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.
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 diabeticparticipants, 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.
Authors: Frances A Tylavsky; Timothy G Lohman; Maurice Dockrell; Thomas Lang; Dale A Schoeller; Jim Y Wan; Thomas Fuerst; Jane A Cauley; Michael Nevitt; Tamara B Harris Journal: Am J Clin Nutr Date: 2003-02 Impact factor: 7.045
Authors: L Joseph Melton; Anne C Looker; John A Shepherd; Michael K O'Connor; Sara J Achenbach; B Lawrence Riggs; Sundeep Khosla Journal: Osteoporos Int Date: 2005-04-06 Impact factor: 4.507
Authors: Elsa S Strotmeyer; Jane A Cauley; Ann V Schwartz; Michael C Nevitt; Helaine E Resnick; Douglas C Bauer; Frances A Tylavsky; Nathalie de Rekeneire; Tamara B Harris; Anne B Newman Journal: Arch Intern Med Date: 2005-07-25
Authors: R Okazaki; M Miura; M Toriumi; M Taguchi; Y Hirota; S Fukumoto; T Fujita; K Tanaka; A Takeuchi Journal: Endocr J Date: 1999-12 Impact factor: 2.349
Authors: M Alexandra Sorocéanu; Dengshun Miao; Xiu-Ying Bai; Hanyi Su; David Goltzman; Andrew C Karaplis Journal: J Endocrinol Date: 2004-10 Impact factor: 4.286
Authors: I I de Liefde; M van der Klift; C E D H de Laet; P L A van Daele; A Hofman; H A P Pols Journal: Osteoporos Int Date: 2005-06-07 Impact factor: 4.507
Authors: S Benvenuti; I Cellai; P Luciani; C Deledda; S Baglioni; C Giuliani; R Saccardi; B Mazzanti; S Dal Pozzo; E Mannucci; A Peri; M Serio Journal: J Endocrinol Invest Date: 2007-10 Impact factor: 4.256