Pathophysiology of Bone Fragility in Patients with Diabetes.
It has been well established that bone fragility is one of the chronic complications of diabetes mellitus, and both type 1 and type 2 diabetes are risk factors for fragility fractures. Diabetes may negatively affect bone health by unbalancing several pathways: bone formation, bone resorption, collagen formation, inflammatory cytokine, muscular and incretin system, bone marrow adiposity and calcium metabolism. The purpose of this narrative review is to explore the current understanding of pathophysiological pathways underlying bone fragility in diabetics. In particular, the review will focus on the peculiar cellular and molecular system impairment that may lead to increased risk of fracture in type 1 and type 2 diabetes.
Diabetes and Bone network, Department Endocrinology and Diabetes, University Campus Bio-Medico of Rome, Via Alvaro del Portillo, 21 - 00128, Rome, Italy.
Andrea
A
Palermo
Department of Experimental Medicine, Polo Pontino, Sapienza University of Rome, Rome, Italy.
Luca
L
D'Onofrio
Department of Experimental Medicine, Polo Pontino, Sapienza University of Rome, Rome, Italy.
Raffaella
R
Buzzetti
Diabetes and Bone network, Department Endocrinology and Diabetes, University Campus Bio-Medico of Rome, Via Alvaro del Portillo, 21 - 00128, Rome, Italy.
Silvia
S
Manfrini
Diabetes and Bone network, Department Endocrinology and Diabetes, University Campus Bio-Medico of Rome, Via Alvaro del Portillo, 21 - 00128, Rome, Italy. n.napoli@unicampus.it.|Division of Bone and Mineral Diseases, Washington University in St Louis, St Louis, USA. n.napoli@unicampus.it.
Nicola
N
Napoli
D001842:Bone and Bones / Q000503:physiopathology*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D050723:Fractures, Bone / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D012307:Risk Factors
Diabetes; Hyperglycaemia; Osteoblast; Osteoclast; Osteoporosis