Research Progress of Exercise Regulating Signaling Pathway of Diabetic Osteopathy

Diabetes is a chronic metabolic disease characterized by hyperglycemia. Patients with long-term type 1 and type 2 diabetes mellitus can develop skeletal complications or “diabetic osteopathy” including osteopenia, osteoporosis, osteoarthropathy and an increased incidence of low-stress fractures. AMPK (adenosine monophosphate-activated protein kinase), mTOR (mechanistic target of rapamycin) and FoxO (fork-head box O transcription factor) play important regulatory roles in glycolipid metabolism and bone metabolism. AMPK is the upstream regulator of mTOR and FoxO. Both AMPK and PI3K/Akt can regulate mTOR and FoxO1. Energy consumption is one of the stimulating factors to activate PI3K/Akt, that is, the change of AMP/ATP ratio can activate PI3K/Akt. Exercise can mediate the above three pathways to regulate diabetic bone disease, but different forms and loads of exercise have different effects on diabetic bone disease-related signaling pathways, in which exercise intensity is the key factor. This paper summarizes the regulation mechanism of these three factors in diabetic osteopathy and discusses the influence of exercise-mediated three factors on diabetic osteopathy, providing a new theoretical basis for the prevention and treatment of diabetic osteopathy.

CSTR: 32200.14.cjcb.2021.05.0019