Diabetes makes bones less bendable, more prone to fracture

January 29, 2018 by Scott Maier, University of California, San Francisco
Credit: University of California, San Francisco

Besides impairing cardiovascular and kidney function, Type 2 diabetes is known to be a risk factor for bone fractures – but exactly how diabetes makes bones more fragile has been unclear.

New research in animal models by a team of scientists at UC San Francisco, UC Davis, and UC Berkeley suggests that the disease compromises the collagen within bones, making the bones less flexible and more likely to break.

Their study appeared online Jan. 17, 2018, in the Journal of Bone and Mineral Research.

"The management of is an important goal for the elderly," said senior author Aaron Fields, Ph.D., assistant professor of orthopaedic surgery at UCSF. "Adults with Type 2 have a higher fracture risk for a given density, which is otherwise the main clinical predictor of fracture risk. This is a widespread and growing issue now that these individuals are living longer with better insulin management."

Fields and colleagues looked at factors outside of that could explain bone fragility in diabetes.

In healthy bones, networks of collagen fibers stretch and slide in response to strain, which helps the bones resist cracking. But hyperglycemia in diabetes leads to the accumulation of so-called advanced glycation end products, which bind to each other and impair their stretching and sliding, according to the new findings.

The researchers examined bones from the lower back and forearm of lean, obese and diabetic obese rat models. They imaged the bones with high-resolution CT scans, tested their biomechanical properties, and measured the collagen networks' response to strain using small-angle X-ray scattering at the Lawrence Berkeley National Laboratory Advanced Light Source. They then simulated the contribution of these various factors to bone strength using supercomputers at the Texas Advanced Computing Center at the University of Texas.

Both the obese and the diabetic obese rats had overall weaker bones for a given . In obese rats, the reduced strength was attributable to structural deficits, such as changes to the microarchitecture of the bones and inefficient distribution of bone mass.

In the diabetic obese rats, however, these structural deficits were compounded by material deficits – changes to the collagen networks – that were previously not well documented.

By comparing the obese rats with the diabetic obese rats, the researchers could isolate the effect of hyperglycemia on bone fragility. In the forearm bones, for example, the changes were responsible for significant reductions in the elastic, yield and ultimate tensile properties of the bone tissue.

The researchers note that they did not study animals with an advanced duration and severity of diabetes, which may limit generalizability, but they expect that long-term diabetes would only further impair bone strength.

"Our findings shed light on why bones in a diabetic milieu are so fragile," said Fields. "And in doing so, may lead to better diagnostic tools and therapies for managing fracture risk in adults with diabetes."

Explore further: Which bone measures predict fractures in postmenopausal women?

More information: Claire Acevedo et al. Contributions of material properties and structure to increased bone fragility for a given bone mass in the UCD-T2DM rat model of type 2 diabetes, Journal of Bone and Mineral Research (2018). DOI: 10.1002/jbmr.3393

Related Stories

Which bone measures predict fractures in postmenopausal women?

January 24, 2018
When investigators compared initial bone parameters with changes in those parameters over time in postmenopausal women, they found that initial measurements were significantly associated with women's risk of fracture. Rates ...

Obesity and type 2 diabetes harm bone health

November 17, 2015
Obesity and Type 2 diabetes have been linked to several health issues, including an increased risk of bone fractures. In a new animal study, University of Missouri researchers examined how the development of obesity and insulin ...

Seniors with Type 2 diabetes may have increased risk for fracture

September 20, 2017
Though seniors with type 2 diabetes (T2D) tend to have normal or higher bone density than their peers, researchers have found that they are more likely to succumb to fractures than seniors without T2D. In a new study published ...

Weight loss surgery's effects on bone marrow fat and bone mass

August 9, 2017
Bone marrow fat is thought to regulate bone metabolism, and high levels of marrow fat are seen in states of low bone mass, severe underweight, and diabetes. In a study of obese women undergoing gastric bypass surgery, increases ...

Recommended for you

Marker may help target treatments for Crohn's patients

October 16, 2018
Crohn's disease (CD), a chronic inflammatory condition of the intestinal tract, has emerged as a global disease, with rates steadily increasing over the last 50 years. Experts have long suspected that CD likely represents ...

Polio: Environmental monitoring will be key as world reaches global eradication

October 15, 2018
Robust environmental monitoring should be used as the world approaches global eradication of polio, say University of Michigan researchers who recently studied the epidemiology of the 2013 silent polio outbreak in Rahat, ...

Study traces hospital-acquired bloodstream infections to patients' own bodies

October 15, 2018
The most common source of a bloodstream infection acquired during a hospital stay is not a nurse's or doctor's dirty hands, or another patient's sneeze or visitor's cough, but the patient's own gut, Stanford University School ...

Researchers make essential imaging tests safer for people at risk of acute kidney injury

October 15, 2018
Every year, millions of people undergo medical tests and procedures, such as coronary angiography, which use intravascular contrast dyes. "For the majority of patients, these are safe and necessary procedures. However, about ...

Do not give decongestants to young children for common cold symptoms, say experts

October 11, 2018
Decongestants should not be given to children under 6—and given with caution in children under 12—as there is no evidence that they alleviate symptoms such as a blocked or runny nose, and their safety is unclear, say ...

New techniques can detect Lyme disease weeks before current tests

October 11, 2018
Researchers have developed techniques to detect Lyme disease bacteria weeks sooner than current tests, allowing patients to start treatment earlier.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.