Bone damage in type 2 diabetes mellitus |
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| Affiliation: | 1. Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, South Korea;2. Department of Internal Medicine, Kosin University, College of Medicine, Busan, South Korea;1. Center of Excellence for Osteoporosis Research, Faculty of Medicine and King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia;2. Department of Clinical Biochemistry, Faculty of Medicine and King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia;3. Department of Internal Medicine, Faculty of Medicine and King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia;4. Department of Hematology, Faculty of Medicine and King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia;5. Department of Obstetrics and Gynecology, Faculty of Medicine and King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia;6. Department of Pharmaceutical Chemistry, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia;1. Department of Public Health, Kindai University Faculty of Medicine, 377-2 Oono-higashi, Osaka-Sayama, Osaka 589-8511, Japan;2. Department of Hygiene and Public Health, Osaka Medical College, 2-7 Daigakumachi, Takatsuki, Osaka 569-8686, Japan;3. Medimaps, Parc d''activités Kennedy Bâtiment F, 5 Avenue Henri Becquerel, 33700 Mérignac, France;4. Department of Human Life, Jin-ai University, 3-1-1 Ohdecho, Echizen, Fukui 915-8586, Japan;5. Department of Nursing, Kio University, 4-2-2 Umami-naka, Koryo-cho, Nara 365-0832, Japan;6. Department of Epidemiology and Preventive Medicine, Nara Medical University School of Medicine, 840 Shijocho, Kashihara, Nara 634-8521, Japan;7. Nara Medical University School of Medicine, 840 Shijocho, Kashihara, Nara 634-8521, Japan |
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| Abstract: | This review focuses on the mechanisms determining bone fragility in patients with type 2 diabetes mellitus (T2DM). Despite bone mineral density (BMD) is usually normal or more often increased in these patients, fracture incidence is high, probably because of altered bone ”quality”. The latter seems to depend on several, only partly elucidated, mechanisms, such as the increased skeletal content of advanced glycation end-products causing collagen deterioration, the altered differentiation of bone osteogenic cells, the altered bone turnover and micro-architecture. Disease duration, its severity and metabolic control, the type of therapy, the presence or absence of complications, as like as the other known predictors for falls, are all relevant contributing factors affecting fracture risk in T2DM. In these patients the estimate of fracture risk in the everyday clinical practice may be challenging, due to the lower predictive capacity of both BMD and risk factors-based algorithms (e.g. FRAX). |
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| Keywords: | Type 2 diabetes mellitus Bone mineral density Bone quality Fractures Clinical risk factors |
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