ORIGINAL RESEARCH article
Front. Med.
Sec. Geriatric Medicine
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1530462
This article is part of the Research TopicAssociation of Diabetes Mellitus with Cognitive Impairment and Neurological Disorders Vol. 2View all articles
Study on the correlation between abnormal bone metabolism and cognitive impairment in type 2 diabetes mellitus Author names and affiliations
Provisionally accepted
- 1The Second Affiliated Hospital of Shandong First Medical University, Tai’an, China
- 2Medical Imaging, Faculty of Health and Life Sciences,St Luke's Campus, Exeter, England, United Kingdom
- 3Faculty of Computer and Mathematical Sciences, MARA University of Technology, Shah Alam, Selangor Darul Ehsan, Malaysia
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Introduction: Type 2 diabetes mellitus (T2DM) is often accompanied by bone metabolic disorders and cognitive impairment, forming an interactive network through metabolic derangements, oxidative stress, and inflammatory responses. Hyperglycemia and insulin resistance disrupt bone remodeling leading to osteoporosis while simultaneously impairing cognition via blood-brain barrier damage and neuroinflammation. Osteogenic factors like osteocalcin may bidirectionally regulate glucose metabolism and brain function, suggesting that "bone-brain axis" dysregulation could be a potential mechanism underlying cognitive impairment in T2DM. This study aims to characterize cognitive function patterns in T2DM patients with bone metabolic abnormalities and their clinical correlations, providing a basis for multisystemic interventions. Methods: The general clinical data, osteocalcin (OC), glycosylated hemoglobin (HbA1c), bone mineral density (BMD), and the Montreal Cognitive Assessment (MoCA) scores of 50 patients with T2DM were collected. According to whether cognitive impairment occurred or not, one-way ANOVA was performed to analyze the correlation between cognitive and clinical indicators, BMD and OC. Multiple linear regression analysis was performed with cognition and bone density as dependent variables and other factors as independent variables. Conclusion: T2DM, osteoporosis, and cognitive impairment form pathological connections through metabolic disorders, chronic inflammation, and bidirectional regulatory networks of the "bone-brain axis," with osteocalcin serving as a key mediator that maintains bone remodeling balance while also exerting cross-domain regulation over central insulin signaling and synaptic plasticity. Understanding these interactive mechanisms provides a basis for developing combined screening models integrating bone density and cognitive assessments, and promotes multidisciplinary collaborative interventions across endocrinology, orthopedics, and neurology to improve overall outcomes for T2DM patients.
Keywords: type 2 diabetes mellitus, Abnormal bone metabolism, cognitive impairment, bone mineral density, Osteocalcin
Received: 29 Nov 2024; Accepted: 18 Apr 2025.
Copyright: © 2025 Li, An, Qin, Shafini and Ramli. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yu Xiao An, The Second Affiliated Hospital of Shandong First Medical University, Tai’an, China
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