Abstract
Background and objective: Epidemiological and observational studies indicate that thiazolidinedione (TZD) therapy with rosiglitazone and pioglitazone is associated with an increased risk of fractures. The effect of TZDs on bone mineral density (BMD) in men with type 2 diabetes is still in debate. The objective of the study was to investigate changes in BMD and bone turnover markers (BTM) associated with Pioglitazone use in men. Design and Methods: This prospective cross sectional comparative study evaluated the changes in BMD and BTM in male veterans aged less than 55 years, with diabetes with or without use of pioglitazone. In a 6 month follow up study, main outcome measures included BMD at AP spine, femur and wrist; and BTM (osteocalcin and CTx) at a referral center, with no interventions. Results: Pioglitazone use was associated with significant decrease in BMD (annualized %change of >3%) at femoral neck, total hip and 1/3rd radius; increase in CTx by 29% and decrease in osteocalin by 20% at 6months. Conclusions: Even in young men pioglitazone use was associated with bone loss. The changes in BTM suggest effect of pioglitazone on both osteoblast and osteoclast activity.
Highlights
Osteoporosis and type 2 diabetes (DM), two of the most common chronic disease conditions, represent ma
The aim of this study was to evaluate the effects of the TZD Pioglitazone on bone mineral density (BMD) and bone turnover markers in young men with type 2 diabetes
28 subjects were being treated with pioglitazone; the control group comprised 64 subjects with diabetes matched for age, ethnicity, body mass index (BMI) and smoking and alcohol history that were not being treated with Pioglitazone or rosiglitazone
Summary
Osteoporosis and type 2 diabetes (DM), two of the most common chronic disease conditions, represent ma-. Epidemiological and observational studies indicate that thiazolidinedione (TZD) therapy with rosiglitazone and Pioglitazone is associated with an increased risk of fractures. The effect of TZDs on bone mineral density (BMD) in men with type 2 diabetes is still in debate. The objective of the study was to investigate changes in BMD and bone turnover markers (BTM) associated with Pioglitazone use in men. Design and Methods: This prospective cross sectional comparative study evaluated the changes in BMD and BTM in male veterans aged less than 55 years, with diabetes with or without use of Pioglitazone. Results: Pioglitazone use was associated with significant decrease in BMD (annualized % change of >3%) at femoral neck, total hip and 1/3rd radius; increase in CTx by 29% and decrease in osteocalin by 20% at 6 months. Conclusions: Even in young men Pioglitazone use was associated with bone loss. The changes in BTM suggest effect of Pioglitazone on both osteoblast and osteoclast activity
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