Cortical porosity and advanced glycation endproducts in diabetic bone disease

Diabetes is a group of metabolic diseases with Type 2 Diabetes Mellitus (T2DM) being prominent and on the rise among the industrialized societies. While diabetic complications are multiple, the elevated fracture risk with T2DM remains obscure and has not been studied in detail yet. A recent article published on Bone, coordinated by Bjorn Busse and co-authored by Katharina Jähn-Rickert and Petar Milovanovic, all ECTS Academy members, aimed at understanding the structural and compositional factors that result in the diabetic bone disease. The Authors utilize numerous experiments to characterize cortical bone from femora of T2DM individuals in comparison with individuals not affected by the disease and show that the cortical bone in some of the T2DM people is more porous as compared to non-diabetic individuals. In addition, the elevated blood sugar level has translated into a higher amount sugar-bound bone matrix proteins (a process called glycation) that may affect the function of these bone molecules. One glycation end-product, Carboxymethyl-lysine (CML), was higher in all T2DM individuals and might affect the biomechanical behavior of the bone tissue. With those and more findings, the authors postulate that cortical porosity and CML might contribute to elevated fracture risk with T2DM.

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