Song Dawei, Wang Chenchen, Liang Jin, Jia Tingting
Department of Stomatology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.
School of Stomatology, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China.
Oral Dis. 2024 Apr;30(3):1583-1590. doi: 10.1111/odi.14600. Epub 2023 Jun 20.
The objectives of the study was to discuss the effect and mechanism of fluctuant glucose (FG) on implant osseointegration in type 2 diabetic mellitus (T2DM).
Rats were divided into control, T2DM and FG group, and the implants were inserted into their femurs. Micro-CT and histological analysis were used to evaluate the effect on osseointegration in vivo. And we investigated the effect of different conditions (normal, control, high glucose, and FG medium) on rat osteoblast in vitro. Then transmission electron microscope (TEM) and Western blot were used to evaluate the endoplasmic reticulum stress (ERS) response. Finally, 4-PBA, an inhibitor of ERS, was added into different conditions to observe the functions of osteoblast.
In vivo, Micro-CT and histological analysis showed that the percentage of osseointegration in FG rats were lower than other two group. In vitro, the results demonstrated that the adhesion of the cells becomes worst, and osteogenic ability was also severely impaired in FG group. In addition, FG could induce more serious ERS and 4-PBA could improve the dysfunction of osteoblasts induced by FG.
Fluctuant glucose could restrain the implant osseointegration in T2DM, and the effect was more obvious than consistent high glucose by a possible mechanism of activation ERS pathway.
本研究旨在探讨波动血糖（FG）对2型糖尿病（T2DM）患者种植体骨整合的影响及机制。
将大鼠分为对照组、T2DM组和FG组，将种植体植入大鼠股骨。采用显微CT和组织学分析评估体内骨整合情况。并研究不同条件（正常、对照、高糖和FG培养基）对大鼠成骨细胞的体外影响。然后用透射电子显微镜（TEM）和蛋白质免疫印迹法评估内质网应激（ERS）反应。最后，将ERS抑制剂4-苯基丁酸（4-PBA）加入不同条件下，观察成骨细胞的功能。
在体内，显微CT和组织学分析显示，FG大鼠的骨整合百分比低于其他两组。在体外，结果表明，FG组细胞的黏附能力最差，成骨能力也严重受损。此外，FG可诱导更严重的ERS，而4-PBA可改善FG诱导的成骨细胞功能障碍。
波动血糖可抑制T2DM患者种植体的骨整合，其作用可能通过激活ERS途径，比持续性高血糖更明显。
