Review
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World J Diabetes. Mar 15, 2011; 2(3): 41-48
Published online Mar 15, 2011. doi: 10.4239/wjd.v2.i3.41
Osteoporosis in diabetes mellitus: Possible cellular and molecular mechanisms
Kannikar Wongdee, Narattaphol Charoenphandhu
Kannikar Wongdee, Narattaphol Charoenphandhu, Consortium for Calcium and Bone Research (COCAB), Faculty of Science, Mahidol University, Bangkok 10400, Thailand
Kannikar Wongdee, Faculty of Allied Health Sciences, Burapha University, Chonburi 20131, Thailand
Narattaphol Charoenphandhu, Department of Physiology, Faculty of Science, Mahidol University, Bangkok 10400, Thailand
Author contributions: Wongdee K and Charoenphandhu N contributed equally to the literature review, data analysis and preparation of the manuscript.
Correspondence to: Narattaphol Charoenphandhu, MD, PhD, Associate Professor, Department of Physiology, Faculty of Science, Mahidol University, Rama VI Road, Bangkok 10400,Thailand. naratt@narattsys.com
Telephone: +66-2-3547154  Fax: +66-2-3547154
Received: October 12, 2010
Revised: December 13, 2010
Accepted: December 20, 2010
Published online: March 15, 2011
Abstract

Osteoporosis, a global age-related health problem in both male and female elderly, insidiously deteriorates the microstructure of bone, particularly at trabecular sites, such as vertebrae, ribs and hips, culminating in fragility fractures, pain and disability. Although osteoporosis is normally associated with senescence and estrogen deficiency, diabetes mellitus (DM), especially type 1 DM, also contributes to and/or aggravates bone loss in osteoporotic patients. This topic highlight article focuses on DM-induced osteoporosis and DM/osteoporosis comorbidity, covering alterations in bone metabolism as well as factors regulating bone growth under diabetic conditions including, insulin, insulin-like growth factor-1 and angiogenesis. Cellular and molecular mechanisms of DM-related bone loss are also discussed. This information provides a foundation for the better understanding of diabetic complications and for development of early screening and prevention of osteoporosis in diabetic patients.

Keywords: Bone remodeling; Bone strength; Diabetes; Fragility fracture; Insulin; Osteoblast; Osteoclast; Osteopenia; Osteoporosis; Pregnancy