Biomolecular basis of the role of diabetes mellitus in osteoporosis and bone fractures

Abstract

Osteoporosis has become a serious health problem throughout the world which is associated with an increased risk of bone fractures and mortality among the people of middle to old ages. Diabetes is also a major health problem among the people of all age ranges and the sufferers due to this abnormality increasing day by day. The aim of this review is to summarize the possible mechanisms through which diabetes may induce osteoporosis. Diabetes mellitus generally exerts its effect on different parts of the body including bone cells specially the osteoblast and osteoclast, muscles, retina of the eyes, adipose tissue, endocrine system specially parathyroid hormone (PTH) and estrogen, cytokines, nervous system and digestive system. Diabetes negatively regulates osteoblast differentiation and function while positively regulates osteoclast differentiation and function through the regulation of different intermediate factors and thereby decreases bone formation while increases bone resorption. Some factors such as diabetic neuropathy, reactive oxygen species, Vitamin D, PTH have their effects on muscle cells. Diabetes decreases the muscle strength through regulating these factors in various ways and ultimately increases the risk of fall that may cause bone fractures.

Keywords: Diabetes; Osteoporosis; Diabetic neuropathy; Muscle atrophy; Insulin; Receptor activator for nuclear factor κ-B ligand; Interleukin 6; Angiotensin II; Tumor necrosis factor; Advanced glycation end product

Core tip: The physical complications due to diabetes mellitus are not limited since there have been going research to elucidate the relation of other diseases with diabetes mellitus (DM). Osteoporosis is one of the complicated diseases of human that may be linked with DM through different networks in the body. In this review a precise relationship has been made between DM and osteoporosis through a broad range of biophysical pathways.