Format

Send to

Choose Destination
Curr Osteoporos Rep. 2019 Aug 7. doi: 10.1007/s11914-019-00528-8. [Epub ahead of print]

Peripheral Neuropathy as a Component of Skeletal Disease in Diabetes.

Author information

1
Department of Medicine, Division of Bone and Mineral Diseases, Washington University, 660 South Euclid Avenue, Saint Louis, MO, 63110, USA.
2
Department of Biomedical Engineering, Washington University, 6201 Forsyth Blvd, Saint Louis, MO, 63105, USA.
3
Department of Medicine, Division of Bone and Mineral Diseases, Washington University, 660 South Euclid Avenue, Saint Louis, MO, 63110, USA. scheller@wustl.edu.
4
Department of Biomedical Engineering, Washington University, 6201 Forsyth Blvd, Saint Louis, MO, 63105, USA. scheller@wustl.edu.
5
Department of Cell Biology and Physiology, Washington University, 660 South Euclid Avenue, Saint Louis, MO, 63110, USA. scheller@wustl.edu.

Abstract

PURPOSE OF REVIEW:

The goal of this review is to explore clinical associations between peripheral neuropathy and diabetic bone disease and to discuss how nerve dysfunction may contribute to dysregulation of bone metabolism, reduced bone quality, and fracture risk.

RECENT FINDINGS:

Diabetic neuropathy can decrease peripheral sensation (sensory neuropathy), impair motor coordination (motor neuropathy), and increase postural hypotension (autonomic neuropathy). Together, this can impair overall balance and increase the risk for falls and fractures. In addition, the peripheral nervous system has the potential to regulate bone metabolism directly through the action of local neurotransmitters on bone cells and indirectly through neuroregulation of the skeletal vascular supply. This review critically evaluates existing evidence for diabetic peripheral neuropathy as a risk factor or direct actor on bone disease. In addition, we address therapeutic and experimental considerations to guide patient care and future research evaluating the emerging relationship between diabetic neuropathy and bone health.

KEYWORDS:

Diabetes; Fracture; Marrow adiposity; Marrow fat; Metabolic bone disease; Microvascular disease; Neuropathy

PMID:
31392667
DOI:
10.1007/s11914-019-00528-8

Supplemental Content

Full text links

Icon for Springer
Loading ...
Support Center