| Abstract Scope |
Individuals with type 2 diabetes (T2D) counterintuitively have greater bone fracture risk despite normal or greater bone mineral density. Although the mechanisms that underlie bone fragility in T2D are not yet well established, factors including hyperglycemia, altered bone remodeling, and accumulation of advanced glycation endproducts (AGEs) in the bone are implicated. In this work we elucidate the factors that influence fragility in T2D by characterizing the biochemical, material, microarchitectural, and mechanical properties of bone from clinical populations of men and women with and without T2D. Across study populations, bone tissue from patients with T2D had greater concentrations of AGEs and mineral content, and trended toward a greater bone volume fraction than the non-DM specimens. Our data suggest that high concentrations of AGEs can increase fragility by reducing the ability of bone to absorb energy prior to failure, especially for the subset of T2D patients with low bone volume fraction. |