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Bhattacharjee B, Chakrovorty A, Biswas M, Samadder A, Nandi S. To Explore the Putative Molecular Targets of Diabetic Nephropathy and their Inhibition Utilizing Potential Phytocompounds. Curr Med Chem 2024; 31:3752-3790. [PMID: 37211853 DOI: 10.2174/0929867330666230519112312] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 03/17/2023] [Accepted: 03/31/2023] [Indexed: 05/23/2023]
Abstract
BACKGROUND This review critically addresses the putative molecular targets of Diabetic Nephropathy (DN) and screens effective phytocompounds that can be therapeutically beneficial, and highlights their mechanistic modalities of action. INTRODUCTION DN has become one of the most prevalent complications of clinical hyperglycemia, with individual-specific variations in the disease spectrum that leads to fatal consequences. Diverse etiologies involving oxidative and nitrosative stress, activation of polyol pathway, inflammasome formation, Extracellular Matrix (ECM) modifications, fibrosis, and change in dynamics of podocyte functional and mesangial cell proliferation adds up to the clinical complexity of DN. Current synthetic therapeutics lacks target-specific approach, and is associated with the development of inevitable residual toxicity and drug resistance. Phytocompounds provides a vast diversity of novel compounds that can become an alternative therapeutic approach to combat the DN. METHODS Relevant publications were searched and screened from research databases like GOOGLE SCHOLAR, PUBMED and SCISEARCH. Out of 4895 publications, the most relevant publications were selected and included in this article. RESULT This study critically reviews over 60 most promising phytochemical and provides with their molecular targets, that can be of pharmacological significance in context to current treatment and concomitant research in DN. CONCLUSION This review highlights those most promising phytocompounds that have the potential of becoming new safer naturally-sourced therapeutic candidates and demands further attention at clinical level.
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Affiliation(s)
- Banani Bhattacharjee
- Endocrinology and Reproductive Biology Laboratory, Department of Zoology, University of Kalyani, Kalyani, 741235, West Bengal, India
| | - Arnob Chakrovorty
- Cytogenetics and Molecular Biology Laboratory, Department of Zoology, University of Kalyani, Kalyani, 741235, India
| | - Maharaj Biswas
- Endocrinology and Reproductive Biology Laboratory, Department of Zoology, University of Kalyani, Kalyani, 741235, West Bengal, India
| | - Asmita Samadder
- Cytogenetics and Molecular Biology Laboratory, Department of Zoology, University of Kalyani, Kalyani, 741235, India
| | - Sisir Nandi
- Department of Pharmaceutical Chemistry, Global Institute of Pharmaceutical Education and Research, Affiliated to Uttarakhand Technical University, Kashipur, 244713, India
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Chen Y, Zhou Y, Chen J, Luo Y, Wang Y, Fan X. A systematic review and meta-analysis of risk factors for reoperation after degenerative lumbar spondylolisthesis surgery. BMC Surg 2023; 23:192. [PMID: 37407952 DOI: 10.1186/s12893-023-02082-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 06/16/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND Considering the high reoperation rate in degenerative lumbar spondylolisthesis (DLS) patients undergoing lumbar surgeries and controversial results on the risk factors for the reoperation, we performed a systematic review and meta-analysis to explore the reoperation rate and risk factors for the reoperation in DLS patients undergoing lumbar surgeries. METHODS Literature search was conducted from inception to October 28, 2022 in Pubmed, Embase, Cochrane Library, and Web of Science. Odds ratio (OR) was used as the effect index for the categorical data, and effect size was expressed as 95% confidence interval (CI). Heterogeneity test was performed for each outcome effect size, and subgroup analysis was performed based on study design, patients, surgery types, follow-up time, and quality of studies to explore the source of heterogeneity. Results of all outcomes were examined by sensitivity analysis. Publication bias was assessed using Begg test, and adjusted using trim-and-fill analysis. RESULTS A total of 39 cohort studies (27 retrospective cohort studies and 12 prospective cohort studies) were finally included in this systematic review and meta-analysis. The overall results showed a 10% (95%CI: 8%-12%) of reoperation rate in DLS patients undergoing lumbar surgeries. In surgery types subgroup, the reoperation rate was 11% (95%CI: 9%-13%) for decompression, 10% (95%CI: 7%-12%) for fusion, and 9% (95%CI: 5%-13%) for decompression and fusion. An increased risk of reoperation was found in patients with obesity (OR = 1.91, 95%CI: 1.04-3.51), diabetes (OR = 2.01, 95%CI: 1.43-2.82), and smoking (OR = 1.51, 95%CI: 1.23-1.84). CONCLUSIONS We found a 10% of reoperation rate in DLS patients after lumbar surgeries. Obesity, diabetes, and smoking were risk factors for the reoperation.
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Affiliation(s)
- Yuzhou Chen
- Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, P.R. China
- Department of Orthopedics, Hospital of Chengdu University of Traditional Chinese Medicine, No.39 Shi-Er-Qiao Road, Jinniu District, Chengdu, 610075, P.R. China
| | - Yi Zhou
- Department of Traditional Chinese Medicine, The Traditional Chinese Medicine Hospital of Wenjiang District, Chengdu, 611130, P.R. China
| | - Junlong Chen
- Department of Anorectal, The Traditional Chinese Medicine Hospital of Wenjiang District, Chengdu, 611130, P.R. China
| | - Yiping Luo
- Department of Gynecology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, P.R. China
| | - Yongtao Wang
- Department of Orthopedics, Hospital of Chengdu University of Traditional Chinese Medicine, No.39 Shi-Er-Qiao Road, Jinniu District, Chengdu, 610075, P.R. China
| | - Xiaohong Fan
- Department of Orthopedics, Hospital of Chengdu University of Traditional Chinese Medicine, No.39 Shi-Er-Qiao Road, Jinniu District, Chengdu, 610075, P.R. China.
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Mahmoud M, Kokozidou M, Gögele C, Werner C, Auffarth A, Kohl B, Mrosewski I, Schulze-Tanzil GG. Does Vitamin K2 Influence the Interplay between Diabetes Mellitus and Intervertebral Disc Degeneration in a Rat Model? Nutrients 2023; 15:2872. [PMID: 37447201 DOI: 10.3390/nu15132872] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 06/14/2023] [Accepted: 06/20/2023] [Indexed: 07/15/2023] Open
Abstract
Intervertebral disc (IVD) degeneration is a common cause of low back pain in diabetes mellitus type 2 (T2DM) patients. Its pathogenesis and the vitamin (vit.) K2 influence on this disease remain unclear. Lumbar motion segments of male Zucker Diabetes Fatty (ZDF) rats (non-diabetic [control] and diabetic; fed without or with vit. K2) were used. Femur lengths and vertebral epiphyseal cross-section areas were measured. IVDs were histopathologically examined. Protein synthesis and gene expression of isolated IVD fibrochondrocytes were analyzed. T2DM rats showed histopathological IVD degeneration. Femur lengths and epiphyseal areas were smaller in T2DM rats regardless of vit. K2 feeding. Fibrochondrocytes synthesized interleukin (IL)-24 and IL-10 with no major differences between groups. Alpha smooth muscle actin (αSMA) was strongly expressed, especially in cells of vit. K2-treated animals. Gene expression of aggrecan was low, and that of collagen type 2 was high in IVD cells of diabetic animals, whether treated with vit. K2 or not. Suppressor of cytokine signaling (Socs)3 and heme oxygenase (Hmox)1 gene expression was highest in the cells of diabetic animals treated with vit. K2. Vit. K2 influenced the expression of some stress-associated markers in IVD cells of diabetic rats, but not that of IL-10 and IL-24.
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Affiliation(s)
- Mohamed Mahmoud
- Institute of Anatomy and Cell Biology, Paracelsus Medical University, Nuremberg and Salzburg, Prof. Ernst Nathan Str. 1, 90419 Nuremberg, Germany
| | - Maria Kokozidou
- Institute of Anatomy and Cell Biology, Paracelsus Medical University, Nuremberg and Salzburg, Prof. Ernst Nathan Str. 1, 90419 Nuremberg, Germany
| | - Clemens Gögele
- Institute of Anatomy and Cell Biology, Paracelsus Medical University, Nuremberg and Salzburg, Prof. Ernst Nathan Str. 1, 90419 Nuremberg, Germany
| | - Christian Werner
- Institute of Anatomy and Cell Biology, Paracelsus Medical University, Nuremberg and Salzburg, Prof. Ernst Nathan Str. 1, 90419 Nuremberg, Germany
| | - Alexander Auffarth
- Department of Orthopedics and Traumatology, Paracelsus Medical University, Müllner-Hauptstraße 48, 5020 Salzburg, Austria
| | - Benjamin Kohl
- Department of Traumatology and Reconstructive Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203 Berlin, Germany
| | - Ingo Mrosewski
- MVZ MDI Limbach Berlin, Aroser Alle 84, 13407 Berlin, Germany
| | - Gundula Gesine Schulze-Tanzil
- Institute of Anatomy and Cell Biology, Paracelsus Medical University, Nuremberg and Salzburg, Prof. Ernst Nathan Str. 1, 90419 Nuremberg, Germany
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Shi ZW, Zhu L, Song ZR, Liu TJ, Hao DJ. Roles of p38 MAPK signalling in intervertebral disc degeneration. Cell Prolif 2023:e13438. [PMID: 36872558 PMCID: PMC10392072 DOI: 10.1111/cpr.13438] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 02/05/2023] [Accepted: 02/20/2023] [Indexed: 03/07/2023] Open
Abstract
Intervertebral disc degeneration (IVDD) is a common degenerative disease mediated by multiple factors. Because of its complex aetiology and pathology, no specific molecular mechanisms have yet been identified and no definitive treatments are currently available for IVDD. p38 mitogen-activated protein kinase (MAPK) signalling, part of the serine and threonine (Ser/Thr) protein kinases family, is associated with the progression of IVDD, by mediating the inflammatory response, increasing extracellular matrix (ECM) degradation, promoting cell apoptosis and senescence and suppressing cell proliferation and autophagy. Meanwhile, the inhibition of p38 MAPK signalling has a significant effect on IVDD treatment. In this review, we first summarize the regulation of p38 MAPK signalling and then highlight the changes in the expression of p38 MAPK signalling and their impact on pathological process of IVDD. Moreover, we discuss the current applications and future prospects of p38 MAPK as a therapeutic target for IVDD treatment.
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Affiliation(s)
- Zheng-Wei Shi
- Department of Spine Surgery, Hong-Hui Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, China
| | - Lei Zhu
- Department of Spine Surgery, Hong-Hui Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, China
| | - Zong-Rang Song
- Department of Spine Surgery, Hong-Hui Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, China
| | - Tuan-Jiang Liu
- Department of Spine Surgery, Hong-Hui Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, China
| | - Ding-Jun Hao
- Department of Spine Surgery, Hong-Hui Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, China
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Aghanoori MR, Agarwal P, Gauvin E, Nagalingam RS, Bonomo R, Yathindranath V, Smith DR, Hai Y, Lee S, Jolivalt CG, Calcutt NA, Jones MJ, Czubryt MP, Miller DW, Dolinsky VW, Mansuy-Aubert V, Fernyhough P. CEBPβ regulation of endogenous IGF-1 in adult sensory neurons can be mobilized to overcome diabetes-induced deficits in bioenergetics and axonal outgrowth. Cell Mol Life Sci 2022; 79:193. [PMID: 35298717 PMCID: PMC8930798 DOI: 10.1007/s00018-022-04201-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 01/28/2022] [Accepted: 02/08/2022] [Indexed: 11/26/2022]
Abstract
Aberrant insulin-like growth factor 1 (IGF-1) signaling has been proposed as a contributing factor to the development of neurodegenerative disorders including diabetic neuropathy, and delivery of exogenous IGF-1 has been explored as a treatment for Alzheimer's disease and amyotrophic lateral sclerosis. However, the role of autocrine/paracrine IGF-1 in neuroprotection has not been well established. We therefore used in vitro cell culture systems and animal models of diabetic neuropathy to characterize endogenous IGF-1 in sensory neurons and determine the factors regulating IGF-1 expression and/or affecting neuronal health. Single-cell RNA sequencing (scRNA-Seq) and in situ hybridization analyses revealed high expression of endogenous IGF-1 in non-peptidergic neurons and satellite glial cells (SGCs) of dorsal root ganglia (DRG). Brain cortex and DRG had higher IGF-1 gene expression than sciatic nerve. Bidirectional transport of IGF-1 along sensory nerves was observed. Despite no difference in IGF-1 receptor levels, IGF-1 gene expression was significantly (P < 0.05) reduced in liver and DRG from streptozotocin (STZ)-induced type 1 diabetic rats, Zucker diabetic fatty (ZDF) rats, mice on a high-fat/ high-sugar diet and db/db type 2 diabetic mice. Hyperglycemia suppressed IGF-1 gene expression in cultured DRG neurons and this was reversed by exogenous IGF-1 or the aldose reductase inhibitor sorbinil. Transcription factors, such as NFAT1 and CEBPβ, were also less enriched at the IGF-1 promoter in DRG from diabetic rats vs control rats. CEBPβ overexpression promoted neurite outgrowth and mitochondrial respiration, both of which were blunted by knocking down or blocking IGF-1. Suppression of endogenous IGF-1 in diabetes may contribute to neuropathy and its upregulation at the transcriptional level by CEBPβ can be a promising therapeutic approach.
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MESH Headings
- Aging/metabolism
- Animals
- Antibodies, Neutralizing/pharmacology
- Axons/drug effects
- Axons/metabolism
- Axons/pathology
- Base Sequence
- CCAAT-Enhancer-Binding Protein-beta/genetics
- CCAAT-Enhancer-Binding Protein-beta/metabolism
- Cell Respiration/drug effects
- Cells, Cultured
- Diabetes Mellitus, Experimental/genetics
- Diabetes Mellitus, Experimental/metabolism
- Diabetes Mellitus, Experimental/pathology
- Diabetes Mellitus, Type 1/genetics
- Diabetes Mellitus, Type 1/pathology
- Diabetes Mellitus, Type 2/genetics
- Diabetes Mellitus, Type 2/pathology
- Energy Metabolism/drug effects
- Ganglia, Spinal/drug effects
- Ganglia, Spinal/metabolism
- Gene Expression Regulation/drug effects
- Glycolysis/drug effects
- HEK293 Cells
- Humans
- Insulin-Like Growth Factor I/genetics
- Insulin-Like Growth Factor I/metabolism
- Liver/metabolism
- Male
- Mitochondria/drug effects
- Mitochondria/metabolism
- NFATC Transcription Factors/metabolism
- Neuronal Outgrowth/drug effects
- Polymers/metabolism
- Promoter Regions, Genetic/genetics
- Protein Transport/drug effects
- Rats, Sprague-Dawley
- Sensory Receptor Cells/metabolism
- Sensory Receptor Cells/pathology
- Signal Transduction/drug effects
- Rats
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Affiliation(s)
- Mohamad-Reza Aghanoori
- Division of Neurodegenerative Disorders, St. Boniface Hospital Albrechtsen Research Centre, Winnipeg, MB, Canada.
- Dept of Pharmacology and Therapeutics, University of Manitoba, Winnipeg, MB, Canada.
- Dept of Medical Genetics, Cumming School of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, AB, T2N 4N2, Canada.
| | - Prasoon Agarwal
- Dept of Pharmacology and Therapeutics, University of Manitoba, Winnipeg, MB, Canada
- Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, MB, Canada
- School of Electrical Engineering and Computer Science, KTH Royal Institute of Technology, 10044, Stockholm, Sweden
| | - Evan Gauvin
- Division of Neurodegenerative Disorders, St. Boniface Hospital Albrechtsen Research Centre, Winnipeg, MB, Canada
| | - Raghu S Nagalingam
- Department of Physiology and Pathophysiology, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Institute of Cardiovascular Sciences, St. Boniface Hospital Albrechtsen Research Centre, Winnipeg, MB, Canada
| | - Raiza Bonomo
- Cellular and Molecular Department, Stritch School of Medicine, Loyola University Chicago, Chicago, USA
| | - Vinith Yathindranath
- Kleysen Institute for Advanced Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Darrell R Smith
- Division of Neurodegenerative Disorders, St. Boniface Hospital Albrechtsen Research Centre, Winnipeg, MB, Canada
| | - Yan Hai
- Department of Biochemistry and Medical Genetics, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Samantha Lee
- Department of Biochemistry and Medical Genetics, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | | | | | - Meaghan J Jones
- Department of Biochemistry and Medical Genetics, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Michael P Czubryt
- Department of Physiology and Pathophysiology, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Institute of Cardiovascular Sciences, St. Boniface Hospital Albrechtsen Research Centre, Winnipeg, MB, Canada
| | - Donald W Miller
- Kleysen Institute for Advanced Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Vernon W Dolinsky
- Dept of Pharmacology and Therapeutics, University of Manitoba, Winnipeg, MB, Canada
- Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, MB, Canada
| | - Virginie Mansuy-Aubert
- Cellular and Molecular Department, Stritch School of Medicine, Loyola University Chicago, Chicago, USA
| | - Paul Fernyhough
- Division of Neurodegenerative Disorders, St. Boniface Hospital Albrechtsen Research Centre, Winnipeg, MB, Canada
- Dept of Pharmacology and Therapeutics, University of Manitoba, Winnipeg, MB, Canada
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Foreman SC, Ashmeik W, Baal JD, Han M, Bahroos E, von Schacky CE, Carl M, Krug R, Joseph GB, Link TM. Patients with Type 2 Diabetes Exhibit a More Mineralized Deep Cartilage Layer Compared with Nondiabetic Controls: A Pilot Study. Cartilage 2021; 13:428S-436S. [PMID: 31455093 PMCID: PMC8808878 DOI: 10.1177/1947603519870853] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVE To assess differences in biochemical composition of the deep cartilage layer in subjects with type 2 diabetes mellitus (T2DM) and nondiabetic controls using UTE (ultra-short echo time) T2* mapping and to investigate the association of vascular health and UTE T2* measurements. DESIGN Ten subjects with T2DM matched for age, sex, and body mass index with 10 nondiabetic controls. A 3D UTE sequence with 6 echo times was acquired using 3T magnetic resonance imaging of the knee. For UTE T2* analysis, the deep cartilage layer was segmented and analyzed in 5 compartments (patella, medial, and lateral femur and tibia). The ankle brachial index (ABI) was obtained in all subjects. Linear regression analyses were used to assess associations of T2DM and UTE T2* relaxation times and the associations of ABI measurements and UTE measurements. RESULTS Compared with nondiabetic controls, T2DM subjects had significantly lower mean T2*-UTE in the patella (mean difference 4.87 ms; 95% confidence interval [CI] 1.09-8.65; P = 0.015), the lateral tibia (mean difference 2.26 ms; 95% CI 0.06-4.45; P = 0.045), and the lateral femur (mean difference 4.96 ms; 95% CI 0.19-9.73; P = 0.043). Independent of diabetic status, subjects with higher ABI values, indicating better vascular health, had higher T2*-UTE of the patella (coefficient 15.2; 95% CI 3.3-21.4; P = 0.017), the medial tibia (coefficient 9.8; 95% CI 1.0-18.6; P = 0.031), and the lateral femur (coefficient 18.8; 95% CI 3.3-34.3; P = 0.021). CONCLUSIONS T2*-UTE measurements of the deep cartilage layer were consistently lower in subjects with T2DM and in subjects with impaired vascular health, likely indicating increased mineralization of this layer.
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Affiliation(s)
- Sarah C. Foreman
- Department of Radiology and Biomedical
Imaging, University of California, San Francisco, CA, USA,Department of Radiology, Klinikum Rechts
der Isar, Technische Universität München, Munich, Germany,Sarah C. Foreman, Department of Radiology
and Biomedical Imaging, University of California, San Francisco, 185 Berry
Street, Lobby 6, Suite 350, San Francisco, CA 94107, USA.
| | - Walid Ashmeik
- Department of Radiology and Biomedical
Imaging, University of California, San Francisco, CA, USA
| | - Joe D. Baal
- Department of Radiology and Biomedical
Imaging, University of California, San Francisco, CA, USA
| | - Misung Han
- Department of Radiology and Biomedical
Imaging, University of California, San Francisco, CA, USA
| | - Emma Bahroos
- Department of Radiology and Biomedical
Imaging, University of California, San Francisco, CA, USA
| | - Claudio E. von Schacky
- Department of Radiology and Biomedical
Imaging, University of California, San Francisco, CA, USA,Department of Radiology, Klinikum Rechts
der Isar, Technische Universität München, Munich, Germany
| | | | - Roland Krug
- Department of Radiology and Biomedical
Imaging, University of California, San Francisco, CA, USA
| | - Gabby B. Joseph
- Department of Radiology and Biomedical
Imaging, University of California, San Francisco, CA, USA
| | - Thomas M. Link
- Department of Radiology and Biomedical
Imaging, University of California, San Francisco, CA, USA
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Strong association of type 2 diabetes with degenerative lumbar spine disorders. Sci Rep 2021; 11:16472. [PMID: 34389750 PMCID: PMC8363740 DOI: 10.1038/s41598-021-95626-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 05/28/2021] [Indexed: 12/19/2022] Open
Abstract
Tantalizing connections between type 2 diabetes and degenerative lumbar spine disorders have become increasingly evident. However, the association of type 2 diabetes with degenerative lumbar spine disorders remains unclear. We sought to clarify the association between type 2 diabetes and lumbar spine disorders using nationwide data in Korea. Furthermore, we explored the association of diabetes with the prevalence of spinal procedures. The data in this study was obtained from Korean health claim database. Between 2016 and 2019, totals of 479,680 diabetes and 479,680 age- and sex-matched control subjects were enrolled. Patients with diabetes had more likely to have degenerative lumbar spine disorders and spinal procedures than controls. Using multivariate-adjusted analysis, patients with diabetes were at increased risk of being concomitantly affected by lumbar disc disorder [adjusted odds ratio 1.11 (95% confidence interval 1.10-1.12)], lumbar spondylotic radiculopathy [1.12 (1.11-1.13)], spondylolisthesis [1.05 (1.02-1.08)] and spinal stenosis [1.16 (1.15-1.18)], compared to controls. Furthermore, diabetic patients had an increased risk of undergoing lumbar spinal injection [1.13 (1.12-1.14)], laminectomy [1.19 (1.15-1.23)], and fusion surgery [1.35 (1.29-1.42)]. We demonstrated that type 2 diabetes was significantly associated with lumbar spine disorders and frequent spinal procedures. Our results suggest diabetes as a predisposing factor for lumbar spine disorders.
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8
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Diabetes mellitus as a risk factor for intervertebral disc degeneration: a critical review. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2019; 28:2129-2144. [PMID: 31201565 DOI: 10.1007/s00586-019-06029-7] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 04/22/2019] [Accepted: 06/06/2019] [Indexed: 02/06/2023]
Abstract
PURPOSE To examine to what extent diabetes mellitus (DM) is implicated as a distinct mechanism in intervertebral disc degeneration (IVDD). METHODS The published clinical and laboratory data relevant to this matter are critically reviewed. A total of 12 clinical studies evaluate the association between DM and degenerative changes such as IVDD, spinal stenosis (SS) and IVD herniation. A total of 34 laboratory research papers evaluate the association between DM and IVDD. RESULTS There are 7 studies that correlate DM with IVDD, 4 of them showing that DM is a significant risk factor for degeneration, and 3 of them failing to establish any association. Three studies demonstrate significant association between DM and SS. However, 2 of these studies also include patients with IVD herniation that failed to demonstrate any correlation with DM. Two other studies indicate a significant association between DM and lumbar disc herniation. Multiple different mechanisms, acting independently or interactively, cause tissue damage leading to IVDD including: microangiopathy of the subchondral vertebral endplate, cellular senescence, cell death (through apoptosis or autophagy), hyperglycaemia, advance glycation end products, adipokines, and cytokines (through oxidative, osmotic, and inflammatory mechanisms). CONCLUSION The clinical evidence is not consistent, but weakly supports the relationship between DM and IVDD. However, the laboratory studies consistently suggest that DM interferes with multipronged aberrant molecular and biochemical pathways that provoke IVDD. Taken as a whole, the strong laboratory evidence and the weak clinical studies implicate DM as a distinct contributing factor for IVDD. These slides can be retrieved under Electronic Supplementary Material.
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9
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Choubaya C, Chahine R, Zalloua P, Salameh Z. Periodontitis and diabetes interrelationships in rats: biochemical and histopathological variables. J Diabetes Metab Disord 2019; 18:163-172. [PMID: 31275887 PMCID: PMC6581989 DOI: 10.1007/s40200-019-00403-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 04/12/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND A two-way relationship between diabetes and periodontitis is now clinically established. Both conditions share common mechanisms of pathogenesis that are related to altered immune-inflammatory responses at local and/or systemic levels. The aim of this study is to investigate whether periodontitis is associated with the development and progression of diabetes and to evaluate the health impact of coexistence of both diseases. MATERIAL AND METHODS Male Sprague Dawley rats (10 weeks old) were randomized into seven groups (n = 12): Group 1) Control; Groups 2 and 6) Periodontitis induced at two or six weeks; Groups 3 and 5) Diabetes induced at two or six weeks; Groups 4 and 7) Periodontitis followed by diabetes, and diabetes followed by periodontitis at two or six weeks. For diabetes induction, animals received a one-time intravenous injection of streptozotocin (50 mg/kg). Periodontitis was induced by Lipoppolysaccharide injection (20 μg/rat) through the palatal gingival and by placing a ligature of 0/0 braided silk around the cervix of the upper right second molar. Body weight, glycaemia as well as urine were collected weekly. Rats were sacrificed at the end of week 10, gingival tissue was removed, fixed in formaldehyde and processed for histopathological study. RESULTS Body weight was significantly decreased (25%) following diabetes induction (p < 0.01). 40% weight loss was observed when diabetes was induced first compared to 30% when periodontitis was first induced in the animals (p < 0.01). Rats treated with streptozotocin showed a three-fold increase in diabetes compared to the control group (p < 0.01). In rats where periodontitis was induced after diabetes, glucose levels increased significantly (450 mg/dL) compared to glucose levels (410 mg/dL) where periodontitis was induced first (p < 0.01). Histopathological studies showed greater alveolar bone loss when both diabetes and periodontitis were present. CONCLUSION When periodontitis occurs after diabetes it aggravates the symptoms of the two pathologies. When diabetes is induced after periodontitis, no symptoms aggravation is observed for diabetes, although periodontitis gets worse.
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Affiliation(s)
- Charbel Choubaya
- Department of Surgery, Faculty of Dentistry, Lebanese University, Hadat, Lebanon
| | - Ramez Chahine
- Oxidative Stress and Antioxidant Research Team, Lebanese University and Faculty of Public Health La Sagesse University, Beirut, Lebanon
| | - Pierre Zalloua
- Faculty of Medicine, Lebanese American University, Byblos, Lebanon
| | - Ziad Salameh
- Department of Prosthodontics and Department of Research, Faculty of Dentistry, Lebanese University, Hadat, Lebanon
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10
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Rinaldo L, McCutcheon BA, Gilder H, Kerezoudis P, Murphy M, Maloney P, Hassoon A, Bydon M. Diabetes and Back Pain: Markers of Diabetes Disease Progression Are Associated With Chronic Back Pain. Clin Diabetes 2017; 35:126-131. [PMID: 28761214 PMCID: PMC5510921 DOI: 10.2337/cd16-0011] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
IN BRIEF Diabetes has been associated with the incidence of back pain. However, the relationship between markers of diabetes progression and back pain has not been studied. The objective of this study was to correlate clinical and laboratory measures of diabetes disease severity to the presence of back pain to provide insight into the relationship between these conditions. Findings showed that markers of diabetes disease progression were associated with the presence of back pain, suggesting that uncontrolled diabetes may contribute to the development of chronic back pain.
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Affiliation(s)
| | | | - Hannah Gilder
- Department of Neurosurgery, Mayo Clinic, Rochester, MN
| | | | - Meghan Murphy
- Department of Neurosurgery, Mayo Clinic, Rochester, MN
| | | | - Ahmed Hassoon
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Mohamad Bydon
- Department of Neurosurgery, Mayo Clinic, Rochester, MN
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11
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Chanchek N, Gersing AS, Schwaiger BJ, Nevitt MC, Neumann J, Joseph GB, Lane NE, Zarnowski J, Hofmann FC, Heilmeier U, McCulloch CE, Link TM. Association of diabetes mellitus and biochemical knee cartilage composition assessed by T 2 relaxation time measurements: Data from the osteoarthritis initiative. J Magn Reson Imaging 2017; 47:380-390. [PMID: 28556419 DOI: 10.1002/jmri.25766] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 05/05/2017] [Indexed: 12/24/2022] Open
Abstract
PURPOSE To investigate the association of the presence and severity of diabetes mellitus (DM) with articular cartilage composition, using magnetic resonance imaging (MRI)-based T2 relaxation time measurements, and structural knee abnormalities. MATERIALS AND METHODS In the Osteoarthritis Initiative 208, participants with DM (age 63.0 ± 8.9 years; 111 females) and risk factors for osteoarthritis (OA) or mild radiographic tibiofemoral OA (Kellgren-Lawrence [KL] grade ≤2) were identified and group-matched with 208 controls without DM (age 63.3 ± 9.1 years; 111 females). Subjects with diabetes-related renal or ophthalmological complications or insulin treatment at baseline (n = 50) were defined as severe DM. 3T MR images of the right knee were assessed for articular cartilage T2 , including texture and laminar analyses derived from the patella, medial, and lateral femur and tibia and for structural abnormalities using the modified whole-organ magnetic resonance imaging score (WORMS). Clustered linear regression analyses were used to assess associations of DM with MRI findings. RESULTS DM subjects had significantly higher cartilage T2 in the patella (mean difference 0.92 msec [95% confidence interval (CI) 0.79, 1.06]; P = 0.001) and medial femur (mean difference 0.36 msec [95% CI 0.27, 0.81]; P = 0.006) compared to controls. Averaged over all compartments, DM subjects showed significantly higher texture parameters (variance, P = 0.001; contrast, P = 0.002; entropy, P < 0.001). Subjects with severe DM additionally showed higher T2 in the medial tibial deep and superficial layers (P = 0.011 and P = 0.041) compared to controls. No significant differences in cartilage, meniscus, and overall WORMS were found between the groups (P > 0.05). CONCLUSION In comparison to nondiabetic controls, cartilage in DM subjects showed higher and more heterogeneous cartilage T2 values, indicating increased articular cartilage degeneration. This affected even more compartments in subjects with severe DM. LEVEL OF EVIDENCE 2 Technical Efficacy: 5 J. Magn. Reson. Imaging 2018;47:380-390.
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Affiliation(s)
- Nattagan Chanchek
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA.,Department of Radiology, Faculty of Medicine, Naresuan University, Phitsanulok, Thailand
| | - Alexandra S Gersing
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA.,Department of Radiology, Technical University of Munich, Munich, Germany
| | - Benedikt J Schwaiger
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Michael C Nevitt
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
| | - Jan Neumann
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Gabby B Joseph
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Nancy E Lane
- Department of Internal Medicine, UC Davis Medical Center, Sacramento, California, USA
| | - Julia Zarnowski
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Felix C Hofmann
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Ursula Heilmeier
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Charles E McCulloch
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
| | - Thomas M Link
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
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12
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Agius R, Galea R, Fava S. Bone mineral density and intervertebral disc height in type 2 diabetes. J Diabetes Complications 2016; 30:644-50. [PMID: 26954485 DOI: 10.1016/j.jdiacomp.2016.01.021] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Revised: 01/26/2016] [Accepted: 01/27/2016] [Indexed: 12/22/2022]
Abstract
BACKGROUND Studies of the effect of type 2 diabetes (T2D) on bone mineral density (BMD have produced conflicting results, possibly due to failure to adjust for potential confounding factors. Nonetheless, T2D has consistently been associated with increased fracture risk, suggesting that other factors might play a role. OBJECTIVE This study assesses the relationship between T2D and BMD at the femoral neck and spine in diabetic and non-diabetic subjects, after adjusting for multiple covariates which may affect BMD. Intervertebral disc height was also investigated in view of its possible relation to fracture risk. METHODS A cross-sectional study of 100 patients with T2DM of at least 5 years duration and 86 non-diabetic subjects was carried out. RESULTS There were no significant differences in T scores in either the spine or femoral neck after adjustment for potential confounding variables between T2D subjects and controls. Diabetic patients had a statistically lower intervertebral disc height between the 2nd and 3rd lumbar vertebrae (D3) after adjustment for potential confounders (p=0.004). Urinary albumin:creatinine ratio, total cholesterol, LDL-cholesterol and cigarette smoking were independently associated with lower height of D3 in diabetic subjects. CONCLUSIONS There is no significant independent association between T2D and BMD. However we found a novel association of significantly lower disc height in patients with T2D. This may contribute to the increased vertebral fracture risk in subjects with T2D. Further studies are needed to investigate the relationship of disc height, T2D and fracture risk.
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Affiliation(s)
- Rachel Agius
- Diabetes and Endocrine Centre, Mater Dei Hospital, Msida, Malta
| | - Raymond Galea
- Diabetes and Endocrine Centre, Mater Dei Hospital, Msida, Malta
| | - Stephen Fava
- Diabetes and Endocrine Centre, Mater Dei Hospital, Msida, Malta.
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13
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Zhu Y, Liu JT, Yang LY, Du WP, Li XC, Qian X, Yu PF, Liu JW, Jiang H. p38 mitogen-activated protein kinase inhibition modulates nucleus pulposus cell apoptosis in spontaneous resorption of herniated intervertebral discs: An experimental study in rats. Mol Med Rep 2016; 13:4001-6. [PMID: 27035219 DOI: 10.3892/mmr.2016.5039] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Accepted: 03/09/2016] [Indexed: 11/06/2022] Open
Abstract
The present study was performed to investigate the role of p38 mitogen‑activated protein kinase (MAPK) in the resorption of herniated intervertebral discs in 30 rats. In the non‑contained and p38 MAPK inhibition (p38i) groups, two coccygeal intervertebral discs (IVDs) were removed and wounded prior to relocation into the subcutaneous space of the skin of the back. In the contained group, the cartilage endplates maintained their integrity. Furthermore, SB203580 was injected intraperitoneally into the p38i group, whereas saline was injected into the other two groups. In the non‑contained group, the weight of the relocated IVDs decreased to a greater extent over time when compared with the contained and p38i groups. Phosphorylated p38, tumor necrosis factor‑α, and interleukin‑1β were observed to exhibit higher expression levels in the non‑contained group compared with the contained and p38i groups, at weeks 1 and 4 post‑surgery. The expression level of caspase‑3 and the densities of apoptotic disc cells were significantly higher in the non‑contained group compared with the contained and p38i groups at 4 weeks post‑surgery. In conclusion, p38 MAPK induces apoptosis in IVDs, while also accelerating the resorption of the relocated IVDs. Thus, p38 MAPK may be important in spontaneous resorption of IVDs.
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Affiliation(s)
- Yu Zhu
- Graduate School of Shanghai University of Traditional Chinese Medicine, Shanghai 201203, P.R. China
| | - Jin-Tao Liu
- Department of Orthopaedic Surgery, Suzhou Hospital of Traditional Chinese Medicine, Suzhou, Jiangsu 215009, P.R. China
| | - Li-Yan Yang
- State Key Laboratory of Bioreactor Engineering and School of Pharmacy, East China University of Science and Technology, Shanghai 200237, P.R. China
| | - Wen-Pei Du
- State Key Laboratory of Bioreactor Engineering and School of Pharmacy, East China University of Science and Technology, Shanghai 200237, P.R. China
| | - Xiao-Chun Li
- Department of Orthopaedic Surgery, Suzhou Hospital of Traditional Chinese Medicine, Suzhou, Jiangsu 215009, P.R. China
| | - Xiang Qian
- Department of Orthopaedic Surgery, Suzhou Hospital of Traditional Chinese Medicine, Suzhou, Jiangsu 215009, P.R. China
| | - Peng-Fei Yu
- Department of Orthopaedic Surgery, Suzhou Hospital of Traditional Chinese Medicine, Suzhou, Jiangsu 215009, P.R. China
| | - Jian-Wen Liu
- State Key Laboratory of Bioreactor Engineering and School of Pharmacy, East China University of Science and Technology, Shanghai 200237, P.R. China
| | - Hong Jiang
- Department of Orthopaedic Surgery, Suzhou Hospital of Traditional Chinese Medicine, Suzhou, Jiangsu 215009, P.R. China
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14
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Laiguillon MC, Courties A, Houard X, Auclair M, Sautet A, Capeau J, Fève B, Berenbaum F, Sellam J. Characterization of diabetic osteoarthritic cartilage and role of high glucose environment on chondrocyte activation: toward pathophysiological delineation of diabetes mellitus-related osteoarthritis. Osteoarthritis Cartilage 2015; 23:1513-22. [PMID: 25987541 DOI: 10.1016/j.joca.2015.04.026] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Revised: 04/14/2015] [Accepted: 04/30/2015] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To examine the relationship between osteoarthritis (OA) and type 2 diabetes mellitus (DM). METHODS OA cartilage from DM and non-DM patients undergoing knee replacement were stimulated by IL-1β for 24 h and release of interleukin-6 (IL-6) and prostaglandin E2 (PGE2) was measured. Primary cultured murine chondrocytes were stimulated for 24 and 72 h with or without IL-1β (5 ng/mL) under normal-glucose (5.5 mM) or high-glucose (25 mM) conditions. The expression and release of pro-inflammatory mediators (IL-6, cyclooxygenase 2 [COX2]/PGE2) were analyzed by quantitative RT-PCR and ELISA/EIA. Glucose uptake was assessed with ((14)C)-2-deoxyglucose. Reactive oxygen species (ROS) and nitric oxide (NO) production were measured. To analyze the mechanism of IL-1β-induced inflammation, cells were pretreated or treated with inhibitors of glucose transport (cytochalasin B), the polyol pathway (epalrestat), mitochondrial oxidative stress (MitoTEMPO) or nitric oxide synthase (l-NAME). RESULTS With IL-1β stimulation, IL-6 and PGE2 release was greater in human DM than non-DM OA cartilage (2.7- and 3-fold, respectively) (P < 0.05). In vitro, with IL-1β stimulation, IL-6 and COX2 mRNA expression, IL-6 and PGE2 release, and ROS and NO production were greater under high-than normal-glucose conditions in cultured chondrocytes. IL-1β-increased IL-6 release was reduced with cytochalasin B, epalrestat, L-NAME or MitoTEMPO treatment (-45%, -62%, -38% and -40%, respectively). CONCLUSION OA cartilages from DM patients showed increased responsiveness to IL-1β-induced inflammation. Accordingly, high glucose enhanced IL-1β-induced inflammation in cultured chondrocytes via oxidative stress and the polyol pathway. High glucose and diabetes may thus participate in the increased inflammation in OA.
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Affiliation(s)
- M-C Laiguillon
- Inserm UMRS_938, Centre de Recherche St-Antoine, Sorbonne Université UPMC Univ Paris 06, Paris, France
| | - A Courties
- Inserm UMRS_938, Centre de Recherche St-Antoine, Sorbonne Université UPMC Univ Paris 06, Paris, France; Rheumatology Department, Assistance Publique - Hôpitaux de Paris (AP-HP), Inflammation-Immunopathology-Biotherapy Department (DHU i2B), Paris, France
| | - X Houard
- Inserm UMRS_938, Centre de Recherche St-Antoine, Sorbonne Université UPMC Univ Paris 06, Paris, France
| | - M Auclair
- Inserm UMRS_938, Centre de Recherche St-Antoine, Sorbonne Université UPMC Univ Paris 06, Paris, France
| | - A Sautet
- Orthopedic Surgery Department, AP-HP, Sorbonne Université UPMC Univ Paris 06, Paris, France
| | - J Capeau
- Inserm UMRS_938, Centre de Recherche St-Antoine, Sorbonne Université UPMC Univ Paris 06, Paris, France
| | - B Fève
- Inserm UMRS_938, Centre de Recherche St-Antoine, Sorbonne Université UPMC Univ Paris 06, Paris, France
| | - F Berenbaum
- Inserm UMRS_938, Centre de Recherche St-Antoine, Sorbonne Université UPMC Univ Paris 06, Paris, France; Rheumatology Department, Assistance Publique - Hôpitaux de Paris (AP-HP), Inflammation-Immunopathology-Biotherapy Department (DHU i2B), Paris, France.
| | - J Sellam
- Inserm UMRS_938, Centre de Recherche St-Antoine, Sorbonne Université UPMC Univ Paris 06, Paris, France; Rheumatology Department, Assistance Publique - Hôpitaux de Paris (AP-HP), Inflammation-Immunopathology-Biotherapy Department (DHU i2B), Paris, France
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15
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King K, Rosenthal A. The adverse effects of diabetes on osteoarthritis: update on clinical evidence and molecular mechanisms. Osteoarthritis Cartilage 2015; 23:841-50. [PMID: 25837996 PMCID: PMC5530368 DOI: 10.1016/j.joca.2015.03.031] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Revised: 03/02/2015] [Accepted: 03/16/2015] [Indexed: 02/02/2023]
Abstract
Projected increases in the prevalence of both diabetes mellitus (DM) and osteoarthritis (OA) ensure their common co-existence. In an era of increasing attention to personalized medicine, understanding the influence of common comorbidities such as DM should result in improved care of patients with OA. In this narrative review, we summarize the literature addressing the interactions between DM and OA spanning the years from 1962 to 2014. We separated studies depending on whether they investigated clinical populations, animal models, or cells and tissues. The clinical literature addressing the influence of DM on OA and its therapeutic outcomes suggests that DM may augment the development and severity of OA and that DM increases risks associated with joint replacement surgery. The few high quality studies using animal models also support an adverse effect of DM on OA. We review strengths and weaknesses of the common rodent models of DM. The heterogeneous literature derived from studies of articular cells and tissues also supports the existence of biochemical and biomechanical changes in articular tissues in DM, and begins to characterize molecular mechanisms activated in diabetic-like environs which may contribute to OA. Increasing evidence from the clinic and the laboratory supports an adverse effect of DM on the development, severity, and therapeutic outcomes for OA. To understand the mechanisms through which DM contributes to OA, further studies are clearly necessary. Future studies of DM-influenced mechanisms may shed light on general mechanisms of OA pathogenesis and result in more specific and effective therapies for all OA patients.
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Affiliation(s)
- K.B. King
- Department of Orthopaedics, University of Colorado School of Medicine, Aurora, CO, USA,Surgical Service, Orthopaedic Service, Eastern Colorado Health Care System, Veterans Affairs, Denver, CO, USA
| | - A.K. Rosenthal
- Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA,Medicine Service, Rheumatology Service, The Clement J. Zablocki Medical Center, Veterans Affairs, Milwaukee, WI, USA,Address correspondence and reprint requests to: A.K. Rosenthal, Zablocki VA Medical Center, 5000 W. National Avenue, Milwaukee, WI 53295-1000, USA. Tel: 1-(414)-955-7027; Fax: 1-(414)-955-6205
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16
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Abstract
There are several mechanisms by which diabetes could affect bone mass and strength. These mechanisms include insulin deficiency; hyperglycemia; the accumulation of advanced glycation end products that may influence collagen characteristics; marrow adiposity and bone inflammation. Furthermore, associated diabetic complications and treatment with thaizolidinediones may also increase risk of fracturing. The following article provides its readers with an update on the latest information pertaining to diabetes related bone skeletal fragility. In the authors' opinion, future studies are needed in order to clarify the impact of different aspects of diabetes metabolism, glycemic control, and specific treatments for diabetes on bone. Given that dual energy x-ray absorptiometry is a poor predictor of bone morbidity in this group of patients, there is a need to explore novel approaches for assessing bone quality. It is important that we develop a better understanding of how diabetes affects bone in order to improve our ability to protect bone health and prevent fractures in the growing population of adults with diabetes.
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Affiliation(s)
- Naiemh Abdalrahman
- a Developmental Endocrinology Research Group, Royal Hospital for Sick Children, School of Medicine, University of Glasgow, Yorkhill, Glasgow G3 8SJ, UK
| | - Suet Ching Chen
- a Developmental Endocrinology Research Group, Royal Hospital for Sick Children, School of Medicine, University of Glasgow, Yorkhill, Glasgow G3 8SJ, UK
| | - Jessie Ruijun Wang
- a Developmental Endocrinology Research Group, Royal Hospital for Sick Children, School of Medicine, University of Glasgow, Yorkhill, Glasgow G3 8SJ, UK
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