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J Clin Endocrinol Metab. 2006 Sep;91(9):3349-54. Epub 2006 Apr 11.

Thiazolidinedione use and bone loss in older diabetic adults.

Author information

  • 1Department of Epidemiology and Biostatistics, University of California, San Francisco, 185 Berry Street, Lobby 4, Suite 5700, San Francisco, California 94107-1762, USA. aschwartz@psg.ucsf.edu

Abstract

CONTEXT:

Activation of peroxisome proliferator-activated receptor-gamma 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 A(1c) 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.

Comment in

PMID:
16608888
[PubMed - indexed for MEDLINE]
PMCID:
PMC1563497
Free PMC Article
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