Ribosylation-induced increase in advanced glycation end products has limited impacts on mechanical properties in human cortical bone

Diabetes affects over 38 million individuals in the U.S. and is associated with a heightened risk of fractures despite normal or elevated bone mineral density (BMD). This increased fracture susceptibility may be linked to the accumulation of advanced glycation end products (AGEs), which are theorized to compromise bone quality by stiffening the collagen network, leading to tissue embrittlement. In this study, the mechanical effects of AGE accumulation in human cortical bone were evaluated <i>in vitro</i>. Bone beams, derived from a human femur, were incubated in a ribose solution to induce AGE accumulation, while control beams were incubated in a control solution. Dynamic Mechanical Analysis (DMA) and three-point bending tests were conducted to assess the mechanical properties of the bone beams. Fluorescent AGE analysis was performed to quantify and compare AGE levels between the groups. The study found no significant differences in mechanical properties between the control and ribose-treated groups, despite a significant elevation in normalized AGE content in the ribose group. These results suggest that AGE accumulation may have a weaker impact on the mechanical properties of human bone than previously hypothesized. However, this study emphasizes the need for further research to explore the relationship between AGE accumulation and bone quality. Understanding this relationship is crucial for developing strategies to reduce fracture risk in populations with high AGE levels, such as diabetic and elderly individuals.