The effects of local insulin delivery on diabetic fracture healing
The effects of local insulin delivery on diabetic fracture healing
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DOI：
10.1016/j.bone.2005.04.039
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发表时间：
2005-10-01
期刊：
影响因子：
4.1
通讯作者：
Lin, SS
中科院分区：
文献类型：
--
作者：
Gandhi, A;Beam, HA;Lin, SS
几项研究已经证明，糖尿病在临床和实验上都会损害骨愈合。全身性胰岛素治疗已被证明可以改善受损的糖尿病骨愈合。然而，这些研究未能区分胰岛素对骨愈合的直接作用和全身作用。将一种新的胰岛素髓内给药系统应用于糖尿病1313 Wistar股骨骨折模型，以探讨胰岛素对骨愈合的潜在直接影响。糖尿病骨折愈合早期(细胞增殖和软骨生成)和晚期(矿化组织、软骨含量和机械强度)参数正常化，而不影响血糖系统参数。这些结果表明，胰岛素在直接介导骨折愈合中起着关键作用，糖尿病状态下全身性胰岛素水平的降低会导致骨折部位局部胰岛素水平的降低，并伴随着糖尿病骨折愈合时间的延长。(C)2005 Elsevier Inc.保留所有权利。
Several studies have documented that diabetes impairs bone healing clinically and experimentally. Systemic insulin treatment has been shown to ameliorate impaired diabetic bone healing. However, these studies failed to distinguish between a direct and a systemic effect of insulin upon bone healing. A novel intramedullary insulin delivery system was used in the diabetic 1313 Wistar femur fracture model to investigate the potential direct effects of insulin on bone healing. Insulin delivery at the fracture site normalized the early (cellular proliferation and chondrogenesis) and late (mineralized tissue, cartilage content and mechanical strength) parameters of diabetic fracture healing without affecting the systemic parameters of blood glucose. These results suggest a critical role for insulin in directly mediating fracture healing and that decreased systemic insulin levels in the diabetic state lead to reduced localized insulin levels at fracture site with concomitant increases in diabetic fracture healing time. (c) 2005 Elsevier Inc. All rights reserved.