Abstract

Diabetes mellitus causes secondary osteoporosis and muscle atrophy. The ability of alfacalcidol (ALF) and exercise (Exe) to inhibit osteoporosis and muscle atrophy in type 2 diabetes mellitus (T2DM) model rats was examined. Twenty-week-old Otsuka Long-Evans Tokushima Fatty rats were randomized to ALF (orally 0.1 μg/kg/day), Exe (treadmill exercise at 10 m/min, 60 min/day, 5 days/week), Comb (ALF and Exe), and Cont (T2DM control treated with vehicle and no exercise) groups (n = 8–10 per group). Sedentary Long-Evans Tokushima Otsuka rats were used as a non-hyperphagic control. After treatment for 2 or 6 weeks, blood glucose (BG) levels, cross-sectional area (CSA) of tibialis anterior muscle fibers, femoral bone mineral density (BMD), and relative quantities of muscle anabolic markers (Pax7, MyoD, and myogenin) and catabolic markers (Atrogin-1, MuRF1, and REDD1) of the soleus muscle assessed by real-time polymerase chain reaction assays were measured. Exe and Comb treatments for 6 weeks decreased BG levels compared with those of the Cont group. ALF, Exe, and Comb treatments for 2 and 6 weeks recovered the CSA compared with that of the Cont group. ALF and Comb treatments for 6 weeks increased femoral BMDs compared with those of the Cont group. After 2 weeks of treatment, Comb treatment increased MyoD expression and decreased MuRF1 expression. ALF or Exe monotherapy significantly decreased Atrogin-1 or MuRF1 expression after 2 weeks of treatment, respectively. After 6 weeks of treatment, ALF and Comb treatments decreased Atrogin-1 and REDD1. These results demonstrate that a combination of ALF and Exe improved CSA from the early phase of treatment by stimulating skeletal muscle differentiation and suppressing muscle catabolic genes. Improvements in BG, BMD, and CSA were observed as long-term effects of the combination therapy. Continued suppression of muscle catabolic genes was observed as a background to these effects.

Highlights

  • In recent years, population aging has become a global public health issue

  • type 2 diabetes mellitus (T2DM) model rats (OLEFT rats) showed increased total and distal femoral bone mineral density (BMD) at 2 weeks and decreased cross-sectional area (CSA) of the tibialis anterior muscle at 2 and 6 weeks compared with non-T2DM control rats (LETO rats)

  • There were no significant changes of muscle anabolic and catabolic-related gene expressions in the soleus muscle compared with those of non-T2DM control rats (LETO rats)

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Summary

Introduction

Population aging has become a global public health issue. Aging societies face a number of issues, such as an increase in aging-associated diseases, multiple comorbidities, and decrease in activities of daily living (ADLs) of elderly persons, who eventually become bedridden. Several recent reports demonstrated that osteoporotic fractures directly decrease ADLs of elderly persons, as well as increase their mortality risk [1,2,3]. Sarcopenia decreases ADLs of elderly persons [4] and is strongly correlated with osteoporosis [5,6,7,8]. In aging societies, management of aging-associated diseases, osteoporosis and sarcopenia, is imperative to maintain ADLs and improve the life expectancy of elderly persons

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