The complex pathophysiology of bone fragility in obesity and type 2 diabetes mellitus: therapeutic targets to promote osteogenesis
Fractures associated with Type2 diabetes (T2DM) are major public health concerns in an increasingly obese and aging population. Patients with obesity or T2DM have normal or better than normal bone mineral density but at an increased risk for fractures. Hence it is crucial to understand the pathophys...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-07-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2023.1168687/full |
| _version_ | 1797770184082063360 |
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| author | Siresha Bathina Siresha Bathina Reina Armamento-Villareal Reina Armamento-Villareal |
| author_facet | Siresha Bathina Siresha Bathina Reina Armamento-Villareal Reina Armamento-Villareal |
| author_sort | Siresha Bathina |
| collection | DOAJ |
| description | Fractures associated with Type2 diabetes (T2DM) are major public health concerns in an increasingly obese and aging population. Patients with obesity or T2DM have normal or better than normal bone mineral density but at an increased risk for fractures. Hence it is crucial to understand the pathophysiology and mechanism of how T2DM and obesity result in altered bone physiology leading to increased fracture risk. Although enhanced osteoclast mediated bone resorption has been reported for these patients, the most notable observation among patients with T2DM is the reduction in bone formation from mostly dysfunction in osteoblast differentiation and survival. Studies have shown that obesity and T2DM are associated with increased adipogenesis which is most likely at the expense of reduced osteogenesis and myogenesis considering that adipocytes, osteoblasts, and myoblasts originate from the same progenitor cells. Furthermore, emerging data point to an inter-relationship between bone and metabolic homeostasis suggesting that these physiologic processes could be under the control of common regulatory pathways. Thus, this review aims to explore the complex mechanisms involved in lineage differentiation and their effect on bone pathophysiology in patients with obesity and T2DM along with an examination of potential novel pharmacological targets or a re-evaluation of existing drugs to improve bone homeostasis. |
| first_indexed | 2024-03-12T21:19:36Z |
| format | Article |
| id | doaj.art-4323465f74d14cadbcba5d3aa939f440 |
| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-03-12T21:19:36Z |
| publishDate | 2023-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-4323465f74d14cadbcba5d3aa939f4402023-07-28T22:07:33ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922023-07-011410.3389/fendo.2023.11686871168687The complex pathophysiology of bone fragility in obesity and type 2 diabetes mellitus: therapeutic targets to promote osteogenesisSiresha Bathina0Siresha Bathina1Reina Armamento-Villareal2Reina Armamento-Villareal3Division of Endocrinology Diabetes and Metabolism, Baylor College of Medicine, Houston, TX, United StatesCenter for Translational Research on Inflammatory Disease, Michael E. DeBakey Veterans Affairs (VA) Medical Center, Houston, TX, United StatesDivision of Endocrinology Diabetes and Metabolism, Baylor College of Medicine, Houston, TX, United StatesCenter for Translational Research on Inflammatory Disease, Michael E. DeBakey Veterans Affairs (VA) Medical Center, Houston, TX, United StatesFractures associated with Type2 diabetes (T2DM) are major public health concerns in an increasingly obese and aging population. Patients with obesity or T2DM have normal or better than normal bone mineral density but at an increased risk for fractures. Hence it is crucial to understand the pathophysiology and mechanism of how T2DM and obesity result in altered bone physiology leading to increased fracture risk. Although enhanced osteoclast mediated bone resorption has been reported for these patients, the most notable observation among patients with T2DM is the reduction in bone formation from mostly dysfunction in osteoblast differentiation and survival. Studies have shown that obesity and T2DM are associated with increased adipogenesis which is most likely at the expense of reduced osteogenesis and myogenesis considering that adipocytes, osteoblasts, and myoblasts originate from the same progenitor cells. Furthermore, emerging data point to an inter-relationship between bone and metabolic homeostasis suggesting that these physiologic processes could be under the control of common regulatory pathways. Thus, this review aims to explore the complex mechanisms involved in lineage differentiation and their effect on bone pathophysiology in patients with obesity and T2DM along with an examination of potential novel pharmacological targets or a re-evaluation of existing drugs to improve bone homeostasis.https://www.frontiersin.org/articles/10.3389/fendo.2023.1168687/fullobesitydiabetesadipogenesismyogenesisosteogenesis |
| spellingShingle | Siresha Bathina Siresha Bathina Reina Armamento-Villareal Reina Armamento-Villareal The complex pathophysiology of bone fragility in obesity and type 2 diabetes mellitus: therapeutic targets to promote osteogenesis Frontiers in Endocrinology obesity diabetes adipogenesis myogenesis osteogenesis |
| title | The complex pathophysiology of bone fragility in obesity and type 2 diabetes mellitus: therapeutic targets to promote osteogenesis |
| title_full | The complex pathophysiology of bone fragility in obesity and type 2 diabetes mellitus: therapeutic targets to promote osteogenesis |
| title_fullStr | The complex pathophysiology of bone fragility in obesity and type 2 diabetes mellitus: therapeutic targets to promote osteogenesis |
| title_full_unstemmed | The complex pathophysiology of bone fragility in obesity and type 2 diabetes mellitus: therapeutic targets to promote osteogenesis |
| title_short | The complex pathophysiology of bone fragility in obesity and type 2 diabetes mellitus: therapeutic targets to promote osteogenesis |
| title_sort | complex pathophysiology of bone fragility in obesity and type 2 diabetes mellitus therapeutic targets to promote osteogenesis |
| topic | obesity diabetes adipogenesis myogenesis osteogenesis |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2023.1168687/full |
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