Iron metabolism and ferroptosis in diabetic bone loss: from mechanism to therapy

Jiahao Bao; Yixuan Yan; Daihui Zuo; Zhiyong Zhuo; Tianhao Sun; Hongli Lin; Zheshen Han; Zhiyang Zhao; Hongbo Yu

doi:10.3389/fnut.2023.1178573

Iron metabolism and ferroptosis in diabetic bone loss: from mechanism to therapy

Front Nutr. 2023 May 5:10:1178573. doi: 10.3389/fnut.2023.1178573. eCollection 2023.

Authors

Jiahao Bao¹, Yixuan Yan², Daihui Zuo³, Zhiyong Zhuo³, Tianhao Sun⁴, Hongli Lin⁵, Zheshen Han⁵, Zhiyang Zhao¹, Hongbo Yu¹

Affiliations

¹ Department of Oral & Cranio-maxillofacial Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China.
² Guangdong Provincial Key Laboratory of Stomatology, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China.
³ Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, China.
⁴ Shenzhen Key Laboratory for Innovative Technology in Orthopaedic Trauma, Guangdong Engineering Technology Research Center for Orthopaedic Trauma Repair, Department of Orthopaedics and Traumatology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China.
⁵ School of Public Health, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China.

Abstract

Osteoporosis, one of the most serious and common complications of diabetes, has affected the quality of life of a large number of people in recent years. Although there are many studies on the mechanism of diabetic osteoporosis, the information is still limited and there is no consensus. Recently, researchers have proven that osteoporosis induced by diabetes mellitus may be connected to an abnormal iron metabolism and ferroptosis inside cells under high glucose situations. However, there are no comprehensive reviews reported. Understanding these mechanisms has important implications for the development and treatment of diabetic osteoporosis. Therefore, this review elaborates on the changes in bones under high glucose conditions, the consequences of an elevated glucose microenvironment on the associated cells, the impact of high glucose conditions on the iron metabolism of the associated cells, and the signaling pathways of the cells that may contribute to diabetic bone loss in the presence of an abnormal iron metabolism. Lastly, we also elucidate and discuss the therapeutic targets of diabetic bone loss with relevant medications which provides some inspiration for its cure.

Keywords: bone; diabetes; ferroptosis; iron metabolism; mechanism; osteoporosis.

Publication types

Review