| Theme |
Beyond bone mineral density : roles of collagen and its related mineral quality in bone fragility in osteoporosis, diabetes, and renal dysfunction |
| Title |
Influence of glycation and oxidation on bone quality in the patients with diabetes and/or chronic renal failure |
| Author |
Masaaki Inaba |
Department of Metabolism, Endocrinology, and Molecular Medicine, Osaka City University Graduate School of Medicine |
| [ Summary ] |
Various bone diseases, including secondary hyperparathyroidism and osteomalacia, develop in association with the progression of renal dysfunction. Since diabetes mellitus has recently been increasing as a causative disease to develop chronic renal failure, associated bone diseases are also affected by diabetes. Diabetic osteopathy is mainly characterized as a low bone turnover disease caused by osteoblast dysfunction. Both insulin depletion and sustained high glucose conditions are known as the primary factors impairing osteoblasts in patients with diabetes. However, it is now increasingly recognized that increases in glycation and oxidation in diabetic conditions directly impair osteoblasts. Furthermore, the production of AGE collagen and carbamylated collagen disturbs collagen structures in bone, leading to the production of fragile bones. In fact, diabetic hemodialysis patients exhibited fracture rates greater than their non-diabetic counterparts in spite of the higher bone mass of diabetic patients. |