Skeletal involvement in patients with diabetes mellitus

Vincenzo Carnevale, Elisabetta Romaglino, Emilio D'Erasmo

Research output: Contribution to journalArticle

109 Citations (Scopus)

Abstract

Studies on skeletal involvement in patients with diabetes mellitus have generated conflicting results, largely because of the pathogenetic complexity of the condition. Several mechanisms may contribute to skeletal damage, including the increased urinary excretion coupled with the lower intestinal absorption of calcium, the inappropriate homeostatic response in terms of parathyroid hormone secretion, and also the complex alteration of vitamin D regulation. Decreased or increased insulin and IGF-1 concentrations and the effects of the accumulation of glycation endproducts on the bone tissue could also play a role. A possible genetic predisposition is also currently under investigation. Finally, the role of fat tissue in type 1 and type 2 diabetes and that of diabetic complications also deserve note. As far as bone mass is concerned, in adult patients with type 1 diabetes a moderately reduced bone mineral density has been shown in both axial and appendicular skeleton. On the contrary, patients with type 2 diabetes seem to have higher bone mineral density in respect to healthy control subjects, especially when overweight women are considered. No clear relationship between bone mass measurements and biochemical parameters of mineral metabolism has been shown in the different types of diabetes. Cohort studies recently carried out on large samples indicate that diabetic patients (with both type 1 and type 2 disease) have a higher risk for fracture, in particular for hip fracture, the most dangerous osteoporotic complication. This seems to be dependent both on qualitative and quantitative alterations of the bone, as well as on extra-skeletal factors due to the neuropathic and microangiopathic complications of the disease.

Original languageEnglish
Pages (from-to)196-204
Number of pages9
JournalDiabetes/Metabolism Research and Reviews
Volume20
Issue number3
DOIs
Publication statusPublished - May 2004

Fingerprint

Medical problems
Diabetes Mellitus
Bone
Bone and Bones
Diabetes Complications
Type 1 Diabetes Mellitus
Bone Density
Type 2 Diabetes Mellitus
Minerals
Intestinal Absorption
Hip Fractures
Genetic Predisposition to Disease
Parathyroid Hormone
Insulin-Like Growth Factor I
Skeleton
Vitamin D
Tissue
Healthy Volunteers
Cohort Studies
Fats

Keywords

  • Bone mineral density
  • Bone turnover
  • Calcium homeostasis
  • Diabetes mellitus
  • Fracture risk

ASJC Scopus subject areas

  • Endocrinology
  • Biochemistry
  • Endocrinology, Diabetes and Metabolism

Cite this

Skeletal involvement in patients with diabetes mellitus. / Carnevale, Vincenzo; Romaglino, Elisabetta; D'Erasmo, Emilio.

In: Diabetes/Metabolism Research and Reviews, Vol. 20, No. 3, 05.2004, p. 196-204.

Research output: Contribution to journalArticle

Carnevale, Vincenzo ; Romaglino, Elisabetta ; D'Erasmo, Emilio. / Skeletal involvement in patients with diabetes mellitus. In: Diabetes/Metabolism Research and Reviews. 2004 ; Vol. 20, No. 3. pp. 196-204.
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