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Poor bone quality in diabetes: detrimental collagen cross-link pattern reduces bone strength without change in bone mineral density

Saito, M.

Clinical Calcium 16(8): 1287-1295

2006

ISSN/ISBN: 0917-5857
PMID: 16883036
Document Number: 598980
Although type 2 diabetes is often characterized by normal or high bone mineral density (BMD), diabetes is associated with increased risk of fracture. This paradoxical phenomenon in type 2 diabetes may be explained by poorer "bone quality" by detrimental collagen cross-links in bone. Recently, we showed that the alteration of enzymatic and nonenzymatic crosslinking in bone could be important for explaining the variation of fracture susceptibility in diabetes (Osteoporos Int, 2006. Epub ahead of print). In this review, we describe that low turnover bone, hyperglycemia, mildly hyperhomocysteinemia, and vitamin B(6) insufficiency are crucial determinants of detrimental crosslinking of bone collagen in diabetes.

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