Diabetes and intervertebral disc degeneration：effects on structure, apoptosis, endplate blood supply and extracellular matrix / 中国组织工程研究

ABSTRACT

BACKGROUND:Diabetes as a systemic metabolic disease induces the disorders of carbohydrates, fat, and protein metabolism, simultaneously easily causes the lesion of surrounding capilaries, and impacts nutrient metabolism of multiple organs including intervertebral discs. OBJECTIVE:To summarize the research progress of diabetes effects on disc degeneration al over the world. METHODS: The first author used the computer to retrieve the information from PubMed and China National Knowledge Infrastructure. The key words were “intervertebral disc, degeneration, diabetes melitus” in English and Chinese. 8 414 relevant articles were found, which were published from January 1981 to January 2014. Repetitive studies were excluded and 34 articles were in accordance with the inclusion criteria. RESULTS AND CONCLUSION: Pathogenesis of diabetes complications was very complicated. Apoptosis is a hot focus in recent years. Hyperglycemia has been a inducer for apoptosis in intervertebral discs. Diabetes easily leads to systemic smal vessel disease, especialy vascular bud contraction in the terminal plate of vertebral body, and results in regional blood flow decrease or interruption. Thus, the nutrient substance carrying along the end plate was reduced, which resulted in disc dystrophy and degeneration. The reduction in extracelular matrix in the intervertebral discs is a major reason for disc degeneration. The mechanisms underlying diabetes effects on disc degeneration remain unclear and deserve further investigations.