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Thiazolidinedione Use and Bone Loss in Older Diabetic Adults

Thiazolidinedione Use and Bone Loss in Older Diabetic Adults AbstractContext: Activation of peroxisome proliferator-activated receptor-γ by thiazolidinediones (TZDs) results in lower bone mass in mice.Objective: The objective of the study was to determine whether TZD use is associated with changes in bone mineral density (BMD) in older adults with type 2 diabetes.Design: We analyzed 4-yr follow-up data from the Health, Aging, and Body Composition observational study.Setting: The study was conducted in a general community.Patients: White and black, physically able men and women, aged 70–79 yr at baseline with diabetes defined by self-report, use of hypoglycemic medication, elevated fasting glucose (≥126 mg/dl), or elevated 2-h glucose tolerance test (≥200 mg/dl) participated in the study.Main Outcome Measures: Whole-body, lumbar spine (derived from whole body), and hip BMD were measured by dual-energy x-ray absorptiometry at 2-yr intervals.Results: Of 666 diabetic participants, 69 reported TZD use at an annual visit, including troglitazone (n = 22), pioglitazone (n = 30), and/or rosiglitazone (n = 31). Those with TZD use had higher baseline hemoglobin A1c and less weight loss over 4 yr but similar baseline BMD and weight than others with diabetes. In repeated-measures models adjusted for potential confounders associated with TZD use and BMD, each year of TZD use was associated with greater bone loss at the whole body [additional loss of −0.61% per year; 95% confidence interval (CI) −1.02, −0.21% per year], lumbar spine (−1.23% per year; 95% CI −2.06, −0.40% per year), and trochanter (−0.65% per year; 95% CI −1.18, −0.12% per year) in women, but not men, with diabetes.Conclusion: These observational results suggest that TZDs may cause bone loss in older women. These results need to be tested in a randomized trial. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Clinical Endocrinology and Metabolism Oxford University Press

Thiazolidinedione Use and Bone Loss in Older Diabetic Adults

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References (30)

Publisher
Oxford University Press
Copyright
Copyright © 2006 by The Endocrine Society
ISSN
0021-972X
eISSN
1945-7197
DOI
10.1210/jc.2005-2226
pmid
16608888
Publisher site
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Abstract

AbstractContext: Activation of peroxisome proliferator-activated receptor-γ by thiazolidinediones (TZDs) results in lower bone mass in mice.Objective: The objective of the study was to determine whether TZD use is associated with changes in bone mineral density (BMD) in older adults with type 2 diabetes.Design: We analyzed 4-yr follow-up data from the Health, Aging, and Body Composition observational study.Setting: The study was conducted in a general community.Patients: White and black, physically able men and women, aged 70–79 yr at baseline with diabetes defined by self-report, use of hypoglycemic medication, elevated fasting glucose (≥126 mg/dl), or elevated 2-h glucose tolerance test (≥200 mg/dl) participated in the study.Main Outcome Measures: Whole-body, lumbar spine (derived from whole body), and hip BMD were measured by dual-energy x-ray absorptiometry at 2-yr intervals.Results: Of 666 diabetic participants, 69 reported TZD use at an annual visit, including troglitazone (n = 22), pioglitazone (n = 30), and/or rosiglitazone (n = 31). Those with TZD use had higher baseline hemoglobin A1c and less weight loss over 4 yr but similar baseline BMD and weight than others with diabetes. In repeated-measures models adjusted for potential confounders associated with TZD use and BMD, each year of TZD use was associated with greater bone loss at the whole body [additional loss of −0.61% per year; 95% confidence interval (CI) −1.02, −0.21% per year], lumbar spine (−1.23% per year; 95% CI −2.06, −0.40% per year), and trochanter (−0.65% per year; 95% CI −1.18, −0.12% per year) in women, but not men, with diabetes.Conclusion: These observational results suggest that TZDs may cause bone loss in older women. These results need to be tested in a randomized trial.

Journal

Journal of Clinical Endocrinology and Metabolism – Oxford University Press

Published: Sep 1, 2006

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