Abstract
Patients with diabetes are at a much higher risk of experiencing bone fractures compared to non-diabetic populations. This happens despite diabetics having relatively normal or high bone mineral density, and so why this occurs is currently under investigation. Research has shown that diabetic bone tissue has a higher prevalence of advanced glycation end-products (AGEs), which are crosslinks induced by non-enzymatic glycation, a spontaneous process where the aldehydes of sugars react with ε-amino groups on proteins in the bone matrix. AGEs alter the matrix, which can lead to stiffer tissue and deteriorated mechanical properties. High AGE accumulation can occur over decades, which makes it a challenge to obtain representative data from diabetic patients or cadaveric bone tissue to study these mechanisms. In vitro incubation simulations have been successfully used to reflect the process of non-enzymatic glycation in bone tissue, with AGE accumulating in a matter of days/weeks. These simulations normally use ribose as the extracellular sugar source. Even though glucose is more physiologically relevant, it has little documentation in its usage in these simulations. This project investigates the effectiveness and differences in reactions of both ribose and glucose with proteins in human cortical bone. Bone samples were incubated with control, ribose, and glucose solutions, and were then tested to measure key mechanical properties as well as AGE content. Results showed that ribose had a significant impact on increasing AGE accumulation and decreasing post-yield mechanical properties, while glucose had no significant impact on AGEs or mechanical properties. This provides a baseline and basic framework for understanding the effects of glucose and ribose on cadaveric bone tissue mechanics, and suggests future study ideas for better understanding the impact of diabetes on bone mechanics.