endocrinology, Xinqiao Hospital, Army Medical University, No. 83 Xinqiaozheng road, Shaping District, Chongqing, 400037, China.
| | - J Shi
- Department of Hepatology & Infectious Diseases, Affiliated Hospital of Hangzhou Normal University, No. 126 Wenzhou Road, Gongshu District, Zhejiang Province, 310000, Hangzhou, China.
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Iki M, Yura A, Fujita Y, Kouda K, Tamaki J, Tachiki T, Kajita E, Iwaki H, Ishizuka R, Moon JS, Okamoto N, Kurumatani N. Circulating osteocalcin levels were not significantly associated with the risk of incident type 2 diabetes mellitus in elderly Japanese men: The Fujiwara-kyo Osteoporosis Risk in Men (FORMEN) Cohort Study. Bone 2021; 147:115912. [PMID: 33722774 DOI: 10.1016/j.bone.2021.115912] [Citation(s) in RCA: 2] [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: 12/10/2020] [Revised: 02/25/2021] [Accepted: 03/09/2021] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Cross-sectional studies have shown that patients with type 2 diabetes mellitus (T2DM) have low circulating levels of osteocalcin (OC) and undercarboxylated OC (ucOC). This longitudinal study aimed to examine whether low OC or ucOC levels at baseline are associated with the risk of incident T2DM. METHODS We examined 1700 community-dwelling Japanese men (≥65 years) after excluding those with history of diseases (other than T2DM) or medications that affect bone and glucose metabolism. T2DM was defined as fasting plasma glucose (FPG) ≥126 mg/dl or glycated hemoglobin A1c (HbA1c) ≥6.5%. Participants without prevalent T2DM at baseline were invited to follow-up surveys 5 and 10 years after baseline. RESULTS Among the participants, 309 with prevalent T2DM showed significantly lower serum OC and ucOC levels at baseline than those without. After excluding these participants, 46 and 57 participants with incident T2DM were identified in the first and second follow-up surveys, respectively. These participants did not show significantly different OC and ucOC levels at baseline relative to those without T2DM, although their FPG and HbA1c levels at baseline were significantly higher compared to those without incident T2DM. Increase in glycemic indices preceded decrease in OC and ucOC levels. OC and ucOC levels at baseline were not significantly associated with the risk of incident T2DM identified in the follow-up surveys. CONCLUSIONS OC and ucOC levels at baseline were not significantly associated with the risk of incident T2DM. Our results do not support the findings of animal studies that ucOC is a hormone regulating glucose metabolism.
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Affiliation(s)
- Masayuki Iki
- Department of Public Health, Kindai University Faculty of Medicine, 377-2 Oono-higashi, Osaka-Sayama, Osaka 589-8511, Japan.
| | - Akiko Yura
- Department of Public Health, Kindai University Faculty of Medicine, 377-2 Oono-higashi, Osaka-Sayama, Osaka 589-8511, Japan
| | - Yuki Fujita
- Department of Public Health, Kindai University Faculty of Medicine, 377-2 Oono-higashi, Osaka-Sayama, Osaka 589-8511, Japan
| | - Katsuyasu Kouda
- Department of Hygiene and Public Health, Kansai Medical University, 2-5-1 Shin-machi, Hirakata, Osaka 573-1010, Japan
| | - Junko Tamaki
- Department of Hygiene and Public Health, Osaka Medical College, 2-7 Daigakumachi, Takatsuki, Osaka 569-8686, Japan
| | - Takahiro Tachiki
- Chukyo Gakuin University Faculty of Nursing, 2216 Tokicho, Mizunami, Gifu 509-6192, Japan
| | - Etsuko Kajita
- Chukyo Gakuin University Faculty of Nursing, 2216 Tokicho, Mizunami, Gifu 509-6192, Japan
| | - Hirohisa Iwaki
- Senken Co. Ltd., 1-12-12 Tagacho, Takamatsu, Kagawa 760-0063, Japan
| | - Rika Ishizuka
- Department of Food and Nutrition, Faculty of Contemporary Human Life Science, Tezukayama University, 3-1-3 Gakuenminami, Nara, Nara 631-8585, Japan
| | - Jong-Seong Moon
- Department of Nursing, Kio University, 4-2-2 Umami-naka, Koryo-cho, Nara 635-0832, Japan
| | - Nozomi Okamoto
- Graduate School of Education, Hyogo University of Teacher Education, 942-1 Shimokume, Kato-City, Hyogo 673-1494, Japan
| | - Norio Kurumatani
- Nara Medical University School of Medicine, 840 Shijocho, Kashihara, Nara 634-8521, Japan
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Donat A, Knapstein PR, Jiang S, Baranowsky A, Ballhause TM, Frosch KH, Keller J. Glucose Metabolism in Osteoblasts in Healthy and Pathophysiological Conditions. Int J Mol Sci 2021; 22:ijms22084120. [PMID: 33923498 PMCID: PMC8073638 DOI: 10.3390/ijms22084120] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 04/11/2021] [Accepted: 04/14/2021] [Indexed: 01/01/2023] Open
Abstract
Bone tissue in vertebrates is essential to performing movements, to protecting internal organs and to regulating calcium homeostasis. Moreover, bone has also been suggested to contribute to whole-body physiology as an endocrine organ, affecting male fertility; brain development and cognition; and glucose metabolism. A main determinant of bone quality is the constant remodeling carried out by osteoblasts and osteoclasts, a process consuming vast amounts of energy. In turn, clinical conditions associated with impaired glucose metabolism, including type I and type II diabetes and anorexia nervosa, are associated with impaired bone turnover. As osteoblasts are required for collagen synthesis and matrix mineralization, they represent one of the most important targets for pharmacological augmentation of bone mass. To fulfill their function, osteoblasts primarily utilize glucose through aerobic glycolysis, a process which is regulated by various molecular switches and generates adenosine triphosphate rapidly. In this regard, researchers have been investigating the complex processes of energy utilization in osteoblasts in recent years, not only to improve bone turnover in metabolic disease, but also to identify novel treatment options for primary bone diseases. This review focuses on the metabolism of glucose in osteoblasts in physiological and pathophysiological conditions.
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High glucose promotes mineralization via bone morphogenetic protein 4-Smad signals in early stage of osteoblast differentiation. Diabetol Int 2021; 12:171-180. [PMID: 33786272 DOI: 10.1007/s13340-020-00463-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 08/24/2020] [Indexed: 12/11/2022]
Abstract
Diabetes mellitus is associated with bone fragility. Although osteoblast maturation is disturbed in patients with diabetes mellitus, the involvement of high glucose (HG) in different stages of osteoblast maturation is unclear. We used MC3T3-E1 cells, a murine osteoblastic cell line. The cells were incubated in high glucose medium (16.5 and 27.5 mM) with three different time courses: throughout 21 days, only first 7 days (early stage) and only last 7 days (late stage). Mineralization assay showed that HG throughout 21 days increased mineralization compared with control (5.5 mM). In the time course experiment, HG increased mRNA expression of Alp, osteocalcin (Ocn), runt-related transcription factor 2 and osterix on days 3 and 5. By contrast, long-term treatment with HG (14 and 21 days) decreased expression of these osteoblastic markers. HG only during early stage enhanced mineralization, while HG only during late stage had no effects. HG increased the expression of bone morphogenetic protein (BMP) 4 and enhanced phosphorylation of Smad1/5/8. Treatment with a BMP receptor antagonist LDN193189 prevented the HG-induced mineralization during early stage of osteoblast differentiation, indicating that HG in the early stage promotes mineralization by BMP4. In conclusion, the study demonstrates that continuous HG treatment might enhance early osteoblast differentiation but disturbs osteoblast maturation, and that BMP-4-Smad signal might be involved in the HG-induced differentiation and mineralization of osteoblasts.
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Sedky AA. Improvement of cognitive function, glucose and lipid homeostasis and serum osteocalcin levels by liraglutide in diabetic rats. Fundam Clin Pharmacol 2021; 35:989-1003. [PMID: 33683755 DOI: 10.1111/fcp.12664] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 02/25/2021] [Accepted: 03/01/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND Glucose and lipid abnormalities, oxidative stress (OXS) and reduced brain-derived neurotrophic factor (BDNF) are involved in cognitive dysfunction in diabetes. Glucagon like peptide 1 (GLP1) receptors modulate glucose and lipid metabolism, cognitive function and serum osteocalcin. On the other hand, osteocalcin modulates cognitive function and glucose and lipid metabolism. This study investigated whether the GLP 1 agonist liraglutide improves cognitive function via modulation of serum osteocalcin and glucose and lipid metabolism. METHODS Effects of 4 weeks liraglutide treatment (100 µg/Kg/d and 300 µg/Kg/d) on changes in cognitive function and bone homeostasis, induced by high fat diet/low-dose streptozotocin (HFD-STZ), were determined in rats. Cognitive function was assessed using Morris water maze (MWM) test. Serum and bone biochemical parameters were determined. RESULTS Liraglutide dose-dependently improved cognitive function in diabetic rats (reduced escape latency, and increased time spent in target quadrant in MWM test, compared to diabetic control). Glucose and lipid abnormalities and the associated changes in serum BDNF and oxidative stress makers were improved. Serum BDNF and glutathione were significantly increased, whereas malondialdehyde level was reduced. Serum osteocalcin was significantly increased and correlated with improvement in cognitive dysfunction. Serum and bone receptor activator of nuclear factor κB ligand (RANKL)/osteoprotegerin ratios were significantly reduced by liraglutide treatment. CONCLUSION Improvement of cognitive dysfunction by liraglutide involves modulation of glucose and lipid metabolism and serum osteocalcin. GLP1 agonists may provide an alternative metabolic approach for cognitive dysfunction in diabetes.
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Gortázar AR, Ardura JA. Osteocytes and Diabetes: Altered Function of Diabetic Osteocytes. Curr Osteoporos Rep 2020; 18:796-802. [PMID: 33184775 DOI: 10.1007/s11914-020-00641-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/28/2020] [Indexed: 12/15/2022]
Abstract
PURPOSE OF REVIEW Diabetes mellitus is a prevalent chronic disease affecting millions of people in the world. Bone fragility is a complication found in diabetic patients. Although osteoblasts and osteoclasts are directly affected by diabetes, herein we focus on how the diabetic state-based on hyperglycemia and accumulation of advanced glycation end products among other features-impairs osteocyte functions exerting deleterious effects on bone. RECENT FINDINGS In the last years, several studies described that diabetic conditions cause morphological modifications on lacunar-canalicular system, alterations on osteocyte mechanoreceptors and intracellular pathways and on osteocyte communication with other cells through the secretion of proteins such as sclerostin or RANKL. This article gives an overview of events occurring in diabetic osteocytes. In particular, mechanical responses seem to be seriously affected in these conditions, suggesting that mechanical sensibility could be a target for future research in the field.
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Affiliation(s)
- Arancha R Gortázar
- Bone Physiopathology laboratory, Applied Molecular Medicine Institute (IMMA), Universidad San Pablo-CEU, CEU Universities, Campus Monteprincipe, 28925, Alcorcón, Madrid, Spain.
- Departamento de Ciencias Médicas Básicas, Facultad de Medicina, Universidad San Pablo-CEU,CEU Universities, Campus Monteprincipe, 28925, Alcorcón, Madrid, Spain.
| | - Juan A Ardura
- Bone Physiopathology laboratory, Applied Molecular Medicine Institute (IMMA), Universidad San Pablo-CEU, CEU Universities, Campus Monteprincipe, 28925, Alcorcón, Madrid, Spain
- Departamento de Ciencias Médicas Básicas, Facultad de Medicina, Universidad San Pablo-CEU,CEU Universities, Campus Monteprincipe, 28925, Alcorcón, Madrid, Spain
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Joseph TV, Caksa S, Misra M, Mitchell DM. Hip Structural Analysis Reveals Impaired Hip Geometry in Girls With Type 1 Diabetes. J Clin Endocrinol Metab 2020; 105:5905592. [PMID: 32929477 PMCID: PMC8161549 DOI: 10.1210/clinem/dgaa647] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 09/10/2020] [Indexed: 01/29/2023]
Abstract
CONTEXT Among patients with type 1 diabetes (T1D), the risk of hip fracture is up to 6-fold greater than that of the general population. However, the cause of this skeletal fragility remains poorly understood. OBJECTIVE To assess differences in hip geometry and imaging-based estimates of bone strength between youth with and without T1D using dual-energy x-ray absorptiometry (DXA)-based hip structural analysis. DESIGN Cross-sectional comparison. PARTICIPANTS Girls ages 10 to 16 years, including n = 62 with T1D and n = 61 controls. RESULTS The groups had similar age, bone age, pubertal stage, height, lean mass, and physical activity. Bone mineral density at the femoral neck and total hip did not differ in univariate comparisons but was lower at the femoral neck in T1D after adjusting for bone age, height, and lean mass. Subjects with T1D had significantly lower cross-sectional area, cross-sectional moment of inertia, section modulus, and cortical thickness at the narrow neck, with deficits of 5.7% to 10.3%. Cross-sectional area was also lower at the intertrochanteric region in girls with T1D. Among those T1D subjects with HbA1c greater than the cohort median of 8.5%, deficits in hip geometry and strength estimates were more pronounced. CONCLUSIONS DXA-based hip structural analysis revealed that girls with T1D have unfavorable geometry and lower estimates of bone strength at the hip, which may contribute to skeletal fragility and excess hip fracture risk in adulthood. Higher average glycemia may exacerbate effects of T1D on hip geometry.
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Affiliation(s)
- Taïsha V Joseph
- Endocrine Unit, Massachusetts General
Hospital, Boston, Massachusetts
| | - Signe Caksa
- Endocrine Unit, Massachusetts General
Hospital, Boston, Massachusetts
| | - Madhusmita Misra
- Pediatric Endocrine Unit, Massachusetts General
Hospital, Boston, Massachusetts
- Neuroendocrine Unit, Massachusetts General
Hospital, Boston, Massachusetts
| | - Deborah M Mitchell
- Endocrine Unit, Massachusetts General
Hospital, Boston, Massachusetts
- Pediatric Endocrine Unit, Massachusetts General
Hospital, Boston, Massachusetts
- Correspondence and Reprint Requests:
Deborah Mitchell, MD, Endocrine Unit, Massachusetts General Hospital, 50 Blossom
St., Boston, MA 02114, USA. E-mail:
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High-fat diet effect on periapical lesions and hepatic enzymatic antioxidant in rats. Life Sci 2020; 264:118637. [PMID: 33203524 DOI: 10.1016/j.lfs.2020.118637] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 10/17/2020] [Accepted: 10/19/2020] [Indexed: 12/11/2022]
Abstract
AIMS To evaluate the effects of a high-fat diet (HFD) on the progression of apical periodontitis (AP), local inflammation, systemic antioxidant status, and blood lipid profile in rats. MAIN METHODS Sixteen male Wistar rats were fed a standard diet (SD) or a HFD. At the sixth experimental week, the pulp chambers of the mandibular first molars were exposed to develop AP. A glucose tolerance test was performed the week before euthanasia. At the tenth experimental week, the animals were euthanized and the livers were collected to estimate catalase (CAT) and reduced glutathione (GSH) levels. Blood was acquired for biochemical analysis. The size of AP was estimated from radiographs and described as AP size-to-body weight ratio; inflammatory grade of AP was determined by histological analysis. KEY FINDINGS At the end of the experimental period, the rats fed the HFD had 30% less weight (P < 0.0001) and higher blood glucose levels after 30 min of sucrose intake (P < 0.05) than those fed the SD. Animals from the HFD group had lower levels of CAT (P < 0.01), but the same was not observed in the GSH levels. Plasma insulin and total cholesterol were not affected by the diet. The rats fed the HFD presented greater AP than those fed the SD (P < 0.05). However, the local inflammatory infiltrate was similar in both groups. SIGNIFICANCE The alterations promoted by the consumption of a HFD were not only observed systemically, but also locally, producing greater AP in rats than a SD.
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de Oliveira PGFP, Bonfante EA, Bergamo ETP, de Souza SLS, Riella L, Torroni A, Benalcazar Jalkh EB, Witek L, Lopez CD, Zambuzzi WF, Coelho PG. Obesity/Metabolic Syndrome and Diabetes Mellitus on Peri-implantitis. Trends Endocrinol Metab 2020; 31:596-610. [PMID: 32591106 DOI: 10.1016/j.tem.2020.05.005] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 05/08/2020] [Accepted: 05/26/2020] [Indexed: 12/27/2022]
Abstract
Literature has reported that up to 50% of dental implants may be affected by peri-implantitis, a bacteria-induced chronic inflammatory process, which promotes osteoclast-mediated bone resorption and inhibits bone formation, leading to progressive bone loss around implants. Current evidence points toward an increased risk for the development of peri-implantitis in both obesity/metabolic syndrome (MetS) and diabetes mellitus (DM) conditions relative to the healthy population. Currently, there is no effective treatment for peri-implantitis and the 50% prevalence in MetS and DM, along with its predicted increase in the worldwide population, presents a major concern in implant dentistry as hyperglycemic conditions are associated with bone-healing impairment; this may be through dysfunction of osteocalcin-induced glucose metabolism. The MetS/DM proinflammatory systemic condition and altered immune/microbiome response affect both catabolic and anabolic events of bone-healing that include increased osteoclastogenesis and compromised osteoblast activity, which could be explained by the dysfunction of insulin receptor that led to activation of signals related with osteoblast differentiation. Furthermore, chronic hyperglycemia along with associated micro- and macro-vascular ailments leads to delayed/impaired wound healing due to activation of pathways that are particularly important in initiating events linked to inflammation, oxidative stress, and cell apoptosis; this may be through deactivation of AKT/PKB protein, which possesses a pivotal role in drive survival and eNOS signaling. This review presents an overview of the local and systemic mechanisms synergistically affecting bone-healing impairment in MetS/DM individuals, as well as a rationale for hierarchical animal model selection, in an effort to characterize peri-implantitis disease and treatment.
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Affiliation(s)
- Paula Gabriela Faciola Pessôa de Oliveira
- Department of Biomaterials and Biomimetics, New York University College of Dentistry, New York, NY, USA; Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, SP, Brazil; Department of Periodontology, School of Dentistry, University Center of State of Para, Belem, PA, Brazil
| | - Estevam A Bonfante
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of Sao Paulo, Bauru, SP, Brazil
| | - Edmara T P Bergamo
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of Sao Paulo, Bauru, SP, Brazil
| | - Sérgio Luis Scombatti de Souza
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Leonardo Riella
- Division of Nephrology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Andrea Torroni
- Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health School of Medicine, New York, NY, USA
| | - Ernesto B Benalcazar Jalkh
- Department of Biomaterials and Biomimetics, New York University College of Dentistry, New York, NY, USA; Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of Sao Paulo, Bauru, SP, Brazil
| | - Lukasz Witek
- Department of Biomaterials and Biomimetics, New York University College of Dentistry, New York, NY, USA; Department of Biomedical Engineering, NYU Tandon School of Engineering, New York University, Brooklyn, NY, USA
| | - Christopher D Lopez
- Department of Plastic and Reconstructive Surgery, Johns Hopkins School of Medicine Baltimore, MD, USA
| | - Willian Fernando Zambuzzi
- Department of Chemical and Biological Sciences, Bioscience Institute (IBB), UNESP - São Paulo State University, Botucatu, São Paulo, Brazil
| | - Paulo G Coelho
- Department of Biomaterials and Biomimetics, New York University College of Dentistry, New York, NY, USA; Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health School of Medicine, New York, NY, USA; Department of Mechanical and Aerospace Engineering, NYU Tandon School of Engineering, Brooklyn, NY, USA.
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Tiedemann K, Hussein O, Komarova SV. Role of Altered Metabolic Microenvironment in Osteolytic Metastasis. Front Cell Dev Biol 2020; 8:435. [PMID: 32582711 PMCID: PMC7290111 DOI: 10.3389/fcell.2020.00435] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 05/08/2020] [Indexed: 12/17/2022] Open
Abstract
Metastatic bone disease is generally incurable and leads to pathological fractures, pain, hypercalcemia, spinal cord compression and decreased mobility. The skeleton is the major site of bone metastases from solid cancers, including breast and prostate carcinoma. Bone metastasis is facilitated by activation of bone-resorbing osteoclasts, terminally differentiated multinucleated cells formed by fusion from monocytic precursors. Cancer cells are known to produce specific factors that stimulate osteoclast differentiation and function. Of interest, cancer cells are also known to alter their own bioenergetics increasing the use of glycolysis for their survival and function. Such change in energy utilization by cancer cells would result in altered levels of cell-permeable metabolites, including glucose, lactate, and pyruvate. Osteoclast resorption is energy-expensive, and we have previously demonstrated that during differentiation osteoclasts actively adapt to their bioenergetics microenvironment. We hypothesize that altered bioenergetics state of cancer cells will also modify the bioenergetics substrate availability for the tissue-resident bone cells, potentially creating a favorable milieu for pathological osteolysis. The goals of this review are to analyze how metastasizing cancer cells change the availability of energy substrates in bone microenvironment; and to assess how the altered bioenergetics may affect osteoclast differentiation and activity.
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Affiliation(s)
- Kerstin Tiedemann
- Faculty of Dentistry, McGill University, Montréal, QC, Canada.,Shriners Hospitals for Children - Canada, Montréal, QC, Canada
| | - Osama Hussein
- Department of Surgery, Mansoura University Cancer Center, Mansoura, Egypt
| | - Svetlana V Komarova
- Faculty of Dentistry, McGill University, Montréal, QC, Canada.,Shriners Hospitals for Children - Canada, Montréal, QC, Canada
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Pahwa H, Khan MT, Sharan K. Hyperglycemia impairs osteoblast cell migration and chemotaxis due to a decrease in mitochondrial biogenesis. Mol Cell Biochem 2020; 469:109-118. [PMID: 32304005 DOI: 10.1007/s11010-020-03732-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Accepted: 04/08/2020] [Indexed: 12/21/2022]
Abstract
Diabetes is associated with an increase in skeletal fragility and risk of fracture. However, the underlying mechanism for the same is not well understood. Specifically, the results from osteoblast cell culture studies are ambiguous due to contradicting reports. The use of supraphysiological concentrations in these studies, unachievable in vivo, might be the reason for the same. Therefore, here, we studied the effect of physiologically relevant levels of high glucose during diabetes (11.1 mM) on MC3T3-E1 osteoblast cell functions. The results showed that high glucose exposure to osteoblast cells increases their differentiation and mineralization without any effect on the proliferation. However, high glucose decreases their migratory potential and chemotaxis with a decrease in the associated cell signaling. Notably, this decrease in cell migration in high glucose conditions was accompanied by aberrant localization of Dynamin 2 in osteoblast cells. Besides, high glucose also caused a shift in mitochondrial dynamics towards the appearance of more fused and lesser fragmented mitochondria, with a concomitant decrease in the expression of DRP1, suggesting decreased mitochondrial biogenesis. In conclusion, here we are reporting for the first time that hyperglycemia causes a reduction in osteoblast cell migration and chemotaxis. This decrease might lead to an inefficient movement of osteoblasts to the erosion site resulting in uneven mineralization and skeletal fragility found in type 2 diabetes patients, in spite of having normal bone mineral density (BMD).
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Affiliation(s)
- Heena Pahwa
- Department of Molecular Nutrition, CSIR-Central Food Technological Research Institute, Mysuru, 570020, India
| | - Md Touseef Khan
- Department of Molecular Nutrition, CSIR-Central Food Technological Research Institute, Mysuru, 570020, India
| | - Kunal Sharan
- Department of Molecular Nutrition, CSIR-Central Food Technological Research Institute, Mysuru, 570020, India.
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India.
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Mitchell DM, Caksa S, Joseph T, Bouxsein ML, Misra M. Elevated HbA1c Is Associated with Altered Cortical and Trabecular Microarchitecture in Girls with Type 1 Diabetes. J Clin Endocrinol Metab 2020; 105:5639696. [PMID: 31761940 PMCID: PMC7064304 DOI: 10.1210/clinem/dgz221] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 11/22/2019] [Indexed: 12/27/2022]
Abstract
CONTEXT Skeletal fragility is a significant complication of type 1 diabetes (T1D), with an increased risk of fracture observed starting in childhood. Altered bone accrual and microarchitectural development during the critical peripubertal years may contribute to this fragility. OBJECTIVE To evaluate differences in skeletal microarchitecture between girls with T1D and controls and to assess factors associated with these differences. DESIGN Cross-sectional comparison. PARTICIPANTS Girls ages 10-16 years, 62 with T1D and 61 controls. RESULTS Areal bone mineral density (BMD) measured by dual-energy x-ray absorptiometry did not differ between girls with and without T1D. At the distal tibia, trabecular BMD was 7.3 ± 2.9% lower in T1D (P = 0.013), with fewer plate-like and axially-aligned trabeculae. Cortical porosity was 21.5 ± 10.5% higher, while the estimated failure load was 4.7 ± 2.2% lower in T1D (P = 0.043 and P = 0.037, respectively). At the distal radius, BMD and microarchitecture showed similar differences between the groups but did not reach statistical significance. After stratifying by HbA1c, only those girls with T1D and HbA1c > 8.5% differed significantly from controls. P1NP, a marker of bone formation, was lower in T1D while CTX and TRAcP5b, markers of bone resorption and osteoclast number, respectively, did not differ. The insulin-like growth factor 1 (IGF-1) Z-score was lower in T1D, and after adjustment for the IGF-1 Z-score, associations between T1D status and trabecular microarchitecture were largely attenuated. CONCLUSIONS Skeletal microarchitecture is altered in T1D early in the course of disease and among those with higher average glycemia. Suppressed bone formation and lower circulating IGF-1 likely contribute to this phenotype.
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Affiliation(s)
- Deborah M Mitchell
- Endocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
- Pediatric Endocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
- Correspondence and Reprint Requests: Deborah Mitchell, MD, Endocrine Unit, Massachusetts General Hospital, 50 Blossom St., Boston, MA 02114. Phone: 617-724-2034; Fax: 617-726-1703. E-mail:
| | - Signe Caksa
- Endocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Taïsha Joseph
- Endocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Mary L Bouxsein
- Endocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconness Medical Center and Harvard Medical School, Boston, Massachusetts
| | - Madhusmita Misra
- Pediatric Endocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
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Jiang F, Zong Y, Ma X, Jiang C, Shan H, Lin Y, Xia W, Yin F, Wang N, Zhou L, Zhou Z, Yu X. miR-26a Attenuated Bone-Specific Insulin Resistance and Bone Quality in Diabetic Mice. MOLECULAR THERAPY-NUCLEIC ACIDS 2020; 20:459-467. [PMID: 32278305 PMCID: PMC7150437 DOI: 10.1016/j.omtn.2020.03.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 03/19/2020] [Accepted: 03/20/2020] [Indexed: 02/06/2023]
Abstract
Diabetes mellitus is a prevalent disease result in several complications, including bone problems. Previous studies have shown that microRNA (miR)-26a regulates glucose metabolism and plays a protective role in diabetes. However, whether miR-26a also affects bone quality in diabetes remains unknown. In the present study, we evaluated the potential effects of miR-26a on bone in diabetic mice. We administrated miR-26a in streptozotocin-induced diabetic mice. The metabolic parameters, bone quality, osteoblast and osteoclast markers, and insulin signaling activation were measured. miR-26a ameliorated insulin resistance and glucose tolerance, improved bone microarchitecture and quality, increased osteoblasts and bone formation, decreased osteoclasts, and promoted the insulin signaling pathway in diabetic mice. These effects were abolished in insulin receptor-compromised Col1a1-Insr+/- mice. In conclusion, miR-26a could ameliorate bone-specific insulin resistance and bone quality in diabetic mice, which depended on the insulin receptors on osteoblasts. Our findings highlight the potential of miR-26a as a therapeutic target for diabetes mellitus-related bone metabolism and diseases.
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Affiliation(s)
- Fusong Jiang
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Center for Diabetes, Shanghai 200233, China
| | - Yang Zong
- Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Xin Ma
- Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Chaolai Jiang
- Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Haojie Shan
- Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Yiwei Lin
- Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Wenyang Xia
- Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Fuli Yin
- Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Nan Wang
- Department of Emergency, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan, China
| | - Lihui Zhou
- Department of Orthopaedic Surgery, Xiangshan First People's Hospital, Ningbo 315700, Zhejiang, China
| | - Zubin Zhou
- Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China.
| | - Xiaowei Yu
- Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China.
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Direct regulation of fibroblast growth factor 23 by energy intake through mTOR. Sci Rep 2020; 10:1795. [PMID: 32020002 PMCID: PMC7000745 DOI: 10.1038/s41598-020-58663-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 01/20/2020] [Indexed: 11/17/2022] Open
Abstract
To test the hypothesis that fibroblast growth factor 23 (FGF23) is directly regulated by energy intake, in vivo and in vitro experiments were conducted. Three groups of rats were fed diets with high (HC), normal (NC) and low (LC) caloric content that resulted in different energy intake. In vitro, UMR106 cells were incubated in high (HG, 4.5 g/l) or low glucose (LG, 1 g/l) medium. Additional treatments included phosphorus (P), mannitol, rapamycin and everolimus. Intestinal absorption of P and plasma P concentrations were similar in the three groups of rats. As compared with NC, plasma FGF23 concentrations were increased in HC and decreased in the LC group. A significant correlation between energy intake and plasma FGF23 concentrations was observed. In vitro, mRNA FGF23 was significantly higher in UMR106 cells cultured in HG than in LG. When exposed to high P, mRNA FGF23 increased but only when cells were cultured in HG. Cells incubated with HG and mechanistic target of rapamycin (mTOR) inhibitors expressed low mRNA FGF23, similar to the values obtained in LG. In conclusion, this study shows a direct regulation of FGF23 production by energy availability and demonstrates that the mTOR signaling pathway plays a central role in this regulatory system.
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Shiomi K, Yamawaki I, Taguchi Y, Kimura D, Umeda M. Osteogenic Effects of Glucose Concentration for Human Bone Marrow Stromal Cells after Stimulation with Porphyromonas gingivalis Lipopolysaccharide. J HARD TISSUE BIOL 2020. [DOI: 10.2485/jhtb.29.17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Kei Shiomi
- Department of Periodontology, Osaka Dental University
| | - Isao Yamawaki
- Department of Periodontology, Osaka Dental University
| | | | | | - Makoto Umeda
- Department of Periodontology, Osaka Dental University
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Dongare-Bhor S, Lohiya N, Maheshwari A, Ekbote V, Chiplonkar S, Padidela R, Mughal Z, Khadilkar V, Khadilkar A. Muscle and bone parameters in underprivileged Indian children and adolescents with T1DM. Bone 2020; 130:115074. [PMID: 31626994 DOI: 10.1016/j.bone.2019.115074] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Revised: 09/13/2019] [Accepted: 09/17/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND The incidence of Type 1 diabetes mellitus (T1DM) is increasing and sarcopenia and osteoporosis have been reported to be associated with long standing diabetes. There is scarcity of data on bone health status of children with T1DM. Our aim was to assess bone health parameters [by Dual energy X-ray absorptiometry (DXA) and peripheral quantitative computed tomography (pQCT)] and muscle strength (by hand grip) in underprivileged Indian children with T1DM. MATERIAL AND METHODS A cross sectional, observational study was conducted in underprivileged children with diabetes attending the out patient clinic for T1DM at a tertiary care hospital. Children with T1DM with disease duration more than 1 year were included in the study. Age and gender matched controls were also enrolled. Data on age, gender, disease duration, anthropometric parameters and HbA1c were collected. Bone mineral density (BMD) was assessed by dual energy X-ray absorptiometry (Lunar iDXA) and peripheral quantitative computed tomography (pQCT, Stratec XCT 2000) and muscle strength by handgrip. Data were analysed using SPSS 25.0. RESULTS 251 children with T1DM and 250 age gender matched controls were studied. Mean age of T1DM children was 10.8 ± 4.3yrs (controls 10.3 ± 3.6). Mean HbA1C was 9.7 ± 2.1%. The total body less head areal BMD (TBLH aBMD) and lumbar spine bone mineral apparent density (LSBMAD) Z-scores were significantly lower in children with T1DM (-1.5 ± 1.3, -1.3 ± 1.6 respectively) as compared to controls (-0.5 ± 1.3, -0.64 ± 1.5 respectively) (p < 0.05 for both). Z-scores for trabecular and total density (vBMD) were significantly lower in patients with T1DM (-0.7 ± 1.0, -0.7 ± 1.0 respectively) than controls (-0.15 ± 1.2, -0.31 ± 1.1), (p < 0.05) and trabecular density was lower at distal radius with increasing disease duration. Hand-grip strength Z-score was lower in children with T1DM (-3.0 ± 0.5) as compared to controls (-2.8 ± 0.5). Trabecular density and HbA1C concentrations were negatively correlated (R = -0.18, p < 0.05) as was muscle area and HbA1C concentrations (R = -0.17, p < 0.05,). CONCLUSION Bone and muscle health were affected in children with poorly controlled T1DM. With increasing disease duration, attention is required for optimising musculoskeletal health.
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Affiliation(s)
- Shital Dongare-Bhor
- Growth and Endocrine Department, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, 32, Sassoon Road, Pune, Maharashtra, India.
| | - Nikhil Lohiya
- Growth and Endocrine Department, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, 32, Sassoon Road, Pune, Maharashtra, India.
| | - Ankita Maheshwari
- Growth and Endocrine Department, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, 32, Sassoon Road, Pune, Maharashtra, India.
| | - Veena Ekbote
- Growth and Endocrine Department, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, 32, Sassoon Road, Pune, Maharashtra, India.
| | - Shashi Chiplonkar
- Growth and Endocrine Department, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, 32, Sassoon Road, Pune, Maharashtra, India.
| | - Raja Padidela
- Department of Paediatric Endocrinology, Royal Manchester Children's Hospital, Manchester, UK; Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.
| | - Zulf Mughal
- Department of Paediatric Endocrinology, Royal Manchester Children's Hospital, Manchester, UK; Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.
| | - Vaman Khadilkar
- Growth and Endocrine Department, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, 32, Sassoon Road, Pune, Maharashtra, India.
| | - Anuradha Khadilkar
- Growth and Endocrine Department, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, 32, Sassoon Road, Pune, Maharashtra, India.
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Activating transcription factor 4 is required for high glucose inhibits proliferation and differentiation of MC3T3-E1 cells. J Recept Signal Transduct Res 2019; 39:407-414. [PMID: 31847659 DOI: 10.1080/10799893.2019.1690510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Activating transcription factor 4 (ATF4) promotes bone formation in human bone marrow mesenchymal stem cells. However, the underlying mechanisms of ATF4 in high glucose-induced injury of osteoblast still remain unclear. Small interfering RNA and plasmid targeting ATF4 were used to transfect MC3T3-E1 cells to knock down and overexpress ATF4 using Lipofectamin 3000. Cell viability, alkaline phosphatase (ALP) activity and levels were determined by MTT, ALP kit assay, quantitative real-time (qRT)-PCR and Western blot. Osteocalcin (OCN) expression was determined by ELISA, PCR and Western blot. The mRNA and protein levels of ATF4, glucose regulated protein 78 kDa (GRP78) and C/EBP homologous protein (CHOP) were detected by PCR and Western blot. In the current study, viabilities of MC3T3-E1 cells were inhibited by high glucose. Meanwhile, the mRNA and protein levels of ATF4 were effectively up-regulated in high glucose-incubated MC3T3-E1 cells. By conducting functional experiments, silencing ATF4 induced by small interfering RNA partially reversed the inhibitory effects of high glucose on viabilities of MC3T3-E1 cells. We also found that the expressions of ER stress-related proteins (ATF4, GRP78 and CHOP) were higher in high glucose-treated MC3T3-E1 cells but were inhibited by siATF4. However, overexpression of AFT4 had opposite results, and high glucose attenuated the protein levels of osteogenic marker genes ALP and OCN, which were further inhibited by ATF4 knockout gene. Thus, ATF4 was a necessary gene for high glucose to inhibit the proliferation and differentiation of MC3T3-E1 cells.
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Cabrera-Domínguez JJ, Castellanos-Cosano L, Torres-Lagares D, Pérez-Fierro M, Machuca-Portillo G. Clinical performance of titanium-zirconium implants with a hydrophilic surface in patients with controlled type 2 diabetes mellitus: 2-year results from a prospective case-control clinical study. Clin Oral Investig 2019; 24:2477-2486. [PMID: 31701247 DOI: 10.1007/s00784-019-03110-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 10/01/2019] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Analyze the 2-year clinical performance of single-unit titanium-zirconium (TiZr) alloy narrow-diameter (3.3 mm) dental implants with a hydrophilic surface (Straumann® Roxolid®, SLActive®) in patients with controlled type 2 diabetes mellitus (T2DM), measured using the glycated hemoglobin A (HbA1c) concentration test, compared with results in individuals without T2DM. MATERIAL AND METHODS The studied sample consisted of 28 patients, 14 with T2DM (study group) and 14 without (control group). The plaque index, bleeding on probing, probing depth, clinical attachment level, gingival biotype, and marginal bone loss (MBL) at the site of the implants were assessed. HbA1c levels were assessed in all patients during each checkup. RESULTS Two years after implant placement and prosthetic restoration no implant failures were reported in either group, resulting in 100% survival and success rates in both groups. No statistically significant differences in MBL were found between the control and study groups (p > 0.05). CONCLUSIONS Within the limitations of this study, it can be concluded that reduced-diameter TiZr alloy implants with a hydrophilic surface represent a safe and predictable treatment option for patients with well-controlled T2DM. The clinical performance was comparable with that observed in individuals without T2DM in the medium term. CLINICAL RELEVANCE The narrow implants placed in patients with T2DM with well-controlled glycemia (HbA1c) showed a marginal bone loss and success and survival rates similar to those of the control group without DM2, in the medium term.
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Affiliation(s)
- José J Cabrera-Domínguez
- Master's Program for Special Care in Dentistry, School of Dentistry, University of Seville, Seville, Spain
| | - Lizett Castellanos-Cosano
- Master's Program for Special Care in Dentistry, School of Dentistry, University of Seville, Seville, Spain
| | | | - Manuel Pérez-Fierro
- Master's Program for Special Care in Dentistry, School of Dentistry, University of Seville, Seville, Spain
| | - Guillermo Machuca-Portillo
- Special Care in Dentistry, School of Dentistry, University of Seville, c/ Avicena s/n, 41009, Seville, Spain.
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Weber DR, Gordon RJ, Kelley JC, Leonard MB, Willi SM, Hatch-Stein J, Kelly A, Kosacci O, Kucheruk O, Kaafarani M, Zemel BS. Poor Glycemic Control Is Associated With Impaired Bone Accrual in the Year Following a Diagnosis of Type 1 Diabetes. J Clin Endocrinol Metab 2019; 104:4511-4520. [PMID: 31034056 PMCID: PMC6736051 DOI: 10.1210/jc.2019-00035] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Accepted: 04/23/2019] [Indexed: 01/19/2023]
Abstract
CONTEXT Type 1 diabetes (T1D) is associated with an increased fracture risk across the life course. The effects on bone accrual early in the disease are unknown. OBJECTIVE To characterize changes in bone density and structure over the year following diagnosis of T1D and to identify contributors to impaired bone accrual. DESIGN Prospective cohort study. SETTING Academic children's hospital. PARTICIPANTS Thirty-six children, ages 7 to 17 years, enrolled at diagnosis of T1D. OUTCOMES Whole body and regional dual-energy X-ray absorptiometry and tibia peripheral quantitative computed tomography obtained at baseline and 12 months. The primary outcome was bone accrual assessed by bone mineral content (BMC) and areal bone mineral density (aBMD) velocity z score. RESULTS Participants had low total body less head (TBLH) BMC (z = -0.46 ± 0.76), femoral neck aBMD (z = -0.57 ± 0.99), and tibia cortical volumetric BMD (z = -0.44 ± 1.11) at diagnosis, compared with reference data, P < 0.05. TBLH BMC velocity in the year following diagnosis was lower in participants with poor (hemoglobin A1c ≥7.5%) vs good (hemoglobin A1c <7.5%) glycemic control at 12 months, z = -0.36 ± 0.84 vs 0.58 ± 0.71, P = 0.003. TBLH BMC velocity was correlated with gains in tibia cortical area (R = 0.71, P = 0.003) and periosteal circumference (R = 0.67, P = 0.007) z scores in participants with good, but not poor control. CONCLUSIONS Our results suggest that the adverse effects of T1D on BMD develop early in the disease. Bone accrual following diagnosis was impaired in participants with poor glycemic control and appeared to be mediated by diminished bone formation on the periosteal surface.
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Affiliation(s)
- David R Weber
- Golisano Children’s Hospital, University of Rochester Medical Center, Rochester, New York
| | - Rebecca J Gordon
- The Children’s Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jennifer C Kelley
- Monroe Carrell Jr Children’s Hospital at Vanderbilt, Nashville, Tennessee
| | - Mary B Leonard
- Lucille Packard Children’s Hospital, Stanford School of Medicine, Stanford, California
| | - Steven M Willi
- The Children’s Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jacquelyn Hatch-Stein
- The Children’s Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Andrea Kelly
- The Children’s Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Oksana Kosacci
- The Children’s Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Olena Kucheruk
- The Children’s Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Mirna Kaafarani
- Golisano Children’s Hospital, University of Rochester Medical Center, Rochester, New York
| | - Babette S Zemel
- The Children’s Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
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Murray CE, Coleman CM. Impact of Diabetes Mellitus on Bone Health. Int J Mol Sci 2019; 20:ijms20194873. [PMID: 31575077 PMCID: PMC6801685 DOI: 10.3390/ijms20194873] [Citation(s) in RCA: 89] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 09/26/2019] [Accepted: 09/27/2019] [Indexed: 12/21/2022] Open
Abstract
Long-term exposure to a diabetic environment leads to changes in bone metabolism and impaired bone micro-architecture through a variety of mechanisms on molecular and structural levels. These changes predispose the bone to an increased fracture risk and impaired osseus healing. In a clinical practice, adequate control of diabetes mellitus is essential for preventing detrimental effects on bone health. Alternative fracture risk assessment tools may be needed to accurately determine fracture risk in patients living with diabetes mellitus. Currently, there is no conclusive model explaining the mechanism of action of diabetes mellitus on bone health, particularly in view of progenitor cells. In this review, the best available literature on the impact of diabetes mellitus on bone health in vitro and in vivo is summarised with an emphasis on future translational research opportunities in this field.
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Affiliation(s)
- Cliodhna E Murray
- Regenerative Medicine Institute, National University of Ireland, Galway, Biomedical Sciences Building, Dangan, Newcastle Road, Galway City, County Galway, H91W2TY, Ireland.
| | - Cynthia M Coleman
- Regenerative Medicine Institute, National University of Ireland, Galway, Biomedical Sciences Building, Dangan, Newcastle Road, Galway City, County Galway, H91W2TY, Ireland.
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Costantini S, Conte C. Bone health in diabetes and prediabetes. World J Diabetes 2019; 10:421-445. [PMID: 31523379 PMCID: PMC6715571 DOI: 10.4239/wjd.v10.i8.421] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 06/03/2019] [Accepted: 07/20/2019] [Indexed: 02/05/2023] Open
Abstract
Bone fragility has been recognized as a complication of diabetes, both type 1 diabetes (T1D) and type 2 diabetes (T2D), whereas the relationship between prediabetes and fracture risk is less clear. Fractures can deeply impact a diabetic patient’s quality of life. However, the mechanisms underlying bone fragility in diabetes are complex and have not been fully elucidated. Patients with T1D generally exhibit low bone mineral density (BMD), although the relatively small reduction in BMD does not entirely explain the increase in fracture risk. On the contrary, patients with T2D or prediabetes have normal or even higher BMD as compared with healthy subjects. These observations suggest that factors other than bone mass may influence fracture risk. Some of these factors have been identified, including disease duration, poor glycemic control, presence of diabetes complications, and certain antidiabetic drugs. Nevertheless, currently available tools for the prediction of risk inadequately capture diabetic patients at increased risk of fracture. Aim of this review is to provide a comprehensive overview of bone health and the mechanisms responsible for increased susceptibility to fracture across the spectrum of glycemic status, spanning from insulin resistance to overt forms of diabetes. The management of bone fragility in diabetic patient is also discussed.
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Affiliation(s)
- Silvia Costantini
- Department of Immunology, Transplantation and Infectious Diseases, Vita-Salute San Raffaele University, Milan 20123, Italy
- Epatocentro Ticino, Lugano 6900, Switzerland
| | - Caterina Conte
- Department of Immunology, Transplantation and Infectious Diseases, Vita-Salute San Raffaele University, Milan 20123, Italy
- IRCCS Ospedale San Raffaele, Internal Medicine and Transplantation, Milan 20123, Italy
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48
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Rehmannia glutinosa Libosch Extracts Prevent Bone Loss and Architectural Deterioration and Enhance Osteoblastic Bone Formation by Regulating the IGF-1/PI3K/mTOR Pathway in Streptozotocin-Induced Diabetic Rats. Int J Mol Sci 2019; 20:ijms20163964. [PMID: 31443143 PMCID: PMC6720794 DOI: 10.3390/ijms20163964] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 08/10/2019] [Accepted: 08/13/2019] [Indexed: 12/16/2022] Open
Abstract
Rehmanniae Radix Praeparata (RR, named as Shudihuang in traditional Chinese medicine), the steamed roots of Rehmannia glutinosa Libosch (Scrophulariaceae), has been demonstrated to have anti-diabetic and anti-osteoporotic activities. This study aimed to explore the protective effect and underlying mechanism of RR on diabetes-induced bone loss. It was found that RR regulated the alkaline phosphatase activity and osteocalcin level, enhanced bone mineral density, and improved the bone microarchitecture in diabetic rats. The catalpol (CAT), acteoside (ACT), and echinacoside (ECH) from RR increased the proliferation and differentiation of osteoblastic MC3T3-E1 cells injured by high glucose and promoted the production of IGF-1 and expression of related proteins in BMP and IGF-1/PI3K/mammalian target of rapamycin complex 1 (mTOR) signaling pathways. The verifying tests of inhibitors of BMP pathway (noggin) and IGF-1/PI3K/mTOR pathway (picropodophyllin) and molecular docking of IGF-1R further indicated that CAT, ACT, and ECH extracted from RR enhanced bone formation by regulating IGF-1/PI3K/mTOR signaling pathways. These findings suggest that RR may prove to be a promising candidate drug for the prevention and treatment of diabetes-induced osteoporosis.
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Papadopoulou A, Todaro A, Eliades T, Kletsas D. Effect of hyperglycaemic conditions on the response of human periodontal ligament fibroblasts to mechanical stretching. Eur J Orthod 2019; 41:583-590. [DOI: 10.1093/ejo/cjz051] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Summary
Objectives
The aim of the present study was to investigate the impact of high glucose concentration on the response of human periodontal ligament fibroblasts (PDLFs) to cyclic tensile strain.
Materials and Methods
Human PDLFs were incubated under normal or high glucose conditions, and then were subjected to cyclic tensile stretching (8 per cent extension, 1 Hz). Gene expression was determined by quantitative real-time polymerase chain reaction. Intracellular reactive oxygen species (ROS) were determined by the 2’,7’-dichlorofluorescein-diacetate assay, activation of mitogen-activated protein kinase (MAPK) was monitored by western analysis and osteoblastic differentiation was estimated with Alizarin Red-S staining.
Results
Cyclic tensile stretching of PDLF leads to an immediate activation of extracellular signal-regulated kinase (ERK) and c-Jun N-terminal kinase (JNK), as well as to the increased expression of the transcription factor c-fos, known to regulate many osteogenesis-related genes. At later time points, the alkaline phosphatase and osteopontin genes were also upregulated. Hyperglycaemic conditions inhibited these effects. High glucose conditions were unable to increase ROS levels, but they increased the medium’s osmolality. Finally, increase of osmolality mimics the inhibitory effect of hyperglycaemia on MAPK activation, c-fos and osteoblast-specific gene markers’ upregulation, as well as osteogenic differentiation capacity.
Conclusion
Our findings indicate that under high glucose conditions, human PDLFs fail to adequately respond to mechanical deformation, while their strain-elicited osteoblast differentiation ability is deteriorated. The aforementioned effects are most probably mediated by the increased osmolality under hyperglycaemic conditions.
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Affiliation(s)
- Adamantia Papadopoulou
- Laboratory of Cell Proliferation & Ageing, Institute of Biosciences & Applications, National Centre for Scientific Research ‘Demokritos’, Athens, Greece
| | - Alexia Todaro
- Clinic of Orthodontics and Paediatric Dentistry, University of Zurich, Zurich, Switzerland
| | - Theodore Eliades
- Clinic of Orthodontics and Paediatric Dentistry, University of Zurich, Zurich, Switzerland
| | - Dimitris Kletsas
- Laboratory of Cell Proliferation & Ageing, Institute of Biosciences & Applications, National Centre for Scientific Research ‘Demokritos’, Athens, Greece
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50
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Osteoporose und Multimorbidität. Z Gerontol Geriatr 2019; 52:433-439. [DOI: 10.1007/s00391-019-01569-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 05/24/2019] [Indexed: 12/18/2022]
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