糖尿病防治新理念——从骨骼入手

Focusing on bone--new means for the management of diabetes

近年来，越来越多的研究显示骨骼可能成为糖尿病防治的另一重要靶器官。来自成骨细胞的骨钙素是一种具有糖脂代谢调节功能的骨骼因子，能促进胰岛素分泌、增强胰岛素敏感性、促进葡萄糖及脂肪酸的摄取及利用。脂质转运蛋白2是另一个由成骨细胞分泌、抑制食欲作用的骨骼因子。成骨细胞来源的神经肽Y在调节白色脂肪棕色化、产热方面可能具有一定作用。骨细胞通过分泌骨形态发生蛋白7和骨硬化蛋白，调节白色脂肪棕色化及机体能量消耗。破骨细胞活性是骨骼参与糖脂代谢的重要一环。除此之外，来源于骨骼的核因子κb受体激活剂配体在能量代谢中的作用亦不容忽视。本文就目前骨骼因子对能量代谢影响的基础和临床研究进行全面综述，并探讨其用于2型糖尿病防治的可能性。

In the past decade, mounting evidence points to the possibility of targeting bone for treating, preventing, and predicting type 2 diabetes mellitus. Osteoblast-derived osteocalcin （OCN） can stimulate insulin secretion, enhance insulin sensitivity, and favor glucose and fatty acid uptake and utilization. Lipocalin 2 is another osteokine secreted by osteoblasts and acts in appetite suppression. Neuropeptide Y may function in browning of white adipose tissue and energy expenditure. Osteocytes are proposed to have impact on the browning of white adipose tissue and energy expenditure through the secretion of bone morphogenetic protein 7 and sclerostin. Active bone resorption is also implicated in glucose homeostasis. In addition, there is evidence indicating the involvement of bone-derived receptor activator of nuclear factor κ-B ligand in the regulation of energy metabolism. We collect and summarize recent advances and the rationales for treating, preventing, and predicting diabetes by targeting skeleton.