| Theme |
Impaired metabolism of bone and calcium in diabetes mellitus |
| Title |
Effects of insulin deficiency on bone and calcium metabolism |
| Author |
Seiki Wada |
Department of Clinical Science, Faculty of Pharmaceutical Sciences, Josai International University |
| Author |
Sadahiro Kamiya |
Department of Clinical Science, Faculty of Pharmaceutical Sciences, Josai International University |
| Author |
Katsuhiro Ono |
Department of Clinical Science, Faculty of Pharmaceutical Sciences, Josai International University |
| [ Summary ] |
Although the pathogenic mechanisms of diabetic osteopathy have not been fully elucidated, diabetes may affect bone remodeling through various mechanisms, including a deficiency of insulin secretion, insulin resistance, increased accumulation of advanced glycation end products and microangiopathy. The majority of clinical studies regarding type 1 diabetes showed decreased bone mineral density (BMD). Lowered BMD levels are related to the decreased bone formation markers. Furthermore, several clinical studies have revealed that BMD is closely associated with circulating insulin levels. Insulin receptors are expressed in osteoblasts. Insulin stimulates the proliferation and differentiation of osteoblasts in vitro. Hyperinsulinemia, therefore, increases BMD both in diabetic and non-diabetic subjects, as shown in a number of studies. A model employing direct injection of insulin over calvariae showed an increase in bone formation as seen by histomorphometric analysis. Futhermore, metabolic control of type 1 diabetes through intensive insulin treatment resulted in the stabilization of BMD. These results would imply that deficiencies of insulin actions may lead to the deterioration of bone remodeling in diabetic individuals. |