Hormonal Regulation of Bone Metabolism in Diabetes
Summary
Diabetes impairs hormonal regulation of skeletal remodelling by disrupting insulin and insulin-like growth factor-1 signalling, altering parathyroid hormone dynamics and modifying gut-derived peptide responses. Insulin deficiency in type 1 diabetes leads to reduced osteoblast activity and diminished bone formation, whereas insulin resistance in type 2 diabetes is associated with low bone turnover and compromised bone microarchitecture despite normal or elevated bone mineral density. Chronic hyperglycaemia promotes the accumulation of advanced glycation end-products in the collagen matrix, increasing fragility. Incretin hormones, notably glucagon-like peptide-1 and glucose-dependent insulinotropic polypeptide, exert anti-resorptive and pro-anabolic effects on bone cells. Adipokines such as leptin and adiponectin further modulate osteoblast and osteoclast function in the diabetic milieu. Therapeutic strategies targeting these hormonal pathways hold promise to integrate glycaemic management with bone-health preservation, addressing the heightened global burden of fractures in diabetes.
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Hormonal Regulation of Bone Metabolism in Diabetes publication trend
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Technical terms
Osteoblast: Cell responsible for bone formation and matrix synthesis.
Osteoclast: Multinucleated cell that degrades bone tissue during remodelling.
Incretin hormones: Gut peptides such as GLP-1 and GIP that enhance insulin secretion and influence bone cell activity.
Advanced glycation end-products (AGEs): Glycated biomolecules that accumulate in collagen, reducing bone quality.
Bone mineral density (BMD): Measure of mineral content in bone, used to assess fracture risk.
References
- GIP reduces osteoclast activity and improves osteoblast survival in primary human bone cells. European Journal of Endocrinology (2023).
- A Pilot Study Showing Acute Inhibitory Effect of GLP 1 on the Bone Resorption Marker CTX in Humans. JBMR Plus (2019).
- Effects of GLP‐1 Receptor Agonists on Bone Mineral Density in Patients with Type 2 Diabetes Mellitus: A 52‐Week Clinical Study. BioMed Research International (2021).
- The Impact of Glucagon-Like Peptide-1 on Bone Metabolism and Its Possible Mechanisms. Frontiers in Endocrinology (2017).
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