“缺氧-高糖”轴对糖尿病性骨质疏松症的影响机制

The mechanism of hypoxia-hyperglycemia axis in diabetic osteoporosis

糖尿病和骨质疏松症均是与衰老紧密相关的全身慢性代谢性疾病,低转换性骨代谢的骨强度降低伴随着糖尿病的发生发展,二者具有相互促进的表型特征:即由衰老、高糖缺氧引起的代谢失调导致了临床常见的糖尿病性骨质疏松症的发生。衰老的本质是机体抗氧化能力的下降,高糖诱导不仅可以加速各类细胞的衰老进程,还可以通过增加细胞线粒体活性氧水平破坏细胞线粒体动力学平衡而造成氧化应激,最终导致细胞损伤。而氧化应激作为糖尿病和骨质疏松症的共病机制,缺氧诱导因子1α在建立“缺氧-高糖轴”上的糖尿病性骨质疏松症的过程中发挥着不可小觑的作用,因此笔者通过“缺氧-高糖”轴的糖尿病性骨质疏松症的氧化应激机制进行探讨,为本病的临床防治提供新思路。

Diabetes and osteoporosis are systemic chronic metabolic diseases closely related to aging. The decrease of bone strength and low turnover bone metabolism are accompanied by the occurrence and development of diabetes. They have mutually reinforcing phenotypic characteristics, i.e., metabolic disorders caused by aging, high glucose, and hypoxia, leading to the occurrence of diabetic osteoporosis. The essence of aging is the decline of antioxidant capacity of the body. High glucose induction not only accelerates the aging process of all kinds of cells, but also causes oxidative stress by increasing the level of reactive oxygen species in cell mitochondria and by destroying the dynamic balance of cell mitochondria, eventually leads to cell damage. As the co-disease mechanism of diabetes and osteoporosis, hypoxia inducible factor-1α plays an important role in the establishment of diabetic osteoporosis in the hypoxia-hyperglycemia axis. Therefore, the author discusses the oxidative stress mechanism of diabetic osteoporosis based on the hypoxia-hyperglycemia axis in order to provide new ideas for the clinical prevention and treatment of the disease.