{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T03:49:13Z","timestamp":1773200953024,"version":"3.50.1"},"reference-count":31,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,4,22]],"date-time":"2022-04-22T00:00:00Z","timestamp":1650585600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81601219"],"award-info":[{"award-number":["81601219"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012226","name":"Fundamental Research Funds for the Central Universities","doi-asserted-by":"publisher","award":["21620452"],"award-info":[{"award-number":["21620452"]}],"id":[{"id":"10.13039\/501100012226","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To explore the effect of diabetes mellitus (DM) on implant osseointegration of titanium screws.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Sixty rats were randomly divided into a DM group and a control group (each group, <jats:italic>n<\/jats:italic>\u00a0=\u00a030). DM group rats were injected with 1% Streptozotocin solution at 65 mg\/kg to establish a DM model. Titanium screws were implanted into the rats' distal femurs in both groups. The rats were sacrificed for micro\u2010CT scanning, micro\u2010indentation, biomechanical detection, confocal Raman microspectroscopy, and histological and histomorphometric analysis at 4, 8, and 12\u2009weeks post\u2010implantation, respectively. Messenger RNA (mRNA) expression and protein expression of the related growth factors around the implant were analyzed using real\u2010time polymerase chain reaction and Western blots.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At 4, 8 and 12\u2009weeks, micro\u2010CT scanning, hematoxylin\u2010eosin (HE) staining, Gieson's acid\u2010magenta staining, and fluorescent labeled staining showed disorder in the bone tissue arrangement, a lack of new bone tissue, poor maturity and continuity, and poor trabecular bone parameters around the implant in the DM group. At 4, 8, and 12\u2009weeks, the interfacial bone binding rate in the DM group was significantly lower (16.2%\u2009\u00b1\u20094.8%, 25.7%\u2009\u00b1\u20095.7%, 42.5%\u2009\u00b1\u20095.8%, respectively) than that in the control group (23.6%\u2009\u00b1\u20095.2%, 40.8%\u2009\u00b1\u20096.3%, 64.2%\u2009\u00b1\u20097.3%, respectively; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). At 8 and 12\u2009weeks, the elastic modulus (17.0\u2009\u00b1\u20091.8 and 15.1\u2009\u00b1\u20091.5 GPa, respectively) and trabecular bone hardness (571\u2009\u00b1\u200939 and 401\u2009\u00b1\u200937 MPa, respectively) in the DM group were significantly lower than the elastic modulus (23.4\u2009\u00b1\u20092.3 and 23.8\u2009\u00b1\u20091.8 GPa, respectively) and trabecular bone hardness (711\u2009\u00b1\u200945 and 719\u2009\u00b1\u200946 MPa, respectively) in the control group (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). The maximum load required for the prosthesis pull\u2010out experiment in the DM group at 4, 8, and 12\u2009weeks (55.14\u2009\u00b1\u20096.74 N, 73.34\u2009\u00b1\u20098.43 N, and 83.45\u2009\u00b1\u20098.32 N, respectively) was significantly lower than that in the control group (77.45\u2009\u00b1\u20097.48 N, 93.28\u2009\u00b1\u20098.29 N, and 123.62\u2009\u00b1\u20099.43 N, respectively, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). At 8 and 12\u2009weeks, the mineral\u2010to\u2010collagen ratio in the DM group (6.56\u2009% \u00b1\u20091.35% and 4.45%\u00b1\u20091.25%, respectively) was significantly higher than that in the control group (5.31%\u2009\u00b1\u20091.42% and 3.62%\u2009\u00b1\u20091.33%, respectively, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). At 12\u2009weeks, mRNA and protein expression levels of bone morphogenetic protein 2, transforming growth factor\u2010\u03b21, vascular endothelial growth factor, osteopontin, osteocalcin, and runt\u2010related transcription factor 2 in the DM group were significantly lower than that in the control group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>DM can negatively affect bone osseointegration, manifesting as disorder in bone tissue arrangement around the implant, a lack of new bone tissue, poor maturity and continuity, poor trabecular bone parameters and lower expression of the related growth factors.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.13274","type":"journal-article","created":{"date-parts":[[2022,4,22]],"date-time":"2022-04-22T07:56:56Z","timestamp":1650614216000},"page":"1217-1228","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Effect of Diabetes Mellitus on Implant Osseointegration of Titanium Screws: An Animal Experimental Study"],"prefix":"10.1111","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0532-7622","authenticated-orcid":false,"given":"Lei","family":"Xiao","sequence":"first","affiliation":[{"name":"Emergency Department The First Affiliated Hospital, Jinan University  Guangzhou China"},{"name":"Department of Orthopaedic Surgery and Sports Medicine Center The First Affiliated Hospital, Jinan University  Guangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi\u2010juan","family":"Zhou","sequence":"additional","affiliation":[{"name":"Emergency Department The First Affiliated Hospital, Jinan University  Guangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ya\u2010bin","family":"Jiang","sequence":"additional","affiliation":[{"name":"Emergency Department The First Affiliated Hospital, Jinan University  Guangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Man Seng","family":"Tam","sequence":"additional","affiliation":[{"name":"IAN WO Medical Center  Macau China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lek Hang","family":"Cheang","sequence":"additional","affiliation":[{"name":"Macau Medical Science and Technology Research Association  Macau China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hua\u2010jun","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and Sports Medicine Center The First Affiliated Hospital, Jinan University  Guangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhen\u2010gang","family":"Zha","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and Sports Medicine Center The First Affiliated Hospital, Jinan University  Guangzhou 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