Abstract
SummaryObjective To evaluate the effect of rosiglitazone on bone metabolism and bone density.Design An open‐label, randomized, controlled trial of 24‐month duration.Patients and measurements Obese, postmenopausal women with newly diagnosed diabetes were studied. Before and after the intervention, metabolic bone markers and bone density were assessed.Results Twenty‐six patients received rosiglitazone (4 mg/day), and 23 remained on diet alone. Serum bone‐specific alkaline phosphatase and osteocalcin levels decreased by 17% (P < 0·001 vs control group) and 26% (P < 0·01 vs control group), respectively, in the rosiglitazone group. There were no significant changes in the deoxypyridinoline levels between the two groups. Annual bone loss at the trochanter and at the lumbar spine associated with each year of rosiglitazone use was 2·56% (P = 0·01 vs control group) and 2·18% (P < 0·01 vs control group), respectively. Femoral neck and total hip bone density declined significantly in both groups (P < 0·01, and P = 0·01, respectively) but was not significantly different between the two groups.Conclusions Rosiglitazone treatment adversely affects bone formation over a 2‐year period. It increases bone loss at the lumbar spine and trochanter in postmenopausal, type 2 diabetic women. However, bone loss at the total hip did not differ with use of this agent.
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