PMID- 32566682
OWN - NLM
STAT- MEDLINE
DCOM- 20210405
LR  - 20210405
IS  - 2314-6753 (Electronic)
IS  - 2314-6745 (Print)
VI  - 2020
DP  - 2020
TI  - Pathophysiology and Management of Type 2 Diabetes Mellitus Bone Fragility.
PG  - 7608964
LID - 10.1155/2020/7608964 [doi]
LID - 7608964
AB  - Individuals with type 2 diabetes mellitus (T2DM) have an increased risk of bone 
      fragility fractures compared to nondiabetic subjects. This increased fracture 
      risk may occur despite normal or even increased values of bone mineral density 
      (BMD), and poor bone quality is suggested to contribute to skeletal fragility in 
      this population. These concepts explain why the only evaluation of BMD could not 
      be considered an adequate tool for evaluating the risk of fracture in the 
      individual T2DM patient. Unfortunately, nowadays, the bone quality could not be 
      reliably evaluated in the routine clinical practice. On the other hand, getting 
      further insight on the pathogenesis of T2DM-related bone fragility could consent 
      to ameliorate both the detection of the patients at risk for fracture and their 
      appropriate treatment. The pathophysiological mechanisms underlying the increased 
      risk of fragility fractures in a T2DM population are complex. Indeed, in T2DM, 
      bone health is negatively affected by several factors, such as inflammatory 
      cytokines, muscle-derived hormones, incretins, hydrogen sulfide (H2S) production 
      and cortisol secretion, peripheral activation, and sensitivity. All these factors 
      may alter bone formation and resorption, collagen formation, and bone marrow 
      adiposity, ultimately leading to reduced bone strength. Additional factors such 
      as hypoglycemia and the consequent increased propensity for falls and the direct 
      effects on bone and mineral metabolism of certain antidiabetic medications may 
      contribute to the increased fracture risk in this population. The purpose of this 
      review is to summarize the literature evidence that faces the pathophysiological 
      mechanisms underlying bone fragility in T2DM patients.
CI  - Copyright (c) 2020 C. Eller-Vainicher et al.
FAU - Eller-Vainicher, C
AU  - Eller-Vainicher C
AUID- ORCID: 0000-0002-6739-4417
AD  - Unit of Endocrinology, Fondazione IRCCS Ca Granda-Ospedale Maggiore Policlinico, 
      Milan, Italy.
FAU - Cairoli, E
AU  - Cairoli E
AD  - Istituto Auxologico Italiano, IRCCS, Unit for Bone Metabolism Diseases and 
      Diabetes & Lab of Endocrine and Metabolic Research, Italy.
AD  - Dept. of Clinical Sciences & Community Health, University of Milan, Milan, Italy.
FAU - Grassi, G
AU  - Grassi G
AD  - Unit of Endocrinology, Fondazione IRCCS Ca Granda-Ospedale Maggiore Policlinico, 
      Milan, Italy.
AD  - Dept. of Clinical Sciences & Community Health, University of Milan, Milan, Italy.
FAU - Grassi, F
AU  - Grassi F
AD  - Ramses Lab, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
FAU - Catalano, A
AU  - Catalano A
AD  - Department of Clinical and Experimental Medicine, University of Messina, Messina, 
      Italy.
FAU - Merlotti, D
AU  - Merlotti D
AD  - Department of Medicine, Surgery and Neurosciences, University of Siena, Italy.
FAU - Falchetti, A
AU  - Falchetti A
AD  - Istituto Auxologico Italiano, IRCCS, Unit for Bone Metabolism Diseases and 
      Diabetes & Lab of Endocrine and Metabolic Research, Italy.
FAU - Gaudio, A
AU  - Gaudio A
AD  - Department of Clinical and Experimental Medicine, University of Catania, 
      University Hospital 'G. Rodolico', Catania, Italy.
FAU - Chiodini, I
AU  - Chiodini I
AUID- ORCID: 0000-0001-7594-3300
AD  - Istituto Auxologico Italiano, IRCCS, Unit for Bone Metabolism Diseases and 
      Diabetes & Lab of Endocrine and Metabolic Research, Italy.
AD  - Dept. of Clinical Sciences & Community Health, University of Milan, Milan, Italy.
FAU - Gennari, L
AU  - Gennari L
AUID- ORCID: 0000-0001-6833-4232
AD  - Department of Medicine, Surgery and Neurosciences, University of Siena, Italy.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20200522
PL  - England
TA  - J Diabetes Res
JT  - Journal of diabetes research
JID - 101605237
RN  - 0 (Hypoglycemic Agents)
SB  - IM
MH  - Bone Density
MH  - Bone Diseases, Metabolic/*etiology/*therapy
MH  - Bone Remodeling/drug effects
MH  - Bone and Bones/drug effects/metabolism
MH  - Diabetes Complications/etiology/therapy
MH  - Diabetes Mellitus, Type 2/*complications/metabolism/*therapy
MH  - Fractures, Bone/etiology/therapy
MH  - Humans
MH  - Hypoglycemic Agents/therapeutic use
PMC - PMC7262667
COIS- The authors declare that they have no competing interests.
EDAT- 2020/06/23 06:00
MHDA- 2021/04/07 06:00
PMCR- 2020/05/22
CRDT- 2020/06/23 06:00
PHST- 2020/02/01 00:00 [received]
PHST- 2020/04/29 00:00 [revised]
PHST- 2020/05/04 00:00 [accepted]
PHST- 2020/06/23 06:00 [entrez]
PHST- 2020/06/23 06:00 [pubmed]
PHST- 2021/04/07 06:00 [medline]
PHST- 2020/05/22 00:00 [pmc-release]
AID - 10.1155/2020/7608964 [doi]
PST - epublish
SO  - J Diabetes Res. 2020 May 22;2020:7608964. doi: 10.1155/2020/7608964. eCollection 
      2020.