Normalisierung histomorphometrischer und biomechanischer Parameter durch kontrollierte Stoffwechselführung bei der Frakturheilung spontandiabetischer BB/OK-Ratten

 

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Zusammenfassung

Studienziel: Ziel der Studie war die detaillierte histomorphometrische und biomechanische Untersuchung von Veränderungen des Knochens während der Frakturheilung bei spontandiabetischen BB/O(ttawa)K(arlsburg) Ratten in Abhängigkeit von der diabetischen Stoffwechsellage. Methode: Anhand der Blutglukosewerte zum Operationszeitpunkt, des Blutglukoseverlaufes und des Insulinbedarfs postoperativ wurden 90 spontandiabetische BB/OK-Ratten mit guter und schlechter diabetischer Stoffwechselführung gruppiert. Fünfundvierzig LEW.1A-Ratten dienten als normoglykämische Kontrolltiere. Eine standardisierte Femurfraktur wurde nach 2, 4 und 6 Wochen Heilung untersucht. Ergebnisse: Unsere Studie zeigte nach histomorphometrischer Abschätzung eine schwere Mineralisationsstörung innerhalb der ersten 4 postoperativen Wochen ausschließlich bei den Ratten mit schlechter diabetischer Stoffwechsellage mit einer signifikanten Abnahme aller fluorochromabhängigen Parameter für die Mineralisation, die Apposition, die Formation und einer signifikanten Verlängerung des zeitlichen Ablaufes der Mineralisation, sowie eine signifikante Abnahme der biomechanischen Werte im Vergleich zu den Ratten mit guter diabetischer Stoffwechselführung und den Kontrollratten. Schlussfolgerung: Mit einer streng kontrollierten Insulintherapie und resultierender guter diabetischer Stoffwechsellage können die schweren Mineralisationsstörungen und die erniedrigten Werte der biomechanischen Eigenschaften bei der Frakturheilung spontandiabetischer Ratten mit schlechter diabetischer Stoffwechsellage verhindert werden.

Abstract

Aim: The objective of this study was to examine changes in the histomorphometrical and mechanical parameters of bone during fracture healing in dependence on the diabetic metabolic state in spontaneously diabetic BB/O(ttawa)K(arlsburg) rats. Methods: Based on blood glucose values at the time of surgery, postoperative blood glucose course and postoperative insulin requirements, 90 spontaneously diabetic BB/OK rats were divided into groups with well compensated or poorly compensated metabolic states. Forty-five LEW.1A rats served as the normoglycemic controls. The femurs were fractured in a standardized procedure and then allowed to heal for 2, 4 and 6 weeks. Results: In terms of bone histomorphometry, our study showed that, within the first four weeks after fracture, severe mineralization disorders occurred exclusively in the rats with poorly compensated diabetic metabolic states, with a significant decrease of all fluorochrome- based parameters of mineralization, apposition, formation and a significantly prolonged timing of mineralization, as well as significantly decreased values of biomechanical properties in comparison to the spontaneously diabetic rats with well compensated metabolic states and to the control rats. Conclusion: With a strictly controlled insulin therapy and a resulting well compensated diabetic metabolic state, severe mineralization disorders and the decreased values of biomechanical properties in the fracture repair in the poorly compensated diabetic metabolic state of the experimental animal can be avoided.

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Dr. med. Niels Follak

Forschungslabor der Klinik und Poliklinik für Orthopädie und Orthopädische Chirurgie der Ernst-Moritz-Arndt-Universität Greifswald

Sauerbruchstraße

17487 Greifswald

Deutschland

Phone: +49-38 34-86 70 72

Fax: +49-38 34-86 70 52

Email: follak@uni-greifswald.de