Diabetes, Vol 44, Issue 7 775-782, Copyright © 1995 by American Diabetes Association

ARTICLES

Bone loss and bone turnover in diabetes

JC Krakauer, MJ McKenna, NF Buderer, DS Rao, FW Whitehouse and AM Parfitt
Division of Bone and Mineral Metabolism, Henry Ford Hospital, Detroit, Michigan 48202, USA.

There have been conflicting reports about the effect of diabetes on bone density. In 1978, we studied 109 patients, 46 with type I and 63 with type II diabetes; approximately 12 years later we restudied 35 of the 66 surviving patients. In the original study, radial bone density did not differ significantly between patients with either type of diabetes but was significantly lower than in nondiabetic control subjects. In eight osteopenic patients, bone formation rate and other histological indexes of osteoblast recruitment and function were markedly depressed compared with those in nondiabetic control subjects. In patients remeasured approximately 2.5 years (41 patients) and approximately 12.5 years (35 patients) after baseline, bone loss had continued at the expected rate in patients with type I diabetes, with maintenance of the same deficit, but was slower than expected in patients with type II diabetes, such that the initial deficit had been completely corrected. In six of the eight patients who had undergone bone biopsy, one with type I and five with type II diabetes, the mean bone mineral density z-score of the spine and femoral neck approximately 12 years later was > 0 and in one subject was significantly higher than normal at both sites. Based on these data and on previous studies, we propose that in patients with diabetes, low bone formation retards bone accumulation during growth, metabolic effects of poor glycemic control lead to increased bone resorption and bone loss in young adults, and low bone turnover retards age-related bone loss.(ABSTRACT TRUNCATED AT 250 WORDS)
CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				S. C. Manolagas and M. Almeida Gone with the Wnts: {beta}-Catenin, T-Cell Factor, Forkhead Box O, and Oxidative Stress in Age-Dependent Diseases of Bone, Lipid, and Glucose Metabolism Mol. Endocrinol., November 1, 2007; 21(11): 2605 - 2614. [Abstract] [Full Text] [PDF]

				R. Murakami, S. Murakami, R. Tsushima, C. Ueda, K. Mikami, T. Ebina, R. Kumasaka, N. Nakamura, and K. Okumura Glycaemic Control and Serum Intact Harathyroid Hormone Levels in Diabetic Patients on Haemodialysis Therapy Nephrol. Dial. Transplant., October 23, 2007; (2007) gfm639v1. [Abstract] [Full Text] [PDF]

				Q. Zhong, T. Itokawa, S. Sridhar, K.-H. Ding, D. Xie, B. Kang, W. B. Bollag, R. J. Bollag, M. Hamrick, K. Insogna, et al. Effects of glucose-dependent insulinotropic peptide on osteoclast function Am J Physiol Endocrinol Metab, February 1, 2007; 292(2): E543 - E548. [Abstract] [Full Text] [PDF]

				T. Miazgowski, S. Pynka, M. Noworyta-Zietara, B. Krzyzanowska-Swiniarska, and R. Pikul Bone mineral density and hip structural analysis in type 1 diabetic men Eur. J. Endocrinol., January 1, 2007; 156(1): 123 - 127. [Abstract] [Full Text] [PDF]

				S. Botolin and L. R. McCabe Bone Loss and Increased Bone Adiposity in Spontaneous and Pharmacologically Induced Diabetic Mice Endocrinology, January 1, 2007; 148(1): 198 - 205. [Abstract] [Full Text] [PDF]

				R. Irwin, H. V. Lin, K. J. Motyl, and L. R. McCabe Normal Bone Density Obtained in the Absence of Insulin Receptor Expression in Bone Endocrinology, December 1, 2006; 147(12): 5760 - 5767. [Abstract] [Full Text] [PDF]

				J. Leger, D. Marinovic, C. Alberti, S. Dorgeret, D. Chevenne, C. L. Marchal, N. Tubiana-Rufi, G. Sebag, and P. Czernichow Lower Bone Mineral Content in Children with Type 1 Diabetes Mellitus Is Linked to Female Sex, Low Insulin-Like Growth Factor Type I Levels, and High Insulin Requirement J. Clin. Endocrinol. Metab., October 1, 2006; 91(10): 3947 - 3953. [Abstract] [Full Text] [PDF]

				E. S. Strotmeyer, J. A. Cauley, T. J. Orchard, A. R. Steenkiste, and J. S. Dorman Middle-Aged Premenopausal Women With Type 1 Diabetes Have Lower Bone Mineral Density and Calcaneal Quantitative Ultrasound Than Nondiabetic Women Diabetes Care, February 1, 2006; 29(2): 306 - 311. [Abstract] [Full Text] [PDF]

				N. Kloting, N. Follak, and I. Kloting Is there an autoimmune process in bone? Gene expression studies in diabetic and nondiabetic BB rats as well as BB rat-related and -unrelated rat strains Physiol Genomics, December 14, 2005; 24(1): 59 - 64. [Abstract] [Full Text] [PDF]

				F. Galluzzi, S. Stagi, R. Salti, S. Toni, E. Piscitelli, G. Simonini, F. Falcini, and F. Chiarelli Osteoprotegerin serum levels in children with type 1 diabetes: a potential modulating role in bone status Eur. J. Endocrinol., December 1, 2005; 153(6): 879 - 885. [Abstract] [Full Text] [PDF]

				K. M. Thrailkill, C. K. Lumpkin Jr., R. C. Bunn, S. F. Kemp, and J. L. Fowlkes Is insulin an anabolic agent in bone? Dissecting the diabetic bone for clues Am J Physiol Endocrinol Metab, November 1, 2005; 289(5): E735 - E745. [Abstract] [Full Text] [PDF]

				K. M. Thrailkill, L. Liu, E. C. Wahl, R. C. Bunn, D. S. Perrien, G. E. Cockrell, R. A. Skinner, W. R. Hogue, A. A. Carver, J. L. Fowlkes, et al. Bone Formation Is Impaired in a Model of Type 1 Diabetes Diabetes, October 1, 2005; 54(10): 2875 - 2881. [Abstract] [Full Text] [PDF]

				S. Botolin, M.-C. Faugere, H. Malluche, M. Orth, R. Meyer, and L. R. McCabe Increased Bone Adiposity and Peroxisomal Proliferator-Activated Receptor-{gamma}2 Expression in Type I Diabetic Mice Endocrinology, August 1, 2005; 146(8): 3622 - 3631. [Abstract] [Full Text] [PDF]

				M. R. Davies, Richard. J. Lund, S. Mathew, and K. A. Hruska Low Turnover Osteodystrophy and Vascular Calcification Are Amenable to Skeletal Anabolism in an Animal Model of Chronic Kidney Disease and the Metabolic Syndrome J. Am. Soc. Nephrol., April 1, 2005; 16(4): 917 - 928. [Abstract] [Full Text] [PDF]

				A. A. Ali, R. S. Weinstein, S. A. Stewart, A. M. Parfitt, S. C. Manolagas, and R. L. Jilka Rosiglitazone Causes Bone Loss in Mice by Suppressing Osteoblast Differentiation and Bone Formation Endocrinology, March 1, 2005; 146(3): 1226 - 1235. [Abstract] [Full Text] [PDF]

				A. Afghani, M. L. Cruz, and M. I. Goran Impaired Glucose Tolerance and Bone Mineral Content in Overweight Latino Children With a Family History of Type 2 Diabetes Diabetes Care, February 1, 2005; 28(2): 372 - 378. [Abstract] [Full Text] [PDF]

				S. A. Brown and J. L. Sharpless Osteoporosis: An Under-appreciated Complication of Diabetes Clin. Diabetes, January 1, 2004; 22(1): 10 - 20. [Abstract] [Full Text] [PDF]

				H. He, R. Liu, T. Desta, C. Leone, L. C. Gerstenfeld, and D. T. Graves Diabetes Causes Decreased Osteoclastogenesis, Reduced Bone Formation, and Enhanced Apoptosis of Osteoblastic Cells in Bacteria Stimulated Bone Loss Endocrinology, January 1, 2004; 145(1): 447 - 452. [Abstract] [Full Text] [PDF]

				R. B. Santana, L. Xu, H. B. Chase, S. Amar, D. T. Graves, and P. C. Trackman A Role for Advanced Glycation End Products in Diminished Bone Healing in Type 1 Diabetes Diabetes, June 1, 2003; 52(6): 1502 - 1510. [Abstract] [Full Text] [PDF]

				H. Lu, D. Kraut, L. C. Gerstenfeld, and D. T. Graves Diabetes Interferes with the Bone Formation by Affecting the Expression of Transcription Factors that Regulate Osteoblast Differentiation Endocrinology, January 1, 2003; 144(1): 346 - 352. [Abstract] [Full Text] [PDF]

				M. Zayzafoon, S. Botolin, and L. R. McCabe p38 and Activating Transcription Factor-2 Involvement in Osteoblast Osmotic Response to Elevated Extracellular Glucose J. Biol. Chem., September 27, 2002; 277(40): 37212 - 37218. [Abstract] [Full Text] [PDF]

				R. Q. Ivers, R. G. Cumming, P. Mitchell, and A. J. Peduto Diabetes and Risk of Fracture: The Blue Mountains Eye Study Diabetes Care, July 1, 2001; 24(7): 1198 - 1203. [Abstract] [Full Text] [PDF]

				L. A. Soyka, W. P. Fairfield, and A. Klibanski Hormonal Determinants and Disorders of Peak Bone Mass in Children J. Clin. Endocrinol. Metab., November 1, 2000; 85(11): 3951 - 3963. [Full Text]

				R. Okazaki, Y. Totsuka, K. Hamano, M. Ajima, M. Miura, Y. Hirota, K. Hata, S. Fukumoto, and T. Matsumoto Metabolic Improvement of Poorly Controlled Noninsulin-Dependent Diabetes Mellitus Decreases Bone Turnover J. Clin. Endocrinol. Metab., September 1, 1997; 82(9): 2915 - 2920. [Abstract] [Full Text] [PDF]