TY - JOUR
T1 - Neuropathy and the vascular-bone axis in diabetes
T2 - Lessons from Charcot osteoarthropathy
AU - Petrova, N. L.
AU - Shanahan, C. M.
PY - 2013/10/3
Y1 - 2013/10/3
N2 - Emerging evidence from the last two decades has shown that vascular calcification (VC) is a regulated, cell-mediated process orchestrated by vascular smooth muscle cells (VSMCs) and that this process bears many similarities to bone mineralization. While many of the mechanisms driving VSMC calcification have been well established, it remains unclear what factors in specific disease states act to promote vascular calcification and in parallel, bone loss. Diabetes is a condition most commonly associated with VC and bone abnormalities. In this review, we describe how factors associated with the diabetic milieu impact on VSMCs, focusing on the role of oxidative stress, inflammation, impairment of the advanced glycation end product (AGE)/receptor for AGE system and, importantly, diabetic neuropathy. We also explore the link between bone and VC in diabetes with a specific emphasis on the receptor activator of nuclear factor κβ ligand/osteoprotegerin system. Finally, we describe what insights can be gleaned from studying Charcot osteoarthropathy, a rare complication of diabetic neuropathy, in which the occurrence of VC is frequent and where bone lysis is extreme.
AB - Emerging evidence from the last two decades has shown that vascular calcification (VC) is a regulated, cell-mediated process orchestrated by vascular smooth muscle cells (VSMCs) and that this process bears many similarities to bone mineralization. While many of the mechanisms driving VSMC calcification have been well established, it remains unclear what factors in specific disease states act to promote vascular calcification and in parallel, bone loss. Diabetes is a condition most commonly associated with VC and bone abnormalities. In this review, we describe how factors associated with the diabetic milieu impact on VSMCs, focusing on the role of oxidative stress, inflammation, impairment of the advanced glycation end product (AGE)/receptor for AGE system and, importantly, diabetic neuropathy. We also explore the link between bone and VC in diabetes with a specific emphasis on the receptor activator of nuclear factor κβ ligand/osteoprotegerin system. Finally, we describe what insights can be gleaned from studying Charcot osteoarthropathy, a rare complication of diabetic neuropathy, in which the occurrence of VC is frequent and where bone lysis is extreme.
KW - Bone fracture
KW - Charcot osteoarthropathy
KW - Diabetes
KW - Neuropathy
KW - RANKL/OPG
KW - Vascular calcification
UR - http://www.scopus.com/inward/record.url?scp=84897876113&partnerID=8YFLogxK
U2 - 10.1007/s00198-013-2511-6
DO - 10.1007/s00198-013-2511-6
M3 - Review article
C2 - 24091593
AN - SCOPUS:84897876113
SN - 0937-941X
VL - 25
SP - 1197
EP - 1207
JO - Osteoporosis International
JF - Osteoporosis International
IS - 4
ER -
