罗格列酮对OLETF大鼠股骨骨密度及成骨细胞BMP-2和Bcl-xL表达的影响
详细信息    本馆镜像全文|  推荐本文 |  |   获取CNKI官网全文
摘要
目的
     糖尿病(DM)是目前继心脏病、肿瘤严重危害人们健康的疾病,随着老龄化社会的到来,糖尿病发病率逐年增加。糖尿病性骨质疏松(DOP)属于继发性骨质疏松(OP),是DM最常见的一种并发症,伴随营养、代谢、内分泌等多因素的变化而发生的一系列病理性改变。
     OLETF鼠是一种自发性2型糖尿病大鼠,本实验以OLETF鼠作为2型糖尿病模型,以LETO鼠和摄入罗格列酮的OLETF鼠作为其对照,通过观察大鼠股骨病理变化、测定骨密度(BMD)及成骨细胞骨形成蛋白-2(BMP-2)、Bcl-xL表达水平,来探讨2型糖尿病本身对骨及罗格列酮对糖尿病大鼠骨的影响及特点。
     方法
     大鼠在无特定病原体(SPF)级条件下单笼饲养,饲以标准饲料,12/12h光照黑暗循环,自由获取食物和饮水。定期行口服葡萄糖耐量试验(OGTT)监测血糖,以血糖峰值>16.7mmol/L和负荷后120 min血糖>11.1mmol/L诊为糖尿病,只具备上述1条为糖耐量减低。至30周时,共有成模OLETF大鼠12只,随机分为糖尿病对照(DM)组、罗格列酮(RGZ)组(每组6只),8只LETO鼠为正常对照(NC)组。RGZ组:罗格列酮以蒸馏水溶解稀释,给药剂量为3mg/kg·d。DM组与NC组以等量蒸馏水灌胃,各组均灌胃给药12周,每日1次。
     处死大鼠,取大鼠离体的左右后肢股骨,仔细剥离表面附着的软组织,避免损伤骨表面。左后肢股骨用磷酸盐缓冲盐水浸湿的纱布包裹后-20℃保存备做BMD、骨胶原含量及骨灰干重比的检测。右后肢股骨置于10%中性福尔马林溶液中固定后用10%EDTA脱钙备做HE及成骨细胞BMP-2、Bcl-xL免疫组化染色。应用多媒体分析软件进行骨组织形态计量学分析,采用SPSS13.0软件进行统计学分析。
     结果
     1.大鼠一般状况比较:OLETF大鼠较LETO肥胖、活动迟缓、懒动、精神萎顿、少动闭眼、弓背蜷缩、喜扎堆、畏寒喜暖、毛色干枯无光泽。
     2.股骨BMD比较:与DM组[(0.198±0.011)g/cm2]相比,NC组BMD[(0.220±0.012)g/cm2]升高(P<0.01),RGZ组BMD[(0.172±0.012)g/cm2]降低(P<0.01)。
     3.骨灰干重比:与DM组(0.521±0.012)相比,NC组股骨灰干重比(0.538±0.018)升高(P<0.05),RGZ组(0.492±0.011)股骨灰干重比降低(P<0.01)。
     4.股骨脱钙状况比较:与DM组相比,NC组股骨脱钙时间延长,(骨重-脱钙后骨重)/骨重比值升高,相比有统计学意义(P<0.01)。而RGZ组相对于DM组脱钙时间缩短,(骨重-脱钙后骨重)/骨重比值降低,相比有统计学意义(P<0.05)。
     5.空骨细胞陷窝率、成骨细胞(OB)和破骨细胞(OC)计数变化:与DM组相比,NC组空骨细胞陷窝率及OC计数降低(P<0.01或P<0.05),OB计数升高(P<0.01)。RGZ组相对于DM组空骨细胞陷窝率及OC计数升高(P<0.01),OB计数降低(P<0.05)。
     6.股骨胶原含量比较:与DM组[(185.60±19.38)mg/g]相比,NC组股骨胶原含量[(243.27±22.19)mg/g]升高(P<0.01),RGZ组[(158.81±17.65)mg/g降低(P<0.05)。
     7.成骨细胞Bcl-xL表达变化:与DM组(84.83±10.82)相比,NC组成骨细胞Bcl-xL阳性表达平均灰度值(69.13±11.56)降低(P<0.05),RGZ组成骨细胞Bcl-xL阳性表达平均灰度值(110.17±15.33)升高(P<0.01)。
     8.成骨细胞BMP-2表达变化:RGZ组成骨细胞BMP-2阳性表达的吸光度值(0.4247±0.0321)明显低于DM组(0.4886±0.0398),而DM组阳性表达的吸光度值明显低于NC组(0.5571±0.0402),结果有统计学意义(P<0.01)。
     结论
     1.该模型大鼠明显肥胖,可作为研究2型糖尿病骨代谢紊乱的理想动物模型。
     2.糖尿病状态下大鼠表现为骨密度和骨量减少,大鼠可出现明显的骨组织形态结构异常,成骨细胞功能障碍可能是糖尿病骨代谢失衡的主要机制,但破骨细胞也可能参与其中。
     3.该糖尿病模型大鼠存在骨胶原代谢异常和结构紊乱,前者表现为骨胶原的合成及含量减少,后者表现为骨胶原连续性差且排列不整齐。骨胶原代谢异常可能与成骨细胞数量下降或功能障碍相关。
     4.罗格列酮对自发肥胖型2型糖尿病大鼠股骨有加重损害作用,提示我们在临床上用药时要关注其对骨的有害作用。
Objective
     Diabetes is seriously endangering people's health, and the disease is currently following heart disease and cancer. With the advent of an aging society, the incidence of diabetes has increased over year by year. Diabetes osteoporosis(DOP) are secondary OP. DOP is one of the most common complications of diabetes mellitus(DM), which is often along with the series of pathological changes.
     OLETF rats are a spontaneous type 2 diabetic model. LETO rats and OLETF rats which were taken rosiglitazone, were enrolled as controls, respectively. Bone histomorphometric, bone mineral density (BMD) and the expression of bone morphogenetic protein-2 (BMP-2) and Bcl-xL of osteoblast were observed to seek the possible mechanism for bone metabolic disturbance.
     Methods
     Blood glucose was determined by oral glucose tolerance test (OGTT) for 20 male OLETF rats. The diabetes was confirmed with blood glucose peak level>16.7 mmol/L and blood glucose level>11.1 mmol/L taken glucose 120 minutes later. After 30 weeks,12 T2DM OLETF rats were randomly divided into diabetes mellitus control (DM) group and rosiglitazone (RGZ) group (n=6 per group). Eight male LETO rats were used as a normal control (NC) group. DM group and NC group were watered intragastrically for 12 weeks. RGZ group was taken the rosiglitazone (3mg/kg-d) intragastrically for 12 weeks.
     After the rats were sacrificed, their left and right femurs were severed completely, and peeled soft tissue carefully. The left femurs covered with isotonic saline gauze were in -20℃refrigerator for measuring BMD, bone collagen and the ratio of ash weight to dry weight of femur. The right femurs within 10% formaldehyde solution were in 4℃refrigerator for observating the expression of BMP-2 and Bcl-xL of osteoblast.
     BMD at the femur was assessed by dual energy X-ray absorption (DEXA). Make right side of the femur into microtome section after the process of immobility and decalcification. Observe their pathological change by using optical microscope and detect the expression of BMP-2, Bcl-xL in osteoblast through making use of immunohistochemistry. All results were performed with analysis software for multimedia pathological image.
     Results
     1. Obervation of the general conditions of rats
     OLETF rats drank much, ate much, had polyuria and felt significantly bleak, and were dull coat. The spirit of OLETF rats was worse than LETO rats. LETO rats' drinking and eating were normal.
     2. Comparison of BMD in femurs among three groups of rats
     Compared with the DM group [(0.198±0.011) g/cm2], NC group [(0.220±0.012) g/cm2] had higher BMD (P<0.01), and RGZ group [(0.172±0.012) g/cm2] had significantly lower (P<0.01).
     3. Comparison of the ratio of ash weight to dry weight in femur among three groups of rats
     Compared with the DM group (0.521±0.012), NC group (0.538±0.018) had higher ratio of ash weight to dry weight of femur (P<0.05), and RGZ group (0.492±0.011) had significantly lower (P<0.01).
     4. Comparison of the decalcification condition in femurs among three groups of rats
     Compared with the DM group, NC group had significantly longer decalcification time of femurs and (bone weight - bone weight after decalcification)/bone weight (P<0.01); RGZ group had lower (P<0.05).
     5. Comparison of the empty osteocyte lacunae ratios, the amount of osteoblast (OB) and osteoclast (OC) in femur among three groups of rats
     Compared with the DM group, NC group had higher amount of OB (P<0.01), and had lower empty osteocyte lacunae ratios and amount of OC (P<0.05 or P<0.01); RGZ group had lower amount of OB (P<0.05), and had higher empty osteocyte lacunae ratios and amount of OC(P<0.01).
     6. Comparison of collagen in femur among three groups of rats
     Compared with the DM group[(185.60±19.38)mg/g], NC group[(243.27±22.19)mg/g] had higher content of collagen(P<0.01); RGZ group[(158.81±17.65)mg/g] had lower(P<0.05).
     7. Comparison of the expression of Bcl-xL in osteoblasts among three groups of rats
     Compared with the DM group(84.83±10.82), NC group(69.13±11.56) had higher the intensity of positive expression of Bcl-xL(P<0.05); RGZ group(110.17±15.33) had lower(P<0.01).
     8. Comparison of the expression of BMP-2 in osteoblast among three groups of rats
     Compared with the DM group (0.4886±0.0398), NC group (0.5571±0.0402) had higher intensity of positive expression of BMP-2(P<0.01); RGZ group(0.424 7±0.0321) had lower(P<0.01).
     Conclusions
     1. The rat model is obesity, and can be the ideal animal model for study on abnormality of bone metabolism under type 2 diabetes.
     2. The diabetic rats have decreased BMD and bone mass. The dysfunction of osteoblasts might be the major mechanism for bone metabolic disturbance under diabetic status, in which osteoclasts may involve.
     3. The bone collagen of T2DM's rats is different from that of rats without T2DM. The metabolism of bone collagen is abnormal and the structures of bone collagen are confused in T2DM's rats. The former presents that the content and synthesis of bone collagen is reduced. The latter presents that the continuity of bone collagen is bad and the alinement of it is untidy.
     4. Rosiglitazone increases the damage effect on the femurs in OLETF rats.
引文
[1]Warriner AH, Patkar NM, Curtis JR, et al. Which fractures are most attributable to osteoporosis [J]. J Clin Epidemiol,2011,64(1):46-53.
    [2]Francucci CM, Ceccoli L, Caudarella R, et al. Skeletal effect of natural early menopause [J]. J Endocrinol Invest,2010,33(7 Suppl):39-44.
    [3]Karunanayake AL, Pinidiyapathirage MJ, Wickremasinghe AR. Prevalence and predictors of osteoporosis in an urban Sri Lankan population [J]. Int J Rheum Dis,2010,13(4):385-390.
    [4]Lin Y, Sun Z. Current views on type 2 diabetes[J]. J Endocrinol,2010, 204(1):1-11.
    [5]Yano S, Sugimoto T. Fracture risk in secondary osteoporosis [J]. Clin Calcium, 2010,20(9):1369-1377.
    [6]Esteves J, Laranjeira AF, Roggia MF, et al. Diabetic retinopathy risk factors[J]. Arq Bras Endocrinol Metabol,2008,52(3):431-441.
    [7]Okazaki R. Management of osteoporosis in diabetes mellitus[J]. Nippon Rinsho, 2009,67(5):1003-1010.
    [8]Li M, Pan LC, Simmon HA, et al. Surface-specific effects of a PPAR y agonist, darglitazone, on bone in mice [J]. Bone,2006,39(4):796-806.
    [9]Glintborg D, Andersen M, Hagen C, et al. Association of pioglitazone treatment with decreased bone mineral density in obese premenopausal patients with polycystic ovary syndrome:a randomized, placebo-controlled trial[J]. J Clin Endocrinol Metab,2008,93(5):1696-1701.
    [10]向雪松,王竹,祝宇铭,等.链脲佐菌素注射剂量对建立2型糖尿病大鼠模型的影响[J].卫生研究,2010,39(2):138-142.
    [11]邓棋卫,陈文,刘玲贞,等.白羽连玉合剂对四氧嘧啶诱导的大鼠糖尿病作用的实验研究[J].时珍国医国药,2010,21(8):1910-1911.
    [12]Moran TH. Unraveling the obesity of OLETF rats [J]. Physiol Behav,2008, 94(1):71-78.
    [13]Mori S, Kawano K, Hirashima T, et al. Relationships between diet control and the development of spontaneous type 2 diabetes and diabetic nephropathy in OLETF rats[J]. Diabetic Res Clin Prac,1996,33(3):145-152.
    [14]Kessabi K, Kerknni A, Said K, et al. Involvement of cd bioaccumulation in spinal deformities occurrence in natural populations of Mediterranean killifish[J]. Biol Trace Elem Res,2009,128(1):72-81.
    [15]Kasiyaphat A, Siriviriyakul P, Patumraj S. Preventive effects of genistein on leukocyte adhesion in femur venules and on bone-loss induced in ovariectomized female rats [J]. Clin Hemorheol Microcirc,2008,38(4):235-243.
    [16]Park S, Sang Mee Hong, Ⅱ Sung Ahn, et al. Olanzapine, not resperidone, exacerbates beta-cell function and mass in ovariectomized diabetic rats and estrogen replacement reverses them[J]. J Psychopharmacol,2010,24 (7):1105-1114.
    [17]Rodrigues G, Marcolin E, Bona S, et al. Hepatics alterations and genotoxic effects of Croton cajucara Benth (SACACA) in diabetic rats [J]. Arq Gastroenterol,2010,47(3):301-305.
    [18]Kruger AJ, Yang C, Tam SW, et al. Haptoglobin as an early serum biomarker of virus-induced autoimmune type 1 diabetes in biobreeding diabetes resistant and LEW1.WR1 rats [J]. Exp Biol Med (Maywood),2010,235(11):1328-1337.
    [19]Asaf R, Blum S, Roguin A, et al. Haptoglobin genotype is a determinant of survival and cardiac remodeling after myocardial infarction in diabetic mice [J]. Cardiovasc Diabetol,2009,8:29.
    [20]Nie J, DuBois DC, Jusko WJ, et al. Mechanistic population modeling of diabetes disease progression in Goto-Kakizaki rat muscle [J]. Biopharm Drug Dispos, 2011,32(1):50-63.
    [21]Schroeder M, Zagoory-Sharon O, Shbiro L, et al. Development of obesity in the Otsuka Long-Evans Tokushima Fatty rat [J]. Am J Physiol Regul Integr Comp Physiol,2009,297(6):R1749-1760.
    [22]Schroeder M, Shbiro L, Zagoory-Sharon O, et al. Toward an animal model of childhood-onset obesity:follow-up of OLETF rats during pregnancy and lactation [J]. Am J Physiol Regul Integr Comp Physiol,2009,296(2):R224-232.
    [23]Ko EA, Park WS, Firth AL, et al. Increased sensitivity of serotonin on the voltage-dependent K+ channels in mesenteric arterial smooth muscle cells of OLETF rats[J]. Prog Biophys Mol Biol,2010,103(1):88-94.
    [24]Ganta DR, McCarthy MB, Gronowicz GA. A scorbic acid alters collagen integrins in bone culture [J]. Endocrinology,1997,138(9):3606-3612.
    [25]Leber B, Lin J, Andrews DW. Still embedded together bingind to membranes regulates Bcl-2 protein interactions [J]. Oncogene,2010,29(38):5221-5230.
    [26]Cao G, Pei W, Ge H, et al. In vivo delivery of a Bcl-x L fusion protein containing the TAT protein transduction domain protects against ischemic brain injury and neuronal apoptosis[J]. J Neurosci,2002,22(13):5423-5431.
    [27]Leber B, Lin J, Andrews DW. Still embedded together binding to membranes regulates Bcl-2 protein interactions [J]. Oncogene,2010,29(38):5221-5230.
    [28]Gronowics G, McCarthy M, Zhang H, et al. Insulin-like growth fathor Ⅱ induces apoptosis in osteoblast[J]. Bone,2004,35(3):621-628.
    [29]Hock JM, Krishnan V, Oniys JE, et al. Osteoblast apoptosis and bone turnover [J]. J Bone Miner Res,2001,16(6):975-984.
    [30]Chen RM, Chen TL, Chiu WT, et al. Molecular mechanism of nitric oxide-induced osteoblast apoptosis [J]. J Orthop Res,2005,23(2):462-468.
    [31]Lin Y, Martin J, Gruendler C, et al. A Novel Link between the Proteasome Pathway and the Signal Transduction Pathway of the Bone Morphogenetic Proteins(BMPs)[J]. BMC Cell Biology,2002,3:15.
    [32]Pountos I, Georgouli T, Henshaw K, et al. The effect of bone morphogenetic protein-2, bone morphogenetic protein-7, parathyroid hormone, and platelet-derived growth factor on the proliferation and osteogenic differentiation of mesenchymal stem cells derived from osteoporotic bone [J]. J Orthop Trauma, 2010,24(9):552-556.
    [33]Spinella-Jaegle S, Roman-Roman S, Faucheu C, et al. Opposite effects of bone morphogenetic protein-2 and transforming growth factor-β1 on osteoblast differentiation [J]. Bone,2001,29(4):323-330.
    [34]Guicheux J, Lemonnier J, Ghayor C, et al. Activation of p38 mitogen-activated protein kinase and C-Jun-NH2-terminal kinase by BMP-2 and their implication in the stimulation of osteoblastic cell differentiaion[J]. J Bone Miner Res,2003, 18(11):2060-2068.
    [35]张勇,马平,刘健,等.去势大鼠骨中BMP-2、BMP-7基因表达[J].第四军医大学学报,2000,21(1):125-126.
    [36]Wang W, Li S, Niu D. Study on relationship between osteoporosis and mRNA expressions of vascular endothelial growth factor and bone morphogenetic protein 2 in nontraumatic avascular necrosis of femoral head [J]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi,2010,24(9):1072-1077.
    [37]Yaturu S, Humphrey S, Landry C, et al. Decreased bone mineral density in men with metabolic syndrome alone and with type 2 diabetes [J]. Med Sci Monit, 2009,15(1):CR5-9.
    [38]Gupta R, Mohammed AM, Mojiminiyi OA, et al. Bone mineral density in premenopausal arab women with type 2 diabetes mellitus[J]. J Clin Densitom, 2009,12(1):54-57.
    [39]Anaforoglu I, Nar-Demirer A, Bascil-Tutuncu N, et al.Prevalence of osteoporosis and factors affecting bone mineral density among postmenopausal Turkish women with type 2 diabetes [J]. J Diabetes Complications,2009, 23(1):12-17.
    [40]Alikhani M, Alikhani Z, Boyd C, et al. Advanced glycation end products stimulate osteoblast apoptosis via the MAP kinase and cytosolic apoptotic pathways [J]. Bone,2007,40(2):345-353.
    [41]Duarte VM, Ramos AM, Rezende LA, et al. Osteopenia:a bone disorder associated with diabetes mellitus[J]. J Bone Miner Metab,2005,23(1):58-68.
    [42]Botolin S, McCabe LR. Chronic hyperglycemia modulates osteoblast gene expression through osmotic and non-osmotic pathways [J]. J Cell Biochem, 2006,99(2):411-424.
    [43]Liu R, Bal HS, Desta T, et al. Diabetes enhances periodontal bone loss through enhanced resorption and diminished bone formation [J]. J Dent Res,2006, 85(6):510-514.
    [44]Li H, Telemaque S, Miller RE, et al. High glucose inhibits apoptosis induced by serum deprivation in vascular smooth muscle cells via upregulation of Bcl-2 and Bcl-xl[J]. Diabetes,2005,54(2):540-545.
    [45]Surdykowski AK, Kenny AM, Insogna KL, et al. Optimizing bone health in older adults:the importance of dietary protein [J]. Aging health,2010, 6(3):345-357.
    [46]Canalis E. Update in new anabolic therapies for osteoporosis[J]. J Clin Endocrinol Metab,2010,95(4):1496-504.
    [47]Bilik D, McEwen LN, Brown MB, et al. Thiazolidinediones and fractures: evidence from translating research into action for diabetes [J]. J Clin Endocrinol Metab,2010,95(10):4560-4565.
    [48]Habib ZA, Havstad SL, Wells K, et al. Thiazolidinedione use and the longitudinal risk of fractures in patients with type 2 diabetes mellitus [J]. J Clin Endocrinol Metab,2010,95(2):592-600.
    [49]Lecka-Czernik B. Bone loss in diabetes:use of antidiabetic thiazolidinediones and secondary osteoporosis [J]. Curr Osteoporos Rep,2010,8(4):178-184.
    [50]Lecka CB, Ackert BC, Adamo ML, et al. Activation of peroxisome proliferators-activated receptor γ (PPAR γ) by rosiglitazone suppresses components of the insulin-like growth factor regulatory system in vitro and in vivo[J]. Endocrinology,2007,148(2):903-911.
    [51]Lin TH, Yang RS, Tang CH, et al. PPARgamma inhibits osteogenesis via the down-regulation of the expression of COX-2 and iNOS in rats [J]. Bone,2007, 41(4):562-574.
    [52]Grey A, Bolland M, Gamble G, et al. The peroxisome proliferator-activated receptor-gamma agonist rosiglitazone decreases bone formation and bone mineral density in healthy postmenopausal women:a randomized, controlled trial [J]. J Clin Endocrinol Metab,2007,92(4):1305-1310.
    [53]Lazarenko OP, Rzonca SO, Hogue WR, et al. Rosiglitazone induces decreases in bone mass and strength that are reminiscent of aged bone [J]. Endocrinology, 2007,148(6):2669-2680.
    [54]Rhee EJ, Oh KW, Lee WY, et al. The effects of C161-T polymorphisms in exon 6 of peroxisome proliferator-activated receptor-ygene on bone mineral metabolism and serum osteoprotegerin levels in healthy middle-aged women [J]. Am J Obstet Gynecol,2005,192(1):1087-1093.
    [55]David V, Martin A, Lafage-Proust MH, et al. Mechanical loading down-regulates peroxisome proliferator-activated receptor in bone marrow stromal cells and favors osteoblast ogenesis at the expense of adipogenesis [J]. Endocrinology, 2007,148(5):2553-2562.
    [56]Lazarenko OP, Rzonca SO, Suva LJ, et al. Netoglitazone is a PPAR-gamma ligand with selective effects on bone and fat [J]. Bone,2006,38(1):74-84.
    [1]Yaturu S, Humphrey S, Landry C, et al. Decreased bone mineral density in men with metabolic syndrome alone and with type 2 diabetes[J]. Med Sci Monit, 2009,15(1):CR5-9.
    [2]Gupta R, Mohammed AM, Mojiminiyi OA, et al. Bone mineral density in premenopausal arab women with type 2 diabetes mellitus[J]. J Clin Densitom,2009,12(1):54-57.
    [3]Anaforoglu I, Nar-Demirer A, Bascil-Tutuncu N, et al. Prevalence of osteoporosis and factors affecting bone mineral density among postmenopausal Turkish women with type 2 diabetes[J]. J Diabetes Complications,2009,23(1):12-17.
    [4]甘利萍,陈治卿,蒋广恩,等.老年糖尿病并骨质疏松血胰岛素与骨钙素及PTH研究[J],中国骨质疏松杂志,2008,14(10):700-703.
    [5]Durarte VM, Ramos AM, Rezende LA, et al. Osteopenia:a bone disorder associated with diabetes mellitus[J]. J Bone Miner Metab,2005,23(1):58-68.
    [6]Vestergaard P, Rejnmark L, Mosekilde L. Diabetes and its complications and their relationship with risk of fractures in type 1 and 2 diabetes[J]. Calcif Tissue Int, 2009,84(1):45-55.
    [7]Alikhani M, Alikhani Z, Boyd C, et al. Advanced glycation end products stimulate osteoblast apoptosis via the MAP kinase and cytosolic apoptotic pathways[J]. Bone,2007,40(2):345-353.
    [8]Wang X, Shen X, Li X, et al. Age-related changes in the collagen network and toughness of bone[J]. Bone,2002,31(1):1-7.
    [9]Ding KH, Wang ZZ, HamrickMW, et al. Disordered osteoclast formation in RAGE-deficient mouse establishes an essential role for RAGE in diabetes related bone loss[J]. Biochem Biophys Res Commun,2006,340(4):1091-1097.
    [10]Miao D, He B, Jiang Y, et al. Osteoblast-derived PTHrP is a potent endogenous bone anabolic agent that modifies the therapeutic efficacy of administered PTH1-34[J]. J Clin Invest,2005,115(9):2402-2411.
    [11]Botolin S, McCabe LR. Chronic hyperglycemia modulates osteoblast gene expression through osmotic and non-osmotic pathways[J]. J Cell Biochem, 2006,99(2):411-424.
    [12]Liu R, Bal HS, Desta T, et al. Diabetes enhances periodontal bone loss through enhanced resorption and diminished bone formation[J]. J Dent Res,2006,85(6): 510-514.
    [13]Lu H, Kraut D, Gerstenfeld LC, et al. Diabetes interferes with the bone formation by affecting the expression of transcription factors that regulate osteoblast differentiation[J]. Endocrinology,2003,144(1):346-352.
    [14]Fang Y, Wang ZY, Mao Y, et al. Effects of insulin-like growth factor I on the development of osteoblasts in hyperglycemia[J]. Diabetes Res Clin Pract,2006, 73 (1):95-97.
    [15]Khosla S, Amin S, Orwoll E. Osteoporosis in men[J]. Endocr Rev,2008, 29(4):441-464.
    [16]Bales CW, Buhr G. Is obesity bad for older persons? A systematic review of the pros and cons of weight reduction in later life[J]. J Am Med Dir Assoc,2008,9 (5):302-312.
    [17]Shan PF, Wu XP, Zhang H, et al. Bone mineral density and its relationship with body mass index in postmenopausal women with type 2 diabetes mellitus in mainland China[J]. J Bone Miner Metab,2009,27 (2):190-197.
    [18]Hamrick MW. Perspectives:leptin and bone:a consensus emerging? Bone K ey-Osteovision,2007,4 (2007):99-107.
    [19]Kusakabe T, Tanioka H, Ebihara K, et al. Beneficial effects of leptin on glycaemic and lipid control in a mouse model of type 2 diabetes with increased adiposity induced by streptozotocin and a high-fat diet[J]. Diabetologia, 2009,52(4):675-683.
    [20]Uchida T, Nakamura T, Hashimoto N, et al. Deletion of Cdknlb ameliorates hyperglycemia by maintaining compensatory hyperinsulinemia in diabetic mice. Nat Med,2005,11 (2):175-182.
    [21]Knudsen ST, Jeppesen P, Poulsen PL, et al. Plasma concentrations of osteoprotegerin during normo-and hyperglycaemic clamping[J]. Scand J Clin Lab Invest,2007,67(2):135-142.
    [22]Stan worth RD, Jones TH. Testosterone in obesity, metabolic syndrome and type 2 diabetes[J]. Front Horm Res,2009,37:74-90.
    [23]Fukui M, Ose H, Nakayama I, et al. Association between serum testosterone concentration and collagen degradation fragments in men with type 2 diabetes mellitus[J]. Metabolism,2007,56(9):1228-1232.
    [24]Colangelo LA, Ouyang P, Liu K, et al. Association of endogenous sex hormones with diabetes and impaired fasting glucose in men:the multi-ethnic study of atherosclerosis[J]. Diabetes Care,2009,32(6):1049-1051.
    [25]Stern A, Laughlin GA, Bergstrom J, et al. The sex-specific association of serum osteoprotegerin and receptor activator of nuclear factor kappa B legend with bone mineral density in older adults:the Rancho Bernardo study[J]. Eur J Endocrinol,2007,156(5):555-562.
    [26]Melton LJ 3rd, Leibson CL, Achenbach SJ, et al. Fracture risk in type 2 diabetes: update of a population-based study[J]. J Bone Miner Res,2008, 23(8):1334-1342.
    [27]Lin J, Hu FB, Qi L, et al. Genetic polymorphisms of angiotensin-2 type 1 receptor and angiotensinogen and risk of renal dysfunction and coronary heart disease in type 2 diabetes mellitus[J]. BMC Nephrol,2009,10(1):9-16.
    [28]关美萍,薛耀明,张倩,等.雌激素受体基因多态性与2型糖尿病患者骨密度的关系[J].中国临床康复,2003,7(15):2140-2141.
    [29]Hu G, Jousilahti P, Tuomilehto J, et al. Association of serum c-reactive protein level with sex-specific type 2 diabetes risk:a prospective finnish study[J]. J Clin Endocrinol Metab,2009,94(6):2099-2105.
    [30]Tomiyama H, Okazaki R, Koji Y, el al. Elevated C-reactive protein:a common marker for atheroselerotie eardiovaseular risk and subclinical stages of pulmonary dysfunction and mteopenia in a healthy population [J]. Atheroselerosis,2005,178(1):187-192.
    [31]Park S, Rich J, Hanses F, et al. Defects in innate immunity predispose C57BL/6J-Leprdb/Leprdb mice to infection by Staphylococcus aureus[J]. Infect Immun,2009,77(3):1008-1014.
    [32]Stolar MW, Hoogwerf BJ, Gorshow SM, et al. Managing type 2 diabetes:going beyond glycemic control [J]. J Manag Care Pharm,2008,14(5):s2-19.
    [33]Syversen U, Stunes Ak, Gustafsson BI, et al. Different skeletal effects of the peroxisome proliferator activated receptor (PPAR) alpha agonist fenofibrate and the PPAR gamma agonist pioglitazone[J]. BMC Endocr Disord,2009,9:10-22.
    [34]Kawashima Y, Fritton JC, Yakar S, et al. Type 2 diabetic mice demonstrate slender long bones with increased fragility secondary to increased osteoclastogenesis[J]. Bone,2009,44(4):648-655.
    [35]Ali AA, Weinstein RS, Stewart SA, et al. Rosiglitazone causes bone loss in mice by suppressing osteoblast differentiation and bone formation [J]. Endocrinology, 2005,146(3):1226-1235.
    [36]Stentz FB, Kitabchi AE. Activated Tlymphocytes in Type 2 diabetes: implications from in vitro studies [J]. Curent Drug Targets,2003,4(6):493-503.
    [37]Majima T, Komatsu Y, Yamada T, et al. Decreased bone mineral density at the distal radius, but not at the lumbar spine or the fem-oral neck, in Japanese type 2 diabetic patients [J]. Osteoporos Int,2005,16(8):907-913.
    [38]Khattab M, Khader YS, A1-Khawaldeh A, et al. Factors associated with poor glycemic control among patients with Type 2 diabetes[J]. J Diabetes Complications,2010,24(2):84-89.
    [39]Nisar N, Qadri MH, Fatima K, et al. Dietary habits and life style among the students of a private medical university Karachi [J]. J Pak Med Assoc,2009, 59(2):98-101.
    [40]Adami S. Bone health in diabetes:considerations for clinical management [J]. Curr Med Res Opin,2009,25(5):1057-1072.
    [41]Nicodemus KK, Folsom AR, Iowa Women's Health study. Type 1 and type 2 diabetes and incident hip fractures in postmenopausal women [J]. Diabetes Care, 2001,24(7):1192-1197.
    [42]Hofbauer LC, Brueck CC, Singh SK, et al. Osteoporosis in patients with diabetes mellitus. J Bone Miner Res,2007,22(9):1317-1328.

© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号

地址:北京市海淀区学院路29号 邮编:100083

电话:办公室:(+86 10)66554848;文献借阅、咨询服务、科技查新:66554700