Diabetes Bone Research Articles

Glycemic Control and Bone in Diabetes.

Purpose of ReviewThis review summarizes recent developments on the effects of glycemic control and diabetes on bone health. We discuss the foundational cellular mechanisms through which diabetes and impaired glucose control impact bone biology, and how these processes contribute to bone fragility in diabetes.Recent FindingsGlucose is important for osteoblast differentiation and energy consumption of mature osteoblasts. The role of insulin is less clear, but insulin receptor deletion in mouse osteoblasts reduces bone formation. Epidemiologically, type 1 (T1D) and type 2 diabetes (T2D) associate with increased fracture risk, which is greater among people with T1D. Accumulation of cortical bone micro-pores, micro-vascular complications, and AGEs likely contribute to diabetes-related bone fragility. The effects of youth-onset T2D on peak bone mass attainment and subsequent skeletal fragility are of particular concern.SummaryFurther research is needed to understand the effects of hyperglycemia on skeletal health through the lifecycle, including the related factors of inflammation and microvascular damage.

Insufficient S-adenosylhomocysteine hydrolase compromises the beneficial effect of diabetic BMSCs on diabetic cardiomyopathy

BackgroundAutologous stem cell therapy is a promising strategy for cardiovascular diseases including diabetic cardiomyopathy (DCM), but conclusions from clinical trials were compromised. We assumed that diabetes might induce the dysfunction of stem cells and thus limit its therapeutic effect. This study aimed to compare the effect of diabetes and nondiabetes-derived bone marrow mesenchymal stem cells (BMSCs) transplantation on DCM and explored the potential mechanism.MethodsRats with diabetes were induced using high-fat diets and streptozotocin (STZ) injection. BMSCs harvested from diabetic and nondiabetic rats were infused into DCM rats, and the effects on the heart were identified by echocardiography and histopathology. The inhibition or overexpression of SAHH in nondiabetic and diabetic BMSCs was used to confirm its key role in stem cell activity and cardiac therapy.ResultsCompared with normal BMSCs, the therapeutic effects of diabetic rat-derived stem cells on improving cardiac function and adverse remodeling were significantly attenuated. In vitro, diabetic BMSCs had lower cell viability and paracrine function than nondiabetic BMSCs. It was further found that diabetic BMSCs had obvious mitochondrial oxidative stress damage and S-adenosylhomocysteine (SAH) accumulation due to S-adenosylhomocysteine hydrolase (SAHH) deficiency. SAHH inhibition by adenosine dialdehyde (ADA) or shSAHH plasmid in normal BMSCs significantly reduced the favorable effects on endothelial cell proliferation and tube-forming capacity. In contrast, SAHH overexpression in diabetic BMSCs significantly improved cellular activity and paracrine function. Transplantation of BMSCs with SAHH overexpression improved cardiac adverse remodeling and angiogenesis. Activation of the Nrf2 signaling pathway may be one of the key mechanisms of SAHH-mediated improvement of stem cell viability and cardiac repair.ConclusionsDiabetes leads to compromised bioactivity and repair capacity of BMSCs. Our study suggests that SAHH activation may improve the cardioprotective effect of autologous transplantation of diabetes-derived BMSCs on patients with DCM.Graphical abstractDiabetes induced the inhibition of S-adenosylhomocysteine (SAH) expression and aging phenotype in BMSCs and thus decreased the cell viability and paracrine function. Compared with normal BMSCs, the therapeutic effects of diabetic rat-derived BMSCs on improving cardiac function and adverse remodeling were significantly attenuated. SAHH overexpression in diabetic BMSCs significantly rescued cellular function partly via activating Nrf2/HO-1 signal. Transplantation of diabetic BMSCs with SAHH overexpression improved angiogenesis and cardiac adverse remodeling in rats.

Factors associated with trabecular bone score in postmenopausal women with type 2 diabetes and normal bone mineral density.

BACKGROUNDOsteoporosis and type 2 diabetes (T2D) have been recognized as a widespread comorbidity leading to excess mortality and an enormous healthcare burden. In T2D, bone mineral density (BMD) may underestimate the risk of low-energy fractures as bone quality is reduced. It was hypothesized that a decrease in the trabecular bone score (TBS), a parameter assessing bone microarchitecture, may be an early marker of impaired bone health in women with T2D.AIMTo identify clinical and body composition parameters that affect TBS in postmenopausal women with T2D and normal BMD.METHODSA non-interventional cross-sectional comparative study was conducted. Potentially eligible subjects were screened at tertiary referral center. Postmenopausal women with T2D, aged 50-75 years, with no established risk factors for secondary osteoporosis, were included. BMD, TBS and body composition parameters were assessed by dual-energy X-ray absorptiometry. In women with normal BMD, a wide range of anthropometric, general and diabetes-related clinical and laboratory parameters were evaluated as risk factors for TBS decrease using univariate and multivariate regression analysis and analysis of receiver operating characteristic (ROC) curves.RESULTSThree hundred twelve women were initially screened, 176 of them met the inclusion criteria and underwent dual X-ray absorptiometry. Those with reduced BMD were subsequently excluded; 96 women with normal BMD were included in final analysis. Among them, 43 women (44.8%) showed decreased TBS values (≤ 1.31). Women with TBS ≤ 1.31 were taller and had a lower body mass index (BMI) when compared to those with normal TBS (Р = 0.008 and P = 0.007 respectively). No significant differences in HbA1c, renal function, calcium, phosphorus, alkaline phosphatase, PTH and 25(ОН)D levels were found. In a model of multivariate linear regression analysis, TBS was positively associated with gynoid fat mass, whereas the height and androgen fat mass were associated negatively (all P < 0.001). In a multiple logistic regression, TBS ≤ 1.31 was associated with lower gynoid fat mass (adjusted odd ratio [OR], 0.9, 95% confidence interval [CI], 0.85-0.94, P < 0.001), higher android fat mass (adjusted OR, 1.13, 95%CI, 1.03-1.24, P = 0.008) and height (adjusted OR, 1.13, 95%CI, 1.05-1.20, P < 0.001). In ROC-curve analysis, height ≥ 162.5 cm (P = 0.04), body mass index ≤ 33.85 kg/m2 (P = 0.002), gynoid fat mass ≤ 5.41 kg (P = 0.03) and android/gynoid fat mass ratio ≥ 1.145 (P < 0.001) were identified as the risk factors for TBS reduction.CONCLUSIONIn postmenopausal women with T2D and normal BMD, greater height and central adiposity are associated with impaired bone microarchitecture.

Platelet Derived Vesicles Enhance the TGF-beta Signaling Pathway of M1 Macrophage.

Macrophages, mainly divided into M1 pro-inflammatory and M2 anti-inflammatory types, play a key role in the transition from inflammation to repair after trauma. In chronic inflammation, such as diabetes and complex bone injury, or the process of certain inflammatory specific emergencies, the ratio of M1/M2 cell populations is imbalanced so that M1-macrophages cannot be converted into M2 macrophages in time, resulting in delayed trauma repair. Early and timely transformation of macrophages from the pro-inflammatory M1-type into the pro-reparative M2-type is an effective strategy to guide trauma repair and establish the original homeostasis. We prepared purified nano-platelet vesicles (NPVs) and assessed their effects on macrophage phenotype switching through transcriptome analysis. The results elucidate that NPVs promote pathways related to angiogenesis, collagen synthesis, cell adhesion, and migration in macrophages, and we speculate that these advantages may promote healing in traumatic diseases.

A Potential Participant in Type 2 Diabetes Bone Fragility: TIMP-1 at Sites of Osteocyte Lacunar-Canalicular System.

Type 2 diabetes mellitus (T2DM) is associated with an increased risk of bone fracture, but the bone mineral density (BMD) is typically normal or higher in such patients. Because the fracture risk is independent of reduced BMD, bone fragility in T2DM may be partially due to poor bone quality. The mechanisms triggering bone quality abnormalities in T2DM are complex, and include the accumulation of advanced glycation end-products, the increased inflammation, and low bone turnover. Matrix metalloproteinases (MMPs) in bone can hydrolyze the bone matrix. Tissue inhibitors of MMPs (TIMPs) can inhibit the activity of MMPs. Both MMPs and TIMPs participate in mediating bone quality. Among all types of TIMPs, TIMP-1 is mostly reportedly increased in the serum of T2DM patients. Because osteocytes can express TIMP-1, and osteocyte pericellular matrix influences bone quality partially regulated by perilacunar/canalicular remodeling, we hypothesized that TIMP-1 at sites of osteocyte lacunar-canalicular system is involved in T2DM bone fragility.

A systematic review investigating patient knowledge and awareness on the association between oral health and their systemic condition

BackgroundThe prevalence of the oral-systemic relationship has accounted for potentially preventable chronic conditions and morbidity worldwide. Health literacy is a large contributing factor. This systematic review investigates the knowledge and awareness of patients with major systemic conditions, regarding the oral associations to their condition.MethodsElectronic databases including Medline (Ovid), CINAHL, The Cochrane Library, Web of Science, Informit Health Databases and Scopus were searched. All articles from 2011 to 2020, investigating knowledge of the oral-systemic link, of adult patients with the following major system conditions were searched: diabetes mellitus (DM), respiratory disease, cardiovascular disease (CVD), pregnancy and bone disease. Two independent reviewers completed screening, data extraction and quality assessment. A synthesis without meta-analysis was conducted. Twenty-four studies, from 14 different countries, were included in the systematic review.ResultsAnalysis showed that globally, patients with major systemic conditions have poor knowledge and awareness (< 50%) of the oral health associations to their condition. Improvements in health education are particularly necessary for patients with heart disease, bone disease and diabetes. Dentists and the media were the most common source of information. There were no relevant studies investigating the knowledge of patients with respiratory disease.ConclusionTo improve the global burden of preventable chronic conditions, it is essential to address inequalities in the dissemination of health education to at-risk populations. Improvements in patient education rely on an increase in patient-practitioner communication on the oral-systemic link, implementation of oral health educational programs and greater interdisciplinary collaboration.

Protective effects of low-magnitude high-frequency vibration on high\xa0glucose-induced osteoblast dysfunction and bone loss in diabetic rats

ObjectiveLow-magnitude high-frequency vibration (LMHFV) has been reported to be capable of promoting osteoblast proliferation and differentiation. Reduced osteoblast activity and impaired bone formation were related to diabetic bone loss. We investigated the potential protective effects of LMHFV on high-glucose (HG)-induced osteoblasts in this study. In addition, the assessment of LMHFV treatment for bone loss attributed to diabetes was also performed in vivo.MethodMC3T3-E1 cells induced by HG only or treated with LMHFV were treated in vitro. The experiments performed in this study included the detection of cell proliferation, migration and differentiation, as well as protein expression. Diabetic bone loss induced by streptozotocin (STZ) in rats was established. Combined with bone morphometric, microstructure, biomechanical properties and matrix composition tests, the potential of LMHFV in treating diabetes bone loss was explored.ResultsAfter the application of LMHFV, the inhibiting effects of HG on the proliferation, migration and differentiation of osteoblasts were alleviated. The GSK3β/β-catenin pathway was involved in the protective effect of LMHFV. Impaired microstructure and biomechanical properties attributed to diabetes were ameliorated by LMHFV treatment. The improvement of femur biomechanical properties might be associated with the alteration of the matrix composition by the LMHFV.ConclusionLMHFV exhibited a protective effect on osteoblasts against HG by regulating the proliferation, migration and differentiation of osteoblasts. The function of promoting bone formation and reinforcing bone strength made it possible for LMHFV to alleviate diabetic bone loss.

Relationship between Type 2 Diabetes Mellitus and Lumbar Bone Mineral Density in Postmenopausal Women.

Study DesignCross-sectional study using radiological measurements.PurposeTo analyze the relationship between type 2 diabetes mellitus (DM) and bone mineral density (BMD) in postmenopausal women and to assess risk factors of osteoporotic vertebral compression fracture (OVCF) in postmenopausal diabetic women.Overview of LiteratureType 2 DM has negative effects on the quality of bone. Patients with type 2 DM have increased risk of hip and other fractures, but their vertebral fracture risk is controversial. There is a positive correlation between body mass index (BMI) and BMD. At the same time, obesity is the most important risk factor for type 2 DM.MethodsConsecutive patients whose BMD had been checked using dual-energy X-ray absorptiometry at Gwangmyung Sungae Hospital were recruited. Patients were divided into two groups according to the presence of type 2 DM. Risk factors of OVCF including age, BMI, current smoking status, current alcohol consumption, and presence of osteoporosis were analyzed separately in the type 2 DM group and control group.ResultsA total of 1,130 patients were enrolled in this study. The mean age was 63.2 years. BMI was positively correlated with lumbar BMD in the control group (r=0.284) and in the diabetic group (r=0.302). In subgroup analysis, BMI and age were significant risk factors of OVCF in the type 2 DM group. In multiple linear regression analysis, type 2 DM (β=0.035; 95% confidence interval [CI], 0.005–0.065; p=0.024) and BMI (β=0.015; 95% CI, 0.012–0.018; p<0.001) were positively correlated with lumbar BMD, and age was negatively correlated with BMD (β=−0.006; 95% CI, −0.007 to −0.004; p<0.001).ConclusionsBMI was positively correlated with lumbar BMD and was higher in type 2 diabetic patients. Age was negatively correlated with lumbar BMD.

Analysis of bone metabolism mechanisms in postmenopausal females with type 2 diabetes and DKK1 gene polymorphisms and the effects of polymer nanomaterials on wound infection in patients

Diabetic patients are prone to abnormal bone metabolism. Menopausal women exhibit reduced estrogen secretion and bone absorption exceeds the rate of bone formation. Therefore, postmenopausal women with diabetes are even more likely to suffer from osteoporosis. Identifying the specific mechanism of abnormal bone metabolism in diabetic menopausal women will help reduce the risk of bone fractures. This study explored the specific mechanisms of bone metabolism disorders in menopausal women with type 2 diabetes in relation to genetic polymorphisms. We found that the distribution frequency of the CA genotype and A allele at the rs1373004 locus of the DKK1 gene in menopausal women with diabetes and abnormal bone mass were significantly lower compared with that in normal bone. The distribution of the GG genotype at the rs1528877 locus was also less frequent compared with those exhibiting normal bone mass. This suggests that the genotype and allele frequency distribution in the DKK1 gene at rs1373004 and RS1528877 in postmenopausal T2DM women is associated with glucose metabolism and bone metabolism. To analyze the efficacy of polylactic acid (PLA)/gelatin nanofibers on T2DM patients with infectious fractures, we compared various aspects of wound healing in patients treated with conventional therapy versus PLA/gelatin nanofibers. The results indicated that the number of days required for wound healing and the frequency of incisions in patients treated with PLA/gelatin nanofibers were significantly lower compared with those treated with conventional therapy (P &lt; 0.05). The wound healing rate of patients treated with PLA/gelatin nanofibers was significantly higher compared with that of patients treated with conventional therapy on days 7, 14, 21, and 28 of treatment. Our findings indicate that PLA/gelatin nanofiber treatment can significantly promote fracture wound healing.

A Case of Iatrogenic Cushing’s Syndrome

Cushing’s syndrome (CS) is considered a rare disease. The most common cause is the exogenous use of glucocorticoids (GCs), which are often given within a controlled medical setting, but their factitious use is rare. Factitious CS is more common in females, young patients, those with psychiatric disorders, and those with contacts within the medical field. The diagnosis of CS is challenging because some features are non-specific and commonly present in the general population, such as obesity, depression, diabetes, hypertension (HTN), and low bone mineral density (BMD). A high suspicion is warranted. We present the case of a 47-year-old man with HTN, obesity, dyslipidemia, obstructive sleep apnea, and low BMD who complained of increased appetite, significant weight gain, fatigue, sleepiness, muscle weakness, and occasional facial flushing. Medications include Hydrochlorothiazide, Furosemide, Losartan, Atorvastatin, and Teriparatide. Vital signs were normal and body mass index was 41.9 kg/m2. He had a round face, central obesity, and wide purple striae in his abdomen. Dual-energy X-ray absorptiometry scan showed low BMD at spine. Laboratories revealed a glycated hemoglobin of 6.1%, late-night salivary cortisol of <0.03 mcg/dL, 24-hour urine free cortisol of 22.5 mcg/24hr, morning cortisol of 0.01 ug/mL, ACTH 23.5pg/mL, and dehydroepiandrosterone sulfate (DHEA-S) 35 mcg/dL. Our patient persistently denied use of exogenous GCs, but a urine synthetic GC screen disclosed a positive result for dexamethasone; levels at 1.1 mcg/dL. After an exhaustive conversation, our patient confessed to using over-the-counter dexamethasone 4mg to treat occasional muscle aches. ACTH is usually suppressed in factitious CS, but this was not our patient’s case, giving the appearance of ACTH-dependent hypercortisolism. This can lead to unnecessary diagnostic and therapeutic approaches. An unsuppressed ACTH could be due to an unreliable ACTH immunoassay or intermittent, instead of continuous, ingestion of GCs. A suppressed DHEA-S level, as seen in our patient, may provide the clue to exogenous GC use as the cause of CS. Our case is also rare because our patient is male, older, and not related to the medical field. Hypercortisolism must be detected and treated early due to its high morbidity and mortality. Several features may be reversed with treatment. The possibility of hypothalamic-pituitary-adrenal (HPA) axis suppression due to prolonged use of GCs, resulting in adrenal insufficiency (AI) should be considered. The prevalence of GC-induced AI ranges from 14–63%, with the highest risk in those with Cushingoid features and those receiving a dose equivalent to prednisone 20mg daily for more than three weeks. Sudden withdrawal of GCs should be avoided to prevent adrenal crisis. A tapering regimen should be adopted with subsequent biochemical testing of the HPA axis once GCs have been reduced to a physiologic dose.

The Effect of Sericin on Bone Regeneration in a Streptozotocin-Induced Type I Diabetes Animal Model

There is an association between diabetes and impaired bone healing. The purpose of this study was to determine whether sericin had a positive effect on bone regeneration with streptozotocin-induced diabetes in a rat model. Sprague Dawley rats (n = 21) were assigned to one of three groups. A critical-sized bone defect was created on the calvaria. In the sericin group (S group, n = 7), the bone defect was filled with a sericin–gelatin combination, whereas in the gelatin group (G group, n = 7), only gelatin sponge was used. The control group (N group, n = 7) did not receive any graft. New bone formation was evaluated by micro-computerized tomogram and histological analysis. The regenerated bone volume in group S was the highest among the three groups (3.87 ± 2.51 mm3), followed by group N (1.71 ± 1.65 mm3) and group G (1.24 ± 1.05 mm3). The application of sericin in combination with a gelatin sponge enhanced the process of bone regeneration in streptozotocin-induced type I diabetes animal model.

A Case Study: Low-carb, High-fat (LCHF) Diet Combined with Fried Food in Patient with Type 2 Diabetes and Central Obesity Reduces Need for Exogenous Insulin Injection

Eating is not a simple act of feeding our body. Diet plays a pivotal role in health promotion and chronic disease prevention. According to DGA [1] more than 117 million of American adults have one or more preventable chronic diseases, many of which are related to poor quality eating patterns and physical inactivity. These include cardiovascular disease, high blood pressure, type 2 diabetes, some cancers, and poor bone health. The importance of diet mostly as prevention for all the disorders correlated with metabolism should be strongly highlighted in this day: in fact, this clinical case shows how it’s possible to decrease glycemia with diet in type 2 diabetes (T2D). Fat foods and fried foods play an unsuspected important role in Diabesity.

The Future of Metformin in the Prevention of Diabetes-Related Osteoporosis.

As a worldwide aging population is on the rise, osteoporosis (OS) is becoming a global health burden. Therefore, many researchers and health authorities are looking into the potential prevention and treatment of OS. Although previously regarded as two separate pathological processes, diabetes (DM) and OS are now regarded as two conditions that can occur together. It is now believed that OS can develop as a complication of DM. This relationship is further evidenced through a reduction in bone mineral density in type-1 diabetes with a resulting increased risk of fracture. Although bone mineral density in type-2 diabetes mellitus is normal or increased, there is also increased fragility due to decreased bone quality. These abnormal bone qualities tend to occur through the production of reduced bone microvasculature and advanced glycation end product, AGE. Interestingly, one of the most common treatments for DM, metformin (MF), shows a promising result on the protection of diabetes and non-diabetes related bone turnover. It is believed that MF modulates its effect through the adenosine monophosphate-activated protein kinase (AMPK) pathway. Recent data regarded AMPK as a vital mediator of homeostasis. It is involved not only in glucose metabolism but also in osteogenesis. AMPK can directly influence the production of mature and good quality bone by decreasing osteoclasts, increasing osteoblast formation, and enhancing bone mineral deposition. As an activator of AMPK, MF also upregulates osteogenesis. Furthermore, MF can influence osteogenesis through a non-AMPK pathway, such as the fructose 1-6 phosphatase pathway, by reducing glucose levels. While already recognized as a safe and effective treatment for DM, this article discusses whether MF can be used for the prevention and treatment of OS.

An advanced prediction model for postoperative complications and early implant failure.

ObjectivesRisk prediction in implant dentistry presents specific challenges including the dependence of observations from patients with multiple implants and rare outcome events. The aim of this study was to use advanced statistical methods based on penalized regression to assess risk factors in implant dentistry.Material and methodsWe conducted a retrospective study from January 2016 to November 2018 recording postoperative complications including bleeding, hematoma, local infection, and nerve damage, as well as early implant failure. We further assessed patient‐ and implant‐related risk factors including smoking and diabetes, as well as treatment parameters including types of gaps and surgical procedures. Univariable and multivariable generalized estimating equation (GEE) models were estimated to assess predictor effects, and a prediction model was fitted using L1 penalized estimation (lasso).ResultsIn a total of 1,132 patients (mean age: 50.6 ± 16.5 years, 55.4% female) and 2,413 implants, postoperative complications occurred in 71 patients. Sixteen implants were lost prior to loading. Multivariable GEE models showed a higher risk of any complication for diabetes mellitus (p = .006) and bone augmentation (p = .039). The models further revealed a higher risk of local infection for bone augmentation (p = .003), and a higher risk of hematoma formation for diabetes mellitus (p = .007) and edentulous jaws (p = .024). The lasso model did not select any risk factors into the prediction model.ConclusionsUsing novel methodology well‐suited to tackle the specific challenges of risk prediction in implant dentistry, we were able to reliably estimate associations of risk factors with outcomes.

Evaluation of Bone Mineral Density among type 2 Diabetes Mellitus Patients in Zagazig University Hospitals

Background: Diabetes is one of the biggest health problems worldwide where the disease affects almost all organ systems. The relationship between type 2 diabetes mellitus (T2DM) and bone mineral density (BMD) has been controversial. Some show increased, decreased and others show no change in BMD among type 2 diabetics. Objective: The aim of the study was to assess the effect of T2DM on BMD among diabetic patients in Zagazig University Hospitals. Also, evaluation of the effect of other factors like menopause, age and gender that may interfere with DM on BMD. Materials and methods: A case control study that was conducted on 90 individuals. Their ages ranged between 40 and 70 years and consisted of 60 diabetic and 30 nondiabetic subjects. BMD was measured using DEXA scan and the data were compared among age-matched subjects of both groups. Results: BMD was significantly decreased among diabetic patients matched to those who are non-diabetics. Also, the incidence of osteopenia and osteoporosis was higher among diabetic patients. On further analysis of date the highest percent of abnormal BMD (osteopenia and osteoporosis) was among diabetic postmenopausal female cases. Conclusion: Type 2 DM negatively affect the bone strength through affection of BMD. Hence, all type 2 diabetics should be evaluated for the risk of osteoporosis and should be offered appropriate preventive measures.

Effects of anti-resorptive drugs on implant survival and peri-implantitis in patients with existing osseointegrated dental implants: a retrospective cohort study.

This retrospective study aimed to determine whether anti-resorptive drug (ARD) usage increased risk of implant failure among patients with successful implant osseointegration. Additionally, the study investigated risk factors that affected implant survival rate in ARD users. Eighty ARD users with 344 implants who had more than 12months of follow-up from the initiation of ARD treatment during the period between 2008 and 2017 were included, along with 80 non-ARD users from the same period. The primary outcome was dental implant survival. Kaplan-Meier survival curves and Cox proportional hazard models were used for survival analysis. Average follow-up was 85.3months. Implant survival rates were 89.83% in ARD users and 96.03% in non-ARD users. In the univariate Cox proportional hazard model, risk of implant failure was significantly higher in patients with pre-existing marginal bone loss (MBL), diabetes, and concurrent bone augmentation. However, risk of implant failure was significantly lower when the interval between implant placement and ARD administration was < 36months. Compared with overdenture, single crown and fixed splinted users had lower risk of implant failure. In multivariate analysis, variables including pre-existing MBL, diabetes, < 36-month interval between implant placement and ARD treatment, and usage of fixed splinted prosthesis were significantly associated with increased risk of implant failure. ARD administration after implant osseointegration was correlated with a reduced implant survival rate. Pre-existing MBL, diabetes, type of final prosthesis, and the interval between implant placement and initiation of ARD administration influenced risk of implant failure.

A Study of the Relationship between the Polymorphism and Mutation of rs682429 and rs3781590 in the LRP5 Gene and Bone Metabolism in Postmenopausal Type 2 Diabetic Women in Xinjiang.

Objective To explore the expression of the polymorphism and mutation of rs682429 and rs3781590 in the low-density lipoprotein receptor-related protein 5 (LRP5) genotype and to analyse the relationship of bone mineral density (BMD) and bone metabolism markers in postmenopausal women with type-2 diabetes mellitus (T2DM) in Xinjiang, China, to provide a basis for prevention and treatment of the disease. Methods A total of 136 postmenopausal women were included in the study. According to the results of an oral glucose tolerance test (OGTT) and dual-energy X-ray (DEXA) determination of BMD, the study subjects were divided into 4 groups: group A: normal OGTT+normal bone mass group; group B: normal OGTT+osteoporotic (OP) group; group C: T2DM+normal bone mass group; group D: T2DM+osteoporotic (OP) group. Calcium (Ca), phosphorus (P), alkaline phosphatase (ALP), and clinical biochemical data were determined; haemoglobin A1c (HbA1c) was measured by HPLC; BMD of the femoral neck, hip, and lumbar spine (L1-4) was measured by dual-energy X-ray (DEXA); and the rs682429 and rs3781590 polymorphisms of the LRP5 gene were detected by time-of-flight mass spectrometry (TOF MS). Results (1) The rs682429 polymorphism of the LRP5 genotype distribution was statistically significant (P < 0.05) in group B compared with group A. (2) The triglycerides (TG) of women with the CT/TT genotype (mutant type) were higher than those of women with the CC genotype (wild type) (2.37 ± 1.30 vs. 1.52 ± 0.83, P < 0.05) at the rs3781590 site of the LRP5 gene in group D. (3) Multiple linear regression analysis showed that TG (β = 0.034, P < 0.05) and body mass index (BMI) (β = 0.013, P < 0.05) were the influencing factors of BMD (L1-4) in T2DM patients. TG (β = 0.022, P < 0.05), BMI (β = 0.009, P < 0.05), and duration of menopause (β = 0.005, P < 0.05) were the influencing factors of BMD (hip). Conclusion (1) The rs682429 polymorphism site in the LRP5 gene may be involved in bone metabolism in postmenopausal women from Xinjiang. (2) The rs3781590 mutation in the LRP5 gene from these subjects may be involved in lipid metabolism. (3) Among postmenopausal women with type 2 diabetes mellitus and bone mass abnormality in the Xinjiang Shihezi area, high BMI and TG are protective factors against increased BMD. Duration of menopause is a risk factor for increased BMD.

Curcumin Therapeutic Modulation of the Wnt Signaling Pathway.

Curcumin, isolated from the rhizome of Curcuma longa, is one of the most extensively studied phytochemicals. This natural compound has a variety of pharmacological effects including antioxidant, anti-inflammatory, anti-tumor, cardio-protective, hepato-protective and anti-diabetic. Wnt signaling pathway, one of the potential targets of curcumin through upregulation and/or downregulation, plays a significant role in many diseases, even in embryogenesis and development of various organs and systems. In order to exert an anti-tumor activity in the organism, curcumin seems to inhibit the Wnt pathway. The downstream mediators of Wnt signaling pathway such as c-Myc and cyclin D1 are also modified by curcumin. This review demonstrates how curcumin influences the Wnt signaling pathway and is beneficial for the treatment of neurological disorders (Alzheimer's and Parkinson's diseases), cancers (melanoma, lung cancer, breast cancer, colon cancer, endothelial carcinoma, gastric carcinoma and hepatocellular carcinoma) and other diseases, such as diabetes mellitus or bone disorders.

Evaluation of Osseointegration and Crestal Bone Loss Associated with Implants Placed in Diabetic and Other Medically Compromised Patients

Diabetes and other medically compromising diseases may affect people in many ways. Missing teeth can be replaced by various methods including dental implants. The stability, a more natural appearance, and minimizing the risk of bone resorption attribute to its direct anchor into bones. Nevertheless, diabetic patients may experience failure of implant placement due to microvascular complications that lead to sluggish healing after surgery. In addition, some medications are believed to impair bone healing, thus compromising dental implant success. This paper evaluates osseointegration and crestal bone loss of implants placed in medically compromised patients. A retrospective cross-sectional study was conducted using patient records from Department of Prosthodontics, Saveetha Dental College, Chennai, from June 2019 to March 2020. Patients who had dental implants and were medically compromised were chosen randomly. Data were collected and then subjected to statistical analysis. Descriptive statistics analysis was done to find the correlation between crestal bone loss and medically compromised individuals. Microsoft Excel 2016 data spreadsheets were used to collect data, which were later exported to SPSS. Among 89 patients, more than 60% experienced crestal bone loss following implant placement. Diabetic patients recorded the highest prevalence of bone loss in comparison to other medically compromised patients. A significant association was found between crestal bone loss and diabetic patients (p < 0.05) Patients whose diseases were under control with medication were also observed to have bone loss. Overall, the prevalence of crestal bone loss seems to be higher in diabetic patients compared to other medically compromised patients. There seems to be definite correlation between diabetes and crestal bone loss.

Discrimination between tuberculous and bacterial pyomyositis in magnetic resonance features

PurposeThe purpose of this study was to assess the differences of magnetic resonance features between tuberculous and bacterial pyomyositis. MethodThis is a retrospective study of patients with bacterial and tuberculous pyomyositis. We excluded patients with pyomyositis caused by actinomycosis, non-tuberculous mycobacterium, fungi, unknown of causative organism, or inadequate imaging for analysis. Magnetic resonance imaging was independently reviewed by two radiologists. ResultsOf the 136 pyomyositis patients, 71 (52.2 %) patients had bacterial pyomyositis while 65 (47.8 %) patients had tuberculous pyomyositis. Seventy-seven patients (56.6 %) had intramuscular abscess. On multivariable analysis, bacterial pyomyositis was associated with diabetes mellitus (odds ratio [OR] 3.17, 95 % confidence interval [CI] 1.30–8.24) and bone marrow involvement (OR 5.02, 95 % CI 1.21–34.4). Spinal involvement had a significantly lower likelihood of bacterial pyomyositis (OR 0.25, 95 %CI 0.11–0.54). In patients with intramuscular abscess, diabetes mellitus and hyperintense on T2-weighted images at the abscess wall had a significantly higher likelihood of bacterial pyomyositis (OR 5.21, 95 %CI 1.33–25.42 and OR 5.34, 95 %CI 1.36–24.71, respectively), whereas spinal involvement had a significantly lower likelihood of bacterial pyomyositis (OR 0.09, 95 %CI 0.02–0.30). ConclusionsMagnetic resonance imaging has modest accuracy for differentiation of tuberculous and bacterial pyomyositis. Diabetes mellitus and extraspinal pyomyositis were the predictors of bacterial pyomyositis. Presence of T2 hyperintense wall of intramuscular abscess was also the predictor of bacterial pyomyositis.