The effect of thiazolidinediones on bone mineral density in Chinese older patients with type 2 diabetes.

The effect of thiazolidinediones (TZDs) on bone mineral density (BMD) and bone metabolism in patients with type 2 diabetes is still in debate. Accumulating evidence has emerged that long-term administration of TZDs may increase the occurrence of osteoporosis, at least in postmenopausal women. Because little clinical data has been reported on Chinese people, a retrospective study was performed. One-hundred ninety-eight Chinese people, all from our inpatients, were selected for a 24-28 month review (26 +/- 0.5 m). Four groups divided according to gender and TZD use were designated fTZD, mTZD, f and m. Changes of subjects' BMD and bone metabolism markers were noted and analyzed. Compared with group f, bone loss from fTZD in this over 24-month review was more significant in lumbar spine (L1-L4) (0.1 +/- 0.15 vs. 0.06 +/- 0.11) and right hip (0.09 +/- 0.15 vs. 0.05 +/- 0.14) (g/cm(3)) (P < 0.05). However, the opposite result was found in male patients with less bone loss in group mTZD. Two bone metabolism markers, including beta C-terminal telopeptide of type I collagen (beta-CTX) and osteocalcin (OC), in this study did not prove valuable in revealing changes among groups. We concluded that long-term TZD use may increase the risk of bone loss in Chinese postmenopausal patients with type 2 diabetes, which may provide caution on drug treatment in clinical practice. Whether TZD can protect male patients against BMD loss or not awaits further research.