scholarly journals Osteoporosis and diabetes mellitus

2013 ◽  
pp. 63-69
Author(s):  
Andrea Montagnani ◽  
Massimo Alessandri
Keyword(s):  
Diabetes Mellitus ◽  
Bone Resorption ◽  
Bone Tissue ◽  
Close Association ◽  
Normal Population ◽  
Diabetic Patients ◽  
Mineral Density ◽  
Apparent Paradox ◽  
Mortality And Morbidity ◽  
Positive Effects

Introduction: Diabetes mellitus (DM) and osteoporotic fractures are major causes of mortality and morbidity in older subjects. Recent reports have revealed close association between fracture risk and DM types 1 and 2 (DM1 and DM2, respectively). Aim of this review is to highlight the importance of these diseases in the elderly and examine certain etiopathogenetic aspects of DM associated osteoporosis, which could be useful in management of diabetic patients. Materials and methods: We searched the Embase and PubMed databases using diabetes, osteoporosis, and bone mineral density (BMD) as search terms and 1989-2009 as publication dates. Discussion: The risk of fractures seems to be increased in both types of DM although DM2 seems to be associated with normal-high BMDs compared with the normal population. This apparent paradox could reflect greater bone frailty in diabetic patients that are unrelated to adipose tissue, hyperinsulinemia, deposition of advanced glycosylation end products in collagen, reduced serum IGF-1 levels, hypercalciuria, renal failure, microangiopathy, and/or inflammation. Diabetic patients’ propensity to fall and multiple comorbidities might also explain their higher fracture rates. The effects of drugs that inhibit bone resorption in diabetic patients are probably similar to those obtained in nondiabetics although there is little information on this issue. In general, effective treatment of diabetes has positive effects on bone metabolism. Metformin acts directly on bone tissue, reducing AGE accumulation, and insulin has direct effects on osteoclast activity. In contrast, the thiazolidinediones seem to have negative effects since they orient mesenchymal progenitor cell differentiation toward adipose rather than bone tissue. Incretin therapy is a newer approach that appears to modify interactions between nutrition and bone turnover (e.g., postprandial suppression of bone resorption). Conclusions: Better understanding of how diabetes and its treatment influence bone tissue could lead to more effective strategies for preventing fractures in diabetic patients. More investigation is needed to determine whether conventional osteoporotic therapy is fully effective in patients with DM.

scholarly journals FTIR Spectroscopic Investigation of Mineral Structure of Streptozotocin Induced Diabetic Rat Femur and Tibia

2003 ◽  
Vol 17 (2-3) ◽  
pp. 627-633 ◽  
Author(s):  
Handan Boyar ◽  
Belma Turan ◽  
Feride Severcan
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Dependent Diabetes Mellitus ◽  
Insulin Dependent Diabetes ◽  
Dependent Diabetes Mellitus ◽  
Diabetic Rat ◽  
Carbonate Content ◽  
Diabetic Patients ◽  
Type I ◽  
Mineral Density ◽  
Insulin Dependent

Diabetes mellitus (DM) can be accepted as a heterogenous multi organ disorder that can affect various systems of the human body. Disorders include retinopathy, neuropathy, cardiomyopathy, musculoskeletal abnormalities such as diminished bone formation and bone healing retardation. Low bone mineral density is often mentioned as a complication for patients with insulin dependent diabetes mellitus (type I DM). Streptozotocin (STZ) induced diabetic rats are good models for investigation of the complications of insulin dependent diabetes. In the present study, the effects of STZ induced diabetes on the mineral environment of rat bones namely femur and tibia were studied by Fourier transform infrared (FTIR) spectroscopic technique. The results revealed that mineral crystal sizes increased and carbonate content decreased for diabetic femur and tibia. These changes can be due to the formation of osteoporosis which is widely seen in diabetic patients.

scholarly journals Osteocalcin: the relationship between bone metabolism and glucose homeostasis in diabetes mellitus

2021 ◽  
Vol 17 (4) ◽  
pp. 322-328
Author(s):  
A.V. Кovalchuk ◽  
О.В. Zinych ◽  
V.V. Korpachev ◽  
N.M. Кushnareva ◽  
О.В. Prybyla ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Bone Metabolism ◽  
The Body ◽  
Diabetic Patients ◽  
Inverse Association ◽  
Mineral Density ◽  
Peripheral Tissues

Recent studies have demonstrated the importance of bone as an endocrine organ that produces biologically active substances, which regulate both local bone metabolism and metabolic functions throughout the body. In the process of bone remodeling (formation/destruction), the active cells secrete specific biomarkers that help detect osteometabolic dysfunction. Among bone hormones, osteocalcin plays an important role as a coordinator of bone modeling processes, energy homeostasis, metabolism of glucose, lipids and minerals. Osteocalcin is a structural protein of the bone matrix, which is synthesized by osteoblasts and enters the bloodstream in the process of bone resorption. The level of osteocalcin in the serum is used as a specific marker of bone formation. Osteocalcin promotes pancreatic β-cell proliferation and insulin secretion, and also affects the insulin sensitivity of peripheral tissues. The inverse association of glycemia with the level of osteocalcin was revealed. Patients with type 2 diabetes mellitus usually have normal or even slightly elevated bone mineral density compared to age-appropriate controls. Decreased bone quality and increased risk of fractures are associated with changes in bone microarchitecture and local humoral environment. An imbalance in osteoblast/osteoclast activity may be due to oxidative stress and the accumulation of glycosylation end products, which contributes to chronic inflammation and bone resorbtion in patients with diabetes. It is shown that the level of osteocalcin in the blood serum is significantly reduced compared to healthy controls, both in patients with type 1 diabetes mellitus and, especially, in type 2 diabetes mellitus. Given the importance of developing new approaches to the diagnosis and correction of metabolic disorders in diabetic patients, the study of the influence of bone hormones on hormonal and metabolic parameters and bone status, including the risk of fractures, remains relevant in modern diabetology.

scholarly journals Pathogenetic aspects of bone metabolism in diabetes mellitus.

2018 ◽  
Vol 96 (8) ◽  
pp. 707-712
Author(s):  
S. S. Safarova
Keyword(s):  
Diabetes Mellitus ◽  
Bone Tissue ◽  
Molecular Mechanisms ◽  
Bone Structure ◽  
Advanced Glycation Endproducts ◽  
Fatty Infiltration ◽  
Osteoporotic Fractures ◽  
Inflammatory Factors ◽  
Mineral Density ◽  
Increased Risk

Metabolic disorders caused by diabetes affect bone remodeling, alter the structure and reduce the strength of bone tissue, leading to the development of diabetic osteopathy. However, between diabetes mellitus (DM) type 1 and 2 there are noticeable differences in the effect on the bone structure, which is obviously due to the different cellular and molecular mechanisms of these processes. The density of bone tissue with DM typel decreases, which leads to an increase in the risk of fractures by 7 times. With DM type 2, bone mineral density is moderately elevated, which is expected to lead to a decrease in the incidence of osteoporotic fractures, but in fact, this index is approximately doubled. Pathophysiological mechanisms underlying osteoporotic changes in diabetes mellitus are complex and included hyperglycemia, oxidative stress and accumulation of advanced glycation endproducts that alter the properties of collagen, increase fatty infiltration of the bone marrow, release inflammatory factors and adipokines from visceral adipose tissue and potentially change the function osteoblasts. Additional factors are, some antidiabetic drugs that directly affect the metabolism of bones and minerals (such as thiazolidinediones), as well as an increased tendency to fall due to micro- and macroangiopathies, all contribute to an increased risk of low-fracture fractures in patients with diabetes mellitus.

scholarly journals Immunohistochemical features of the bone tissue of the lower extremities in patients with type 2 diabetes mellitus

2022 ◽  
Vol 24 (5) ◽  
pp. 448-455
Author(s):  
A. Yu. Tokmakova ◽  
E. A. Kogan ◽  
E. L. Zaitseva ◽  
S. A. Demura ◽  
N. V. Zharkov ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Bone Resorption ◽  
Bone Tissue ◽  
Immunohistochemical Study ◽  
Control Group ◽  
Diabetic Neuroosteoarthropathy ◽  
Group 1

Background: Diabetic neuroosteoarthropathy is a serious disabling complication of diabetes mellitus, which, in the absence of timely correct treatment, can lead to high amputations of the affected limb. At present, the reasons and mechanism of the development of Charcot’s foot are not completely clear. It is extremely important to determine the pathophysiological mechanisms of DNOAP formation and to search for reliable markers-predictors of this pathology.Aim: To study the immunohistochemical characteristics of the bone tissue of the lower extremities in patients with diabetic neuroosteoarthropathy in comparison with patients with diabetes mellitus without this pathology.Materials and methods: During the foot surgery, a bone fragment of the foot was harvested for immunohistochemical study of receptor markers for PINP, PIIINP, and RAGE in the group of patients with DNOAP compared with the control group.Results: The study included 20 patients with type 2 diabetes mellitus and were divided into 2 groups: 10 patients with DNOAP made up group 1, 10 patients without DNOAP — group 2.Patients in both groups were comparable in AGE, experience with type 2 diabetes, and glycemic control.During the immunohistochemical study, a significant increase in the staining intensity of receptor markers for PINP, PIIINP, and AGE was recorded in the group of patients with DNOAP compared with the control group (p <0.05).Conclusion: For the first time, an immunohistochemical study of markers of bone resorption and AGE was carried out in persons with DNOAP. The results obtained indicate impaired collagen formation and, as a consequence, impaired bone formation and bone resorption in patients with DNOAP: in group 1, a statistically significant increase in the expression of PINP, PIIINP, and RAGE was revealed.

scholarly journals ASSESSMENT OF THE STATUS OF BONE TISSUE IN THE WORKING VIBRATION THREATENING OCCUPATIONS

2018 ◽  
Vol 97 (6) ◽  
pp. 542-546 ◽  
Author(s):  
Anna V. Sukhova ◽  
E. N. Kryuchkova
Keyword(s):  
Bone Resorption ◽  
Bone Formation ◽  
Bone Tissue ◽  
Biochemical Markers ◽  
Clinical Laboratory ◽  
Mineral Metabolism ◽  
Epidemiological Studies ◽  
Mineral Density ◽  
Local Vibration ◽  
Vibration Disease

Introduction. Vibration in conjunction with an unfavorable microclimate and physical stress, acting on mining workers, can lead to the development of pathology of the musculoskeletal system with the violation of bone metabolism and the formation of the osteopenic syndrome. The results of epidemiological studies indicate a high prevalence of osteoporosis among persons of working age. The purpose of the study was to study the effect of the general and local vibration on the state of bone remodeling processes in workers of vibration-hazardous occupations. Material and methods. Two groups of patients with vibration disease were examined. The first group consisted of 53 cases working in the contact with local vibration. The second group included 52 workers exposed to combined effects of the general and local vibration. The condition of the osteoarticular apparatus was determined by means of by X-ray examination and ultrasonic osteodensitometry. Laboratory studies included the evaluation of indices of mineral metabolism and bone tissue metabolism. Results. Osteochondrosis of the spine was revealed in 54.7% and 69.2%, osteopenia of the spine - 17.0% and 21.2%, arthrosis of the joints of the hands - 64.2% and 57.7% in the patients of the first and second groups, respectively. The prevalence rate of bone-dystrophic changes depends on the stage of the vibration disease and increases as the disease progresses. There were established interrelations of clinical functional and clinical laboratory indices with the trainee exposure of industrial vibration in terms of bone mineral density (T and Z criteria) (r = 0.56), biochemical markers of bone formation (r = -0.62-0.70) and bone resorption (r = 0.72-0.85). Biochemical markers of the osteopenic syndrome in the vibration disease are bone formation (osteocalcin, alkaline phosphatase) and bone resorption (ionized calcium, calcium/creatinine). Discussion. The obtained results served as a basis for developing a system of preventive measures of bone-dystrophic disorders in persons with vibration dangerous occupations.

scholarly journals A Study of Comorbidity of Depression, Anxiety and Diabetes Mellitus

2017 ◽  
Vol 6 (2) ◽  
pp. 1513
Author(s):  
Deepali Gul ◽  
Kusum Bali
Keyword(s):  
Diabetes Mellitus ◽  
Rating Scale ◽  
Negative Impact ◽  
Normal Population ◽  
Diabetic Patients ◽  
Depression And Anxiety ◽  
Mild Depression ◽  
Type 2 Diabetic Patients ◽  
Family History Of Diabetes

<p><strong>Background:</strong> The prevalence of depression and anxiety in diabetes is considerably higher than normal population and found to have a negative impact on diabetes.</p><p><strong>Objective:</strong> The present study aimed at assessing the prevalence of anxiety and depression among outpatients receiving treatment for diabetes.</p><p><strong>Materials and Methods:</strong> Ours was a cross-sectional study where data was collected from 100 consecutive patients receiving treatment from the outpatient department of a teaching hospital for diabetes mellitus. The socio-demographic details were collected with the help of a self-structured questionnaire. Hamilton Rating Scale for Depression (H.D.R.S.) and Amritsar Depressive Inventory (A.D.I.) and Hamilton Anxiety Rating Scale (H.A.R.S.) were used to assess the presence and severity of depression and anxiety. The details regarding the diabetes included the duration of the condition, family history of diabetes, if any, and Body Mass Index (BMI).</p><p><strong>Results:</strong> The study sample consisted of 34 male and 66 female patients and their average age was 54.2 years. Most of the patients had mild depression, as indicated by an A.D.I. score of 8 to 13. Significant anxiety symptoms were seen in 30% of the patients. Most of the patients were having mild to moderate anxiety. Depression and anxiety was more prevalent in Type 2 diabetic patients in comparison to Type 1 diabetic patients.</p><p><strong>Conclusion:</strong> The comorbidity of depression, anxiety and diabetes mellitus is frequent. Depression and anxiety are more commonly associated with Type-2 Diabetes Mellitus. These findings underscore the need to screen all diabetic patients for the presence of psychiatric disorders.</p>

scholarly journals Ruolo del citrato nel metabolismo osseo

2020 ◽  
Vol 32 (1) ◽  
pp. 15-20
Author(s):  
Giuseppe Vezzoli ◽  
Giulia Magni ◽  
Monica Avino ◽  
Teresa Arcidiacono
Keyword(s):  
Bone Resorption ◽  
Bone Formation ◽  
Bone Tissue ◽  
Calcium Ions ◽  
Soft Tissues ◽  
Tricarboxylic Acid Cycle ◽  
Organic Matrix ◽  
Volumetric Bone Mineral Density ◽  
Acid Base Balance ◽  
Mineral Density

Citrate is an organic compound involved in tricarboxylic acid cycle, regulation of acid-base balance, lipid metabolism and bone formation. The 90% of body citrate is deposited in bone tissue and is released with calcium ions during bone resorption; therefore, bone resorption contributes to maintain normal plasma levels of citrate together with kidney excretion. The parallel release of citrate and calcium from bones decreases the possibility of calcium-phosphate precipitation in soft tissues, as citrate can bind calcium ions in organic fluids. Citrate may also take part to the bone formation as it sustains the correct mineralization of bone organic matrix: its molecule binds calcium ions at the surface of hydroxyapatite nanocrystals and maintains the correct spatial disposition of nanocrystals, thus, stabilizing the structure of bone lamellae and sustaining biomechanical characteristics of bone tissue. Multiple studies observed that citrate administration significantly increased areal and volumetric bone mineral density at different locations of 1-2% per year and improved bone resorption markers as well. Therefore, it has been hypothesised a therapeutic role of citrate in osteoporosis; however, this role has to be better clarified to understand its real anti-fracture effect.

Calcium-dependent complications of lactase deficiency in patients with type 2 diabetes mellitus

2021 ◽  
Author(s):  
A. B. Andrusha
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Bone Resorption ◽  
Bone Tissue ◽  
Bone Remodelling ◽  
Osteoporotic Fractures ◽  
Lactase Deficiency ◽  
X Ray

Objective — to assess the degree of osteodeficiency and probability of osteoporotic fractures in patients with type 2 diabetes mellitus in the absence or presence of lactase deficiency. Materials and methods. All examined patients with type 2 diabetes mellitus were divided into 2 groups depending on the presence/absence of lactase deficiency. In addition to routine examination methods, specific methods were used for diagnosing lactase deficiency, assessing bone mineral density (using dual‑energy X‑ray absorptiometry) and bone quality (ultrasound densitometry), the state of bone remodelling (according to markers of bone resorption and formation), probability of osteoporotic fractures (using FRAX and QFracture calculators), dietary and lifestyle habits were also studied. Results. The changes have been revealed in both processes of bone remodelling — increased bone resorption and insufficient bone formation, and the activity of bone formation, which was the lowest in patients with lactase deficiency and type 2 diabetes mellitus. The results of X‑ray absorptiometry confirmed that osteoporosis was significantly more often in patients with type 2 diabetes mellitus in the presence of lactase deficiency. The use of ultrasonic densitometry confirmed the violation of bone tissue micro architectonics. The indicator of broadband ultrasound attenuation, which reflects the qualitative characteristics of bone tissue, was the lowest in patients with type 2 diabetes mellitus accompanied by lactase deficiency. The probability of osteoporotic fractures according to the results of the assessment with the online calculator FRAX® was higher than the average risk in both groups of patients. No significant difference was established in this indicator between these groups of patients in contrast to the risk calculated with the QFracture instrument — it was the highest in patients with lactase deficiency. Conclusions. The presence of lactase deficiency in patients with type 2 diabetes mellitus can be considered as a factor that contributes to the development of osteodeficiency, deterioration of the quality of bone tissue, imbalance in bone remodelling and an increase in the probability of osteoporotic fractures.  

scholarly journals Characteristics of bone mineral density in elderly patients with diabetes mellitus

2017 ◽  
Vol 95 (3) ◽  
pp. 228-232
Author(s):  
V. V. Sergeeva ◽  
S. E. Dymnova ◽  
V. A. Bobylev
Keyword(s):  
Diabetes Mellitus ◽  
Bone Mineral Density ◽  
Literature Review ◽  
Elderly Patients ◽  
Bone Tissue ◽  
Social Problem ◽  
Mineral Density ◽  
Chronic Complications ◽  
Patients With Diabetes ◽  
Mechanisms Of Development

Diabetes mellitus is a most important medical and social problem in Russia. Osteoarthropathy, osteopenia and osteoporosis are chronic complications of diabetes. There is no consensus on the pathogenetic mechanisms of development of changes of the bone tissue in this pathology. The present literature review outlines the problem.

scholarly journals Incidence of different types of Myocardial Infarctions (MI) in diabetic and non-diabetic patients in cardiology unit of Lady Reading Hospital, Peshawar

2020 ◽  
Vol 2 (1) ◽  
pp. 24-26
Author(s):  
Sumbal Jamil ◽  
Mustajab Ghani
Keyword(s):  
Diabetes Mellitus ◽  
Myocardial Infarction ◽  
Cross Sectional Study ◽  
Anterior Wall ◽  
Myocardial Infarctions ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Mortality And Morbidity ◽  
Different Types ◽  
Online Calculator

Introduction: In past few decades prevalence of diabetes in patients with myocardial infarction has been remarkably increased. Diabetes mellitus has been well defined as a cardiovascular determinant in emergent nations. Myocardial infarction is the common cause of mortality and morbidity worldwide. Globally over 15.9 million myocardial infarction appeared in 2015. Cardiovascular events represent 80% of total deaths due to diabetes mellitus. Therefore, the objective was to determine the incidence of different types of myocardial infarctions in correlation with presence or absence of diabetes mellitus. Material & Methods: This was a cross sectional study carried out at Lady Reading Hospital Peshawar on 160 participants calculated by online calculator. Convenience sampling was applied, and subjects admitted in cardiology unit, CCU and emergency department of the hospital with the complaint of known myocardial infarction included. Pre-formed proforma was used to collect data from cardiology ward and CCU. Results: Total of 160 subjects were included in this study. 101 subjects (63.1%) were male while share of female subjects in the study was 59 (36.9%). Mean age of the participants was 57.54 ± 11.43 (mean±S.D) and a range of 32-91 years. Diabetes was present in 85 (53.1%) participants while other 75 participants (46.9%) were non-diabetics. Anterior MI was seen in 36 diabetic subjects, inferior MI in 23, Lateral MI in 8, 14 were with extensive wall MI, 2 antero-lateral 2 & infero-lateral MI in 2 diabetic subjects. Among non-diabetic participants, anterior MI was seen in 31 subjects, 11 had inferior MI, 14 were with lateral MI, 11 had extensive MI, 5 subjects showed antero-lateral and 3 were with infero-lateral MI of the heart. Conclusion: Incidence of MI was found more in diabetics as compared to non-diabetics. Anterior wall MI was commonest among diabetic participants.

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