Analysis of bone quality in the elderly: effects of immobilization and type 2 diabetes mellitus as age-related risk factors

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Pathological changes in bone morphology and composition strongly influence bones fracture resistance. These changes gain importance with age since bone fractures are emerging as a major public health problem due to the expanding elderly population and increased life expectancies. Unraveling how skeletal aging accompanied by common concomitant conditions such as immobilization and type 2 diabetes mellitus alter the quality of bone tissue and influence its resistance to fracture is our important contemporary goal. The objective of the proposed research program is to identify and quantify relevant, measurable influences that amplify fracture risk in aged individuals.Bone quality is defined as the sum of all characteristics that contribute to the inherent fracture resistance of bone. In this context, the status of the bone cells, along with microstructure, mechanical properties and biochemical composition, play an important role since they actively contribute to the maintenance of bone quality. We will perform high-resolution analyses of the composition and structure of cortical bone from femora - a frequent fracture site. Samples will be obtained post mortem from tissue donors affected by immobilization and type 2 diabetes mellitus. With our targeted analysis of the individual hierarchical levels of bone, we aim to investigate the influences that endanger the stability, the strength and the resistance to fracture under immobilization and type 2 diabetes mellitus. Our goal is to examine the function and integrity of the cellular network and specifically focus on its relation to the mineral and collagen characteristics, thereby increasing the understanding of the complex multidimensional changes in aged individuals. The cross-disciplinary combination of clinical analytic tools and high-resolution characterization techniques in the proposed project can complement results from the clinics with valuable new findings. Thus, our work program will not only contribute to the advancement of the field of osteology but provide innovative perspectives for the search for new diagnostic tools and treatment options for elderly individuals with bone quality changes due to immobilization and type 2 diabetes mellitus.