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Pathophysiology of Bone Fragility in Patients with Diabetes

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Abstract

It has been well established that bone fragility is one of the chronic complications of diabetes mellitus, and both type 1 and type 2 diabetes are risk factors for fragility fractures. Diabetes may negatively affect bone health by unbalancing several pathways: bone formation, bone resorption, collagen formation, inflammatory cytokine, muscular and incretin system, bone marrow adiposity and calcium metabolism. The purpose of this narrative review is to explore the current understanding of pathophysiological pathways underlying bone fragility in diabetics. In particular, the review will focus on the peculiar cellular and molecular system impairment that may lead to increased risk of fracture in type 1 and type 2 diabetes.

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Acknowledgements

The authors thank Anda Naciu, MD, for the valuable support given to the drafting of this work.

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Authors and Affiliations

  1. Diabetes and Bone network, Department Endocrinology and Diabetes, University Campus Bio-Medico of Rome, Via Alvaro del Portillo, 21 – 00128, Rome, Italy

    Andrea Palermo, Silvia Manfrini & Nicola Napoli

  2. Department of Experimental Medicine, Polo Pontino, Sapienza University of Rome, Rome, Italy

    Luca D’Onofrio & Raffaella Buzzetti

  3. Division of Bone and Mineral Diseases, Washington University in St Louis, St Louis, USA

    Nicola Napoli

Authors
  1. Andrea Palermo
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  2. Luca D’Onofrio
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  3. Raffaella Buzzetti
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  4. Silvia Manfrini
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  5. Nicola Napoli
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Corresponding author

Correspondence to Nicola Napoli.

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Conflict of interest

Andrea Palermo, Luca D’Onofrio, Raffaella Buzzetti, Silvia Manfrini and Nicola Napoli declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This is a systematic review and we did not perform any animal or human experiments for this work. For this type of study formal consent is not required.

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Palermo, A., D’Onofrio, L., Buzzetti, R. et al. Pathophysiology of Bone Fragility in Patients with Diabetes. Calcif Tissue Int 100, 122–132 (2017). https://doi.org/10.1007/s00223-016-0226-3

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  • DOI: https://doi.org/10.1007/s00223-016-0226-3

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