| [ Summary ] |
Recent meta-analyses show that type 1 diabetes mellitus is associated with low bone mineral density (BMD) as well as increased fracture risk. In contrast, type 2 diabetes mellitus have an increased risk of femoral and vertebral fractures in spite of higher BMD than those of control subjects. This suggests that the bone strength of patients with type 2 diabetes is more impacted by bone quality than by BMD. Several studies suggest that pentosidine, which is one of well-known advanced glycation end-products (AGEs) and infl uences decreased bonestrength caused by the changing property of collagen fi bers in the bone matrix, and endogenous secretory receptor for AGE (esRAGE) may possibly be useful in predicting vertebral fractures independent of BMD in patients with type 2 diabetes. From another perspective, metaanalysis reveals that thiazolidinediones are associated with increased bone fracture risk. When treating for diabetes, we need to take into account the negative aspects of these therapeutic agents on bone metabolism. |