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Chuang TL, Koo M, Wang YF. The impact of diabetes, anemia, and renal function in the relationship between osteoporosis and fasting blood glucose among Taiwanese women: a cross-sectional study. BMC Womens Health 2024; 24:23. [PMID: 38172731 PMCID: PMC10765617 DOI: 10.1186/s12905-023-02851-w] [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: 08/27/2023] [Accepted: 12/16/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND The aim of this study was to investigate the association between fasting blood glucose and osteoporosis in women with diabetes, anemia, and renal function. METHODS The medical records of women who underwent a general health examination at a regional hospital in southern Taiwan were retrospectively reviewed. Logistic regression analysis was performed to assess the association between osteoporosis and fasting blood glucose separately for the eight subgroups (diabetes or non-diabetes, anemia or non-anemia, normal or decreased renal function), adjusting for other clinical characteristics and laboratory findings. RESULTS A total of 11,872 women were included in the study. Among women with diabetes, anemia, and decreased renal function, an increment of 10 mg/dL in fasting blood glucose was associated with an increased risk of osteoporosis (adjusted odds ratio [aOR] = 1.57, p = 0.004). Among women without diabetes, fasting blood glucose was significantly associated with an increased risk of osteoporosis in those with anemia and normal renal function (OR = 1.14, p = 0.023) and those without anemia and normal renal function (OR = 1.04, p = 0.015), but these associations were not significant after adjusting for other covariates. CONCLUSIONS Higher fasting blood glucose levels in women with diabetes, anemia, and decreased renal function were associated with an increased risk of osteoporosis. Clinicians should be vigilant about glucose control in patients with diabetes to reduce the risk of fracture.
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Affiliation(s)
- Tzyy-Ling Chuang
- Department of Nuclear Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan
- School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Malcolm Koo
- Department of Nursing, Tzu Chi University of Science and Technology, Hualien, 970302, Taiwan.
| | - Yuh-Feng Wang
- Department of Nuclear Medicine, Taipei Veterans General Hospital, No.201, Sec. 2, Shipai Road, Beitou District, Taipei City, 11217, Taiwan.
- Department of Biomedical Imaging and Radiological Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan.
- Department of Medical Imaging and Radiological Technology, Yuanpei University of Medical Technology, Hsinchu, Taiwan.
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Gao L, Liu Y, Li M, Wang Y, Zhang W. Based on HbA1c Analysis: Bone Mineral Density and Osteoporosis Risk in Postmenopausal Female with T2DM. J Clin Densitom 2024; 27:101442. [PMID: 38039558 DOI: 10.1016/j.jocd.2023.101442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 11/01/2023] [Indexed: 12/03/2023]
Abstract
INTRODUCTION This study aims to investigate association between glycosylated hemoglobin (HbA1c) with bone mineral density (BMD) and osteoporosis-risk in postmenopausal female with type 2 diabetes mellitus (T2DM). METHODOLOGY HbA1c values, BMD of L3 vertebra and basic clinical data of 152 postmenopausal females with T2DM and 326 postmenopausal females without T2DM were retrospectively analyzed. The propensity score matching was used to match the T2DM and the non-T2DM group at a ratio of 1:1. Restricted cubic spline (RCS) analysis and piecewise linear regression were used to evaluate the relationship between HbA1c and BMD. Univariable and multivariable logistic regression were utilized to evaluate the effect of HbA1c on the risk of osteoporosis in matched diabetes population. RESULTS After matching, the BMD (66.60 (46.58, 93.23) vs. 63.50 (36.70, 83.33), P < 0.05), HbA1c value (7.50 (6.72, 8.80) vs 5.30 (5.14, 5.50), P < 0.05) in the T2DM group were significantly higher than that of non-T2DM group. We found a nonlinear relation between HbA1c value and BMD, which showing a U-shaped curve with the cutoff value around 7.5 % (Poverall < 0.001, Pnonliearity < 0.05). The prevalence of osteoporosis in T2DM group was similar to that in controls (64.9 % vs 73.6 %, P = 0.102). Age-adjusted HbA1c value was not risk factor of osteoporosis in postmenopausal females with T2DM. CONCLUSION In postmenopausal females with T2DM, high BMD and similar risk of osteoporosis were confirmed; HbA1c was a contributing factor to BMD when values exceed 7.5 %. However, HbA1c does not seem to be associated with osteoporosis risk.
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Affiliation(s)
- Lei Gao
- Department of Radiology, Hebei Medical University Third Hospital, No.139 ziqiang road, Qiaoxi District, Shijiazhuang, Hebei 050051, China
| | - Ying Liu
- Department of Radiology, Hebei Medical University Third Hospital, No.139 ziqiang road, Qiaoxi District, Shijiazhuang, Hebei 050051, China
| | - Min Li
- Department of Endocrinology, Hebei Medical University Third Hospital, No.139 ziqiang road, Qiaoxi District, Shijiazhuang, Hebei 050051, China
| | - Yan Wang
- Department of Endocrinology, Hebei Medical University Third Hospital, No.139 ziqiang road, Qiaoxi District, Shijiazhuang, Hebei 050051, China.
| | - Wei Zhang
- Department of Radiology, Hebei Medical University Third Hospital, No.139 ziqiang road, Qiaoxi District, Shijiazhuang, Hebei 050051, China.
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Lao A, Wu J, Li D, Shen A, Li Y, Zhuang Y, Lin K, Wu J, Liu J. Functionalized Metal-Organic Framework-Modified Hydrogel That Breaks the Vicious Cycle of Inflammation and ROS for Repairing of Diabetic Bone Defects. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2023; 19:e2206919. [PMID: 37183293 DOI: 10.1002/smll.202206919] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 03/24/2023] [Indexed: 05/16/2023]
Abstract
The regeneration of diabetic bone defects remains challenging. Hyperglycemia causes inflammation state and excessive reactive oxygen species (ROS) during bone regeneration period. These two effects reinforce one another and create an endless loop that is also accompanied by mitochondrial dysfunction. However, there is still no effective and inclusive method targeting at the two aspects and breaking the vicious cycle. Herein, nanoparticles-Met@ZIF-8(metformin loaded zeolitic imidazolate frameworks) modified hydrogel that is capable of releasing metformin and Zn elements are constructed. This hydrogel treats hyperglycemia while also controlling mitochondrial function, reducing inflammation, and restoring homeostasis. In addition, the synergetic effect from metformin and Zn ions inhibits ROS-inflammation cascade generation and destroys the continuous progress by taking effects in both ROS and inflammation and further keeping organelles' homeostasis. Furthermore, with the recovery of mitochondria and breakdown of the ROS-inflammation cascade cycle, osteogenesis under a diabetic microenvironment is enhanced in vivo and in vitro. In conclusion, the study provides critical insight into the biological mechanism and potential therapy for diabetic bone regeneration.
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Affiliation(s)
- An Lao
- Department of Oral and Cranio-maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, 200120, China
- Department of Stomatology, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Jiaqing Wu
- Department of Oral and Cranio-maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, 200120, China
| | - Dejian Li
- Department of Oral and Cranio-maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, 200120, China
- Department of Orthopedics, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, 201301, China
| | - Aili Shen
- Department of Oral and Cranio-maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, 200120, China
| | - Yaxin Li
- Department of Oral and Cranio-maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, 200120, China
| | - Yu Zhuang
- Department of Oral and Cranio-maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, 200120, China
| | - Kaili Lin
- Department of Oral and Cranio-maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, 200120, China
| | - Jianyong Wu
- Department of Stomatology, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Jiaqiang Liu
- Department of Oral and Cranio-maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, 200120, China
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Wang S, Wang J, Wang S, Tao R, Yi J, Chen M, Zhao Z. mTOR Signaling Pathway in Bone Diseases Associated with Hyperglycemia. Int J Mol Sci 2023; 24:ijms24119198. [PMID: 37298150 DOI: 10.3390/ijms24119198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 05/02/2023] [Accepted: 05/04/2023] [Indexed: 06/12/2023] Open
Abstract
The interplay between bone and glucose metabolism has highlighted hyperglycemia as a potential risk factor for bone diseases. With the increasing prevalence of diabetes mellitus worldwide and its subsequent socioeconomic burden, there is a pressing need to develop a better understanding of the molecular mechanisms involved in hyperglycemia-mediated bone metabolism. The mammalian target of rapamycin (mTOR) is a serine/threonine protein kinase that senses extracellular and intracellular signals to regulate numerous biological processes, including cell growth, proliferation, and differentiation. As mounting evidence suggests the involvement of mTOR in diabetic bone disease, we provide a comprehensive review of its effects on bone diseases associated with hyperglycemia. This review summarizes key findings from basic and clinical studies regarding mTOR's roles in regulating bone formation, bone resorption, inflammatory responses, and bone vascularity in hyperglycemia. It also provides valuable insights into future research directions aimed at developing mTOR-targeted therapies for combating diabetic bone diseases.
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Affiliation(s)
- Shuangcheng Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Jiale Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Shuangwen Wang
- West China School of Medicine, Sichuan University, Chengdu 610041, China
| | - Ran Tao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Jianru Yi
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Miao Chen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Zhihe Zhao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
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Shahen VA, Schindeler A, Rybchyn MS, Girgis CM, Mulholland B, Mason RS, Levinger I, Brennan-Speranza TC. Rescue of High Glucose Impairment of Cultured Human Osteoblasts Using Cinacalcet and Parathyroid Hormone. Calcif Tissue Int 2023; 112:452-462. [PMID: 36754901 PMCID: PMC10025212 DOI: 10.1007/s00223-023-01062-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 01/16/2023] [Indexed: 02/10/2023]
Abstract
Patients with type 2 diabetes mellitus (T2DM) experience a higher risk of fractures despite paradoxically exhibiting normal to high bone mineral density (BMD). This has drawn into question the applicability to T2DM of conventional fracture reduction treatments that aim to retain BMD. In a primary human osteoblast culture system, high glucose levels (25 mM) impaired cell proliferation and matrix mineralization compared to physiological glucose levels (5 mM). Treatment with parathyroid hormone (PTH, 10 nM), a bone anabolic agent, and cinacalcet (CN, 1 µM), a calcimimetic able to target the Ca2+-sensing receptor (CaSR), were tested for their effects on proliferation and differentiation. Strikingly, CN+PTH co-treatment was shown to promote cell growth and matrix mineralization under both physiological and high glucose conditions. CN+PTH reduced apoptosis by 0.9-fold/0.4-fold as measured by Caspase-3 activity assay, increased alkaline phosphatase (ALP) expression by 1.5-fold/twofold, increased the ratio of nuclear factor κ-B ligand (RANKL) to osteoprotegerin (OPG) by 2.1-fold/1.6-fold, and increased CaSR expression by 1.7-fold/4.6-fold (physiological glucose/high glucose). Collectively, these findings indicate a potential for CN+PTH combination therapy as a method to ameliorate the negative impact of chronic high blood glucose on bone remodeling.
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Affiliation(s)
- V A Shahen
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
| | - A Schindeler
- Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
- Bioengineering & Molecular Medicine Laboratory, The Children's Hospital at Westmead and the, Westmead Institute for Medical Research, Westmead, NSW, 2006, Australia
| | - M S Rybchyn
- School of Chemical Engineering, University of New South Wales, Sydney, NSW, 2033, Australia
| | - C M Girgis
- Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
- Department of Diabetes and Endocrinology, Westmead Hospital, Sydney, Australia
- Department of Endocrinology, Royal North Shore Hospital, Sydney, Australia
| | - B Mulholland
- Graduate School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - R S Mason
- School of Life and Environmental Sciences, Faculty of Science, University of Sydney, Sydney, NSW, 2006, Australia
| | - I Levinger
- Institute for Health and Sport (IHES), Victoria University, Melbourne, VIC, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, St Albans, VIC, Australia
| | - T C Brennan-Speranza
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia.
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia.
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Dule S, Barchetta I, Cimini FA, Passarella G, Dellanno A, Filardi T, Venditti V, Bleve E, Bailetti D, Romagnoli E, Morano S, Baroni MG, Cavallo MG. Reduced High-Density Lipoprotein Cholesterol Is an Independent Determinant of Altered Bone Quality in Women with Type 2 Diabetes. Int J Mol Sci 2023; 24:ijms24076474. [PMID: 37047445 PMCID: PMC10095189 DOI: 10.3390/ijms24076474] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 03/21/2023] [Accepted: 03/28/2023] [Indexed: 04/03/2023] Open
Abstract
Type 2 diabetes mellitus (T2DM) is associated with an increased fracture risk. Our study aimed to explore differences in bone alterations between T2DM women and controls and to assess clinical predictors of bone impairment in T2DM. For this observational case control study, we recruited 126 T2DM female patients and 117 non-diabetic, age- and BMI-comparable women, who underwent clinical examination, routine biochemistry and dual-energy X-ray absorptiometry (DXA) scans for bone mineral density (BMD) and trabecular bone score (TBS) assessment-derived indexes. These were correlated to metabolic parameters, such as glycemic control and lipid profile, by bivariate analyses, and significant variables were entered in multivariate adjusted models to detect independent determinants of altered bone status in diabetes. The T2DM patients were less represented in the normal bone category compared with controls (5% vs. 12%; p = 0.04); T2DM was associated with low TBS (OR: 2.47, C.I. 95%: 1.19–5.16, p = 0.016) in a regression model adjusted for age, menopausal status and BMI. In women with T2DM, TBS directly correlated with plasma high-density lipoprotein cholesterol (HDL-c) (p = 0.029) and vitamin D (p = 0.017) levels. An inverse association was observed with menopausal status (p < 0.001), metabolic syndrome (p = 0.014), BMI (p = 0.005), and waist circumference (p < 0.001). In the multivariate regression analysis, lower HDL-c represented the main predictor of altered bone quality in T2DM, regardless of age, menopausal status, BMI, waist circumference, statin treatment, physical activity, and vitamin D (p = 0.029; R2 = 0.47), which likely underlies common pathways between metabolic disease and bone health in diabetes.
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Affiliation(s)
- Sara Dule
- Department of Experimental Medicine, Sapienza University, 00161 Rome, Italy
| | - Ilaria Barchetta
- Department of Experimental Medicine, Sapienza University, 00161 Rome, Italy
| | | | - Giulia Passarella
- Department of Experimental Medicine, Sapienza University, 00161 Rome, Italy
| | - Arianna Dellanno
- Department of Experimental Medicine, Sapienza University, 00161 Rome, Italy
| | - Tiziana Filardi
- Department of Experimental Medicine, Sapienza University, 00161 Rome, Italy
| | - Vittorio Venditti
- Department of Experimental Medicine, Sapienza University, 00161 Rome, Italy
| | - Enrico Bleve
- Department of Experimental Medicine, Sapienza University, 00161 Rome, Italy
| | - Diego Bailetti
- Department of Clinical Medicine, Public Health, Life and Environmental Sciences (MeSVA), University of L’Aquila, 67100 L’Aquila, Italy
| | | | - Susanna Morano
- Department of Experimental Medicine, Sapienza University, 00161 Rome, Italy
| | - Marco Giorgio Baroni
- Department of Clinical Medicine, Public Health, Life and Environmental Sciences (MeSVA), University of L’Aquila, 67100 L’Aquila, Italy
- Neuroendocrinology and Metabolic Diseases, IRCCS Neuromed, 86077 Pozzilli, Italy
- Correspondence:
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Cai F, Liu Y, Liu K, Zhao R, Chen W, Yusufu A, Liu Y. Diabetes mellitus impairs bone regeneration and biomechanics. J Orthop Surg Res 2023; 18:169. [PMID: 36872328 PMCID: PMC9987049 DOI: 10.1186/s13018-023-03644-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Accepted: 02/24/2023] [Indexed: 03/07/2023] Open
Abstract
BACKGROUND With the rise of high-calorie diets and the aging of populations, the incidence of diabetes was increased dramatically in the world and the number of people with diabetes was predicted to rise to 600 million by 2045. Numerous studies have confirmed that several organ systems, including the skeletal system, are seriously affected by diabetes. In that study, the bone regeneration and the biomechanics of the newly regenerated bone were investigated in diabetic rats, which may provide a supplement for previous studies. METHODS A total of 40 SD rats were randomly divided into the type 2 diabetes mellitus (T2DM) group (n = 20) and the control group (n = 20). Beyond that high fat diet and streptozotocin (STZ) were jointly used in the T2DM group, there were no differences between the two groups in terms of treatment conditions. Distraction osteogenesis was used in all animals for the next experimental observation. The evaluation criterion of the regenerated bone was based on radioscopy (once a week), micro-computed tomography (CT), general morphology, biomechanics (including ultimate load, modulus of elasticity, energy to failure, and stiffness), histomorphometry (including von Kossa, Masson trichrome, Goldner trichrome, and safranin O staining), and immunohistochemistry. RESULTS All rats in the T2DM group with fasting glucose levels (FGL, > 16.7 mmol/L) were allowed to complete the following experiments. The results showed that rats with T2DM have a higher body weight (549.01 g ± 31.34 g) than rats in the control group (488.60 g ± 33.60 g) at the end of observation. Additionally, compared to the control group, slower bone regeneration in the distracted segments was observed in the T2DM group according to radiography, micro-CT, general morphology, and histomorphometry. Furthermore, a biomechanical test showed that there was a worse ultimate load (31.01 ± 3.39%), modulus of elasticity (34.44 ± 5.06%), energy to failure (27.42 ± 5.87%), and stiffness (34.55 ± 7.66%) than the control group (45.85 ± 7.61%, 54.38 ± 9.33%, 59.41 ± 10.96%, and 54.07 ± 9.30%, respectively). Furthermore, the decreased expressions of hypoxia-inducible factor 1α (HIF-1α) and vascular endothelial growth factor (VEGF) were presented in T2DM group by immunohistochemistry. CONCLUSION The present study demonstrated that diabetes mellitus impairs bone regeneration and biomechanics in newly regenerated bone, a phenomenon that might be related to oxidative stress and poor angiogenesis brought on by the disease.
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Affiliation(s)
- Feiyu Cai
- Department of Burns and Plastic Surgery and Wound Repair Surgery, The Lanzhou University Second Hospital, Lanzhou, Gansu, China
| | - Yanshi Liu
- Department of Orthopaedics, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Kai Liu
- Department of Trauma and Micro Reconstructive Surgery, The First Affiliated Hospital of Xinjiang Medical University, Ürümqi, Xinjiang, China
| | - Ruomei Zhao
- Department of Burns and Plastic Surgery and Wound Repair Surgery, The Lanzhou University Second Hospital, Lanzhou, Gansu, China
| | - Wenjiao Chen
- Department of Burns and Plastic Surgery and Wound Repair Surgery, The Lanzhou University Second Hospital, Lanzhou, Gansu, China
| | - Aihemaitijiang Yusufu
- Department of Trauma and Micro Reconstructive Surgery, The First Affiliated Hospital of Xinjiang Medical University, Ürümqi, Xinjiang, China.
| | - Yi Liu
- Department of Burns and Plastic Surgery and Wound Repair Surgery, The Lanzhou University Second Hospital, Lanzhou, Gansu, China.
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Icariin Treatment Rescues Diabetes Induced Bone Loss via Scavenging ROS and Activating Primary Cilia/Gli2/Osteocalcin Signaling Pathway. Cells 2022; 11:cells11244091. [PMID: 36552853 PMCID: PMC9777100 DOI: 10.3390/cells11244091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/10/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022] Open
Abstract
Diabetes-associated bone complications lead to fragile bone mechanical strength and osteoporosis, aggravating the disease burden of patients. Advanced evidence shows that chronic hyperglycemia and metabolic intermediates, such as inflammatory factor, reactive oxygen species (ROS), and advanced glycation end products (AGEs), are regarded as dominant hazardous factors of bone complications, whereas the pathophysiological mechanisms are complex and controversial. By establishing a diabetic Sprague-Dawley (SD) rat model and diabetic bone loss cell model in vitro, we confirmed that diabetes impaired primary cilia and led to bone loss, while adding Icariin (ICA) could relieve the inhibitions. Mechanistically, ICA could scavenge ROS to maintain the mitochondrial and primary cilia homeostasis of osteoblasts. Intact primary cilia acted as anchoring and modifying sites of Gli2, thereby activating the primary cilia/Gli2/osteocalcin signaling pathway to promote osteoblast differentiation. All results suggest that ICA has potential as a therapeutic drug targeting bone loss induced by diabetes.
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Wu B, Fu Z, Wang X, Zhou P, Yang Q, Jiang Y, Zhu D. A narrative review of diabetic bone disease: Characteristics, pathogenesis, and treatment. Front Endocrinol (Lausanne) 2022; 13:1052592. [PMID: 36589835 PMCID: PMC9794857 DOI: 10.3389/fendo.2022.1052592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 12/01/2022] [Indexed: 12/23/2022] Open
Abstract
Recently, the increasing prevalence of diabetes mellitus has made it a major chronic illness which poses a substantial threat to human health. The prevalence of osteoporosis among patients with diabetes mellitus has grown considerably. Diabetic bone disease is a secondary osteoporosis induced by diabetes mellitus. Patients with diabetic bone disease exhibit variable degrees of bone loss, low bone mineral density, bone microarchitecture degradation, and increased bone fragility with continued diabetes mellitus, increasing their risk of fracture and impairing their ability to heal after fractures. At present, there is extensive research interest in diabetic bone disease and many significant outcomes have been reported. However, there are no comprehensive review is reported. This review elaborates on diabetic bone disease in the aspects of characteristics, pathogenesis, and treatment.
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Affiliation(s)
| | | | | | | | | | | | - Dong Zhu
- Department of Orthopaedic Trauma, Center of Orthopaedics and Traumatology, The First Hospital of Jilin University, Changchun, China
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Lao A, Chen Y, Sun Y, Wang T, Lin K, Liu J, Wu J. Transcriptomic analysis provides a new insight: Oleuropein reverses high glucose-induced osteogenic inhibition in bone marrow mesenchymal stem cells via Wnt10b activation. Front Bioeng Biotechnol 2022; 10:990507. [PMID: 36091442 PMCID: PMC9459378 DOI: 10.3389/fbioe.2022.990507] [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: 07/10/2022] [Accepted: 07/27/2022] [Indexed: 11/17/2022] Open
Abstract
Adverse events of diabetes mellitus (DM) include bone damages, such as the increased incidence of osteoporosis and bone fractures, which are known as diabetic osteopathy. The pathogenic mechanism of diabetic osteopathy is complex, and hyperglycemia is a vital cause involved in it. Bone marrow mesenchymal stem cells (BMSCs) exert a significant effect on bone formation. Therefore, in this paper, transcriptomic changes of BMSCs cultured in high glucose (35 mM) for 30 days are mainly investigated. In addition, 794 up-regulated genes and 1,162 down-regulated genes were identified. Then, biological functions of the differentially expressed genes in the high glucose microenvironment were investigated by two kinds of functional analyses. Gene Set Enrichment Analysis was also applied to focus on the significant gene sets and it is found that Wnt10b expression witnessed a remarkable decrease in BMSCs under the high glucose microenvironment. At last, in vitro experiments revealed that oleuropein effectively reversed high glucose-induced osteogenic inhibition via activating Wnt10b in BMSCs.
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Affiliation(s)
- An Lao
- Department of Stomatology, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yu Chen
- Shanghai Key Laboratory of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Oral and Cranio-maxillofacial Surgery, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Yiting Sun
- Shanghai Key Laboratory of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Oral and Cranio-maxillofacial Surgery, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Tiange Wang
- Shanghai Key Laboratory of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Oral and Cranio-maxillofacial Surgery, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Kaili Lin
- Shanghai Key Laboratory of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Oral and Cranio-maxillofacial Surgery, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University, Shanghai, China
- *Correspondence: Kaili Lin, ; Jiaqiang Liu, ; Jianyong Wu,
| | - Jiaqiang Liu
- Shanghai Key Laboratory of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Oral and Cranio-maxillofacial Surgery, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University, Shanghai, China
- *Correspondence: Kaili Lin, ; Jiaqiang Liu, ; Jianyong Wu,
| | - Jianyong Wu
- Department of Stomatology, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- *Correspondence: Kaili Lin, ; Jiaqiang Liu, ; Jianyong Wu,
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11
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Hemoglobin level and osteoporosis in Chinese elders with type 2 diabetes mellitus. Nutr Diabetes 2022; 12:19. [PMID: 35414128 PMCID: PMC9005625 DOI: 10.1038/s41387-022-00198-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 03/09/2022] [Accepted: 03/28/2022] [Indexed: 11/21/2022] Open
Abstract
Objectives Several studies demonstrated a positive relationship between hemoglobin level and bone mineral density (BMD). Thus, the association between hemoglobin concentration and osteoporosis in elders with type 2 diabetes mellitus (T2DM) was explored in this study. Methods Totally, 573 elders with T2DM were included in the study. BMD was measured by dual-energy X-ray absorptiometry. Hemoglobin levels were tested. The association between the hemoglobin level and osteoporosis was subjected to logistic regression analysis. Results For men, the hemoglobin levels were significantly lower in osteoporosis group than that in non-osteoporosis group (135.98 ± 16.20 vs. 142.84 ± 13.78 g/L, P = 0.002). Hemoglobin levels were positively related with BMD of total hip and femoral neck in men (r = 0.170, P = 0.004; r = 0.148, P = 0.012, respectively). After adjusting for age, body mass index (BMI), hemoglobin A1c (HbA1c), estimated glomerular filtration rate (eGFR) and 25-hydroxyvitamin D3 [25(OH) D3], the hemoglobin level was related with a 0.97-fold lower risk of osteoporosis (odds ratio (OR): 0.97; 95% confidence interval (CI): 0.95–0.99; P = 0.004) in men, but no such association was found in women. Conclusion Higher levels of hemoglobin play a protective role against osteoporosis in older men with T2DM.
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12
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Cifuentes-Mendiola SE, Solis-Suarez DL, Martínez-Dávalos A, Godínez-Victoria M, García-Hernández AL. CD4 + T-cell activation of bone marrow causes bone fragility and insulin resistance in type 2 diabetes. Bone 2022; 155:116292. [PMID: 34896656 DOI: 10.1016/j.bone.2021.116292] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 12/02/2021] [Accepted: 12/03/2021] [Indexed: 12/14/2022]
Abstract
Type 2 diabetes mellitus (T2DM) causes an increased risk of bone fractures. However, the pathophysiology of diabetic bone fragility is not completely understood. It has been proposed that an inflammatory microenvironment in bone could be a major mechanism by inducing uncontrolled bone resorption, inadequate bone formation and consequently more porous bones. We propose that activated T-cells in the bone marrow cause a pro-inflammatory microenvironment in bone, and cause bone fragility in T2DM. We induced T2DM in C57BL/6 male mice through a hypercaloric diet rich in carbohydrates and low doses of streptozocin. In T2DM mice we inhibited systemic activation of T-cells with a fusion protein between the extracellular domain of Cytotoxic T-Lymphocyte Antigen 4 and the Fc domain of human immunoglobulin G (CTLA4-Ig). We analysed the effects of T2DM or CTLA4-Ig in lymphocyte cell subsets and antigen-presenting cells in peripheral blood and femoral bone marrow; and their effect on the metabolic phenotype, blood and bone cytokine concentration, femoral bone microarchitecture and biomechanical properties, and the number of osteoblast-like cells in the femoral endosteum. We performed a Pearson multiple correlation analysis between all variables in order to understand the global mechanism. Results demonstrated that CTLA4-Ig decreased the number of activated CD4+ T-cells in the femoral bone marrow and consequently decreased TNF-α and RANK-L concentration in bone, notably improved femoral bone microarchitecture and biomechanical properties, increased the number of osteoblast-like cells, and reduces osteoclastic activity compared to T2DM mice that did not receive the inhibitor. Interestingly, we observed that blood glucose levels and insulin resistance may be related to the increase in activated CD4+ T-cells in the bone marrow. We conclude that bone marrow activated CD4+ T-cells cause poor bone quality and insulin resistance in T2DM.
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Affiliation(s)
- S E Cifuentes-Mendiola
- Laboratory of Dental Research, Section of Osteoimmunology and Oral Immunology, FES Iztacala, National Autonomous University of Mexico, A. Jiménez Gallardo SN, San Sebastián Xhala, Cuautitlán Izcalli, Estado de México, CP 54714, Mexico; Postgraduate in Biological Sciences, National Autonomous University of Mexico, Mexico, Mexico
| | - D L Solis-Suarez
- Laboratory of Dental Research, Section of Osteoimmunology and Oral Immunology, FES Iztacala, National Autonomous University of Mexico, A. Jiménez Gallardo SN, San Sebastián Xhala, Cuautitlán Izcalli, Estado de México, CP 54714, Mexico
| | - A Martínez-Dávalos
- Physics Institute, National Autonomous University of Mexico, Circuito de la Investigación Científica, Ciudad Universitaria, 04510 México City, Mexico
| | - M Godínez-Victoria
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico, Mexico
| | - A L García-Hernández
- Laboratory of Dental Research, Section of Osteoimmunology and Oral Immunology, FES Iztacala, National Autonomous University of Mexico, A. Jiménez Gallardo SN, San Sebastián Xhala, Cuautitlán Izcalli, Estado de México, CP 54714, Mexico.
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13
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Anna UM, Maria S, Kerstin B. Comparison of quantitative ultrasound of calcaneus and dual energy X-ray absorptiometry in measuring bone density and predicting fractures in patients with diabetic polyneuropathy: A prospective cohort study. Diabetes Res Clin Pract 2021; 180:109064. [PMID: 34562510 DOI: 10.1016/j.diabres.2021.109064] [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: 07/01/2021] [Revised: 09/14/2021] [Accepted: 09/17/2021] [Indexed: 12/11/2022]
Abstract
AIMS Compare quantitative ultrasound (QUS) of calcaneus and dual energy X-ray absorptiometry (DXA) as measurements of bone density, calculate 20-year fracture incidence in patients with T1DM and T2DM and multiple complications, and compare the methods' predictive ability. METHODS Sixty-two hospital foot clinic patients with T1DM or T2DM and complications were followed (1995-2015; 610 person-years). Clinical assessments and QUS of calcaneus were performed on all at inclusion and DXA of the spine and femoral neck on a subgroup (n = 34). Fracture incidence was assessed at follow-up and compared to incidence in the general population. We evaluated the correlation between QUS of calcaneus and DXA (Pearson's correlation test) and the association between bone density and fracture incidence at follow-up (logistic regression). RESULTS Bone density (QUS of calcaneus) correlated with hip bone density (DXA). Incidence of all fractures (30/62 patients; 48%) and hip fractures (6/62 patients; 10%) was higher in patients than the general population. Twelve (19%) experienced foot fracture. QUS of calcaneus predicted hip, lower leg, and foot fractures; DXA did not. CONCLUSIONS Because QUS of calcaneus predicted fractures in patients with diabetes and multiple complications, it seems appropriate to test QUS of calcaneus as a fracture risk predictor in primary care.
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Affiliation(s)
- Ugarph-Morawski Anna
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Solna (L1:00), SE-171 76 Stockholm, Sweden.
| | - Sääf Maria
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Solna (L1:00), SE-171 76 Stockholm, Sweden
| | - Brismar Kerstin
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Solna (L1:00), SE-171 76 Stockholm, Sweden; The Rolf Luft Research Center for Diabetes and Endocrinology, Box 1421, 111 84 Stockholm, Sweden
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14
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Ross DS, Yeh TH, King S, Mathers J, Rybchyn MS, Neist E, Cameron M, Tacey A, Girgis CM, Levinger I, Mason RS, Brennan-Speranza TC. Distinct Effects of a High Fat Diet on Bone in Skeletally Mature and Developing Male C57BL/6J Mice. Nutrients 2021; 13:nu13051666. [PMID: 34068953 PMCID: PMC8157111 DOI: 10.3390/nu13051666] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 05/07/2021] [Accepted: 05/08/2021] [Indexed: 01/01/2023] Open
Abstract
Increased risks of skeletal fractures are common in patients with impaired glucose handling and type 2 diabetes mellitus (T2DM). The pathogenesis of skeletal fragility in these patients remains ill-defined as patients present with normal to high bone mineral density. With increasing cases of glucose intolerance and T2DM it is imperative that we develop an accurate rodent model for further investigation. We hypothesized that a high fat diet (60%) administered to developing male C57BL/6J mice that had not reached skeletal maturity would over represent bone microarchitectural implications, and that skeletally mature mice would better represent adult-onset glucose intolerance and the pre-diabetes phenotype. Two groups of developing (8 week) and mature (12 week) male C57BL/6J mice were placed onto either a normal chow (NC) or high fat diet (HFD) for 10 weeks. Oral glucose tolerance tests were performed throughout the study period. Long bones were excised and analysed for ex vivo biomechanical testing, micro-computed tomography, 2D histomorphometry and gene/protein expression analyses. The HFD increased fasting blood glucose and significantly reduced glucose tolerance in both age groups by week 7 of the diets. The HFD reduced biomechanical strength, both cortical and trabecular indices in the developing mice, but only affected cortical outcomes in the mature mice. Similar results were reflected in the 2D histomorphometry. Tibial gene expression revealed decreased bone formation in the HFD mice of both age groups, i.e., decreased osteocalcin expression and increased sclerostin RNA expression. In the mature mice only, while the HFD led to a non-significant reduction in runt-related transcription factor 2 (Runx2) RNA expression, this decrease became significant at the protein level in the femora. Our mature HFD mouse model more accurately represents late-onset impaired glucose tolerance/pre-T2DM cases in humans and can be used to uncover potential insights into reduced bone formation as a mechanism of skeletal fragility in these patients.
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Affiliation(s)
- Dean S. Ross
- Faculty of Medicine and Health, School of Medical Sciences, University of Sydney, Sydney 2006, Australia; (D.S.R.); (T.-H.Y.); (S.K.); (J.M.); (M.S.R.); (E.N.); (M.C.); (R.S.M.)
| | - Tzu-Hsuan Yeh
- Faculty of Medicine and Health, School of Medical Sciences, University of Sydney, Sydney 2006, Australia; (D.S.R.); (T.-H.Y.); (S.K.); (J.M.); (M.S.R.); (E.N.); (M.C.); (R.S.M.)
| | - Shalinie King
- Faculty of Medicine and Health, School of Medical Sciences, University of Sydney, Sydney 2006, Australia; (D.S.R.); (T.-H.Y.); (S.K.); (J.M.); (M.S.R.); (E.N.); (M.C.); (R.S.M.)
- Faculty of Medicine and Health, School of Dentistry, University of Sydney, Sydney 2006, Australia
| | - Julia Mathers
- Faculty of Medicine and Health, School of Medical Sciences, University of Sydney, Sydney 2006, Australia; (D.S.R.); (T.-H.Y.); (S.K.); (J.M.); (M.S.R.); (E.N.); (M.C.); (R.S.M.)
| | - Mark S. Rybchyn
- Faculty of Medicine and Health, School of Medical Sciences, University of Sydney, Sydney 2006, Australia; (D.S.R.); (T.-H.Y.); (S.K.); (J.M.); (M.S.R.); (E.N.); (M.C.); (R.S.M.)
| | - Elysia Neist
- Faculty of Medicine and Health, School of Medical Sciences, University of Sydney, Sydney 2006, Australia; (D.S.R.); (T.-H.Y.); (S.K.); (J.M.); (M.S.R.); (E.N.); (M.C.); (R.S.M.)
| | - Melissa Cameron
- Faculty of Medicine and Health, School of Medical Sciences, University of Sydney, Sydney 2006, Australia; (D.S.R.); (T.-H.Y.); (S.K.); (J.M.); (M.S.R.); (E.N.); (M.C.); (R.S.M.)
| | - Alexander Tacey
- Institute for Health and Sport (IHES), Victoria University, Melbourne 3011, Australia; (A.T.); (I.L.)
- Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, St Albans 3021, Australia
| | - Christian M. Girgis
- Department of Diabetes and Endocrinology, Westmead Hospital, Sydney 2145, Australia;
- Department of Endocrinology, Royal North Shore Hospital, Sydney 2065, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney 2006, Australia
| | - Itamar Levinger
- Institute for Health and Sport (IHES), Victoria University, Melbourne 3011, Australia; (A.T.); (I.L.)
- Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, St Albans 3021, Australia
| | - Rebecca S. Mason
- Faculty of Medicine and Health, School of Medical Sciences, University of Sydney, Sydney 2006, Australia; (D.S.R.); (T.-H.Y.); (S.K.); (J.M.); (M.S.R.); (E.N.); (M.C.); (R.S.M.)
| | - Tara C. Brennan-Speranza
- Faculty of Medicine and Health, School of Medical Sciences, University of Sydney, Sydney 2006, Australia; (D.S.R.); (T.-H.Y.); (S.K.); (J.M.); (M.S.R.); (E.N.); (M.C.); (R.S.M.)
- Faculty of Medicine and Health, School of Public Health, University of Sydney, Sydney 2006, Australia
- Correspondence: ; Tel.: +61-2-9351-4099
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Zuccarini M, Giuliani P, Caciagli F, Ciccarelli R, Di Iorio P. In Search of a Role for Extracellular Purine Enzymes in Bone Function. Biomolecules 2021; 11:biom11050679. [PMID: 33946568 PMCID: PMC8147220 DOI: 10.3390/biom11050679] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 04/27/2021] [Accepted: 04/29/2021] [Indexed: 12/12/2022] Open
Abstract
Bone is one of the major tissues that undergoes continuous remodeling throughout life, thus ensuring both organic body growth during development and protection of internal organs as well as repair of trauma during adulthood. Many endogenous substances contribute to bone homeostasis, including purines. Their role has increasingly emerged in recent decades as compounds which, by interacting with specific receptors, can help determine adequate responses of bone cells to physiological or pathological stimuli. Equally, it is recognized that the activity of purines is closely dependent on their interconversion or metabolic degradation ensured by a series of enzymes present at extracellular level as predominantly bound to the cell membrane or, also, as soluble isoforms. While the effects of purines mediated by their receptor interactions have sufficiently, even though not entirely, been characterized in many tissues including bone, those promoted by the extracellular enzymes providing for purine metabolism have not been. In this review, we will try to circumstantiate the presence and the role of these enzymes in bone to define their close relationship with purine activities in maintaining bone homeostasis in normal or pathological conditions.
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Affiliation(s)
- Mariachiara Zuccarini
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Via dei Vestini 29, 66100 Chieti, Italy; (M.Z.); (P.G.); (P.D.I.)
- Center for Advanced Studies and Technologies (CAST), University of Chieti-Pescara, Via L. Polacchi, 66100 Chieti, Italy;
| | - Patricia Giuliani
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Via dei Vestini 29, 66100 Chieti, Italy; (M.Z.); (P.G.); (P.D.I.)
- Center for Advanced Studies and Technologies (CAST), University of Chieti-Pescara, Via L. Polacchi, 66100 Chieti, Italy;
| | - Francesco Caciagli
- Center for Advanced Studies and Technologies (CAST), University of Chieti-Pescara, Via L. Polacchi, 66100 Chieti, Italy;
| | - Renata Ciccarelli
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Via dei Vestini 29, 66100 Chieti, Italy; (M.Z.); (P.G.); (P.D.I.)
- Center for Advanced Studies and Technologies (CAST), University of Chieti-Pescara, Via L. Polacchi, 66100 Chieti, Italy;
- StemTeCh Group, Via L. Polacchi, 66100 Chieti, Italy
- Correspondence:
| | - Patrizia Di Iorio
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Via dei Vestini 29, 66100 Chieti, Italy; (M.Z.); (P.G.); (P.D.I.)
- Center for Advanced Studies and Technologies (CAST), University of Chieti-Pescara, Via L. Polacchi, 66100 Chieti, Italy;
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Different Stages of Alveolar Bone Repair Process Are Compromised in the Type 2 Diabetes Condition: An Experimental Study in Rats. BIOLOGY 2020; 9:biology9120471. [PMID: 33339217 PMCID: PMC7766949 DOI: 10.3390/biology9120471] [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: 11/06/2020] [Revised: 12/08/2020] [Accepted: 12/14/2020] [Indexed: 11/17/2022]
Abstract
Simple Summary Type 2 diabetes (T2D) affects more than 90% of all patients diagnosed with diabetes, and among its risk factors, unhealthy eating habits are worth mentioning. With the notorious increase in the incidence of diabetic patients, there has also been an increase in surgical complications in dentistry, so this work presents a study model that mimics the T2D condition in rats, where animals receive a diet composed of foods rich in sugar and fat equivalent to the poor diet of the current population. The animals were submitted to dental extraction to perform analyzes at different stages of the alveolar bone. It is important to highlight that with the development of this experimental model it will be possible to simulate different conditions that are observed in clinics and in consequence and improve the characterization of the cellular responses involved in this complex condition of T2D. The scientific evidence presented in this study shows that T2D prolongs the local inflammatory process, which impairs the organization and maturation of collagen fibers, delaying bone formation and bone turnover. This fact implies in a series of disorders in dental practice, that would need to compensate in other ways, either with systemic medications or local therapies. Abstract The aim of this study was to analyze the stages of the alveolar bone repair in type 2 diabetic rats evaluating the mechanism of mineralization and bone remodeling processes after dental extraction. Forty-eight rats were divided into normoglycemic (NG) and type 2 diabetes (T2D) groups. The upper right incisor was extracted and after 3, 7, 14 and 42 days the animals were euthanized. The following analyses were performed: immunolabeling against antibodies TNFα, TGFβ, IL6, WNT, OCN and TRAP, collagen fibers maturation, microtomography and confocal microscopy. Data were submitted to statistical analysis. The immunolabeling analysis showed that the T2D presented a more pronounced alveolar inflammation than NG. Labeling of proteins responsible for bone formation and mineralization was higher in NG than T2D, which presented greater resorptive activity characterized by TRAP labeling. Also, T2D group showed a decrease in the amount of collagen fibers. Micro-CT analysis showed that T2D causes a decrease in bone volume percentage due to deficient trabecular parameters and higher porosity. The T2D bone dynamics show a loss in bone remodeling process. T2D prolongs the local inflammatory process, which impairs the organization and maturation of collagen fibers, delaying bone formation that generates impact on mineralization and bone turnover.
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