TY - JOUR
T1 - Thiazolidinedione use and bone loss in older diabetic adults
AU - Schwartz, Ann V.
AU - Sellmeyer, Deborah E.
AU - Vittinghoff, Eric
AU - Palermo, Lisa
AU - Lecka-Czernik, Beata
AU - Feingold, Kenneth R.
AU - Strotmeyer, Elsa S.
AU - Resnick, Helaine E.
AU - Carbone, Laura
AU - Beamer, Brock A.
AU - Seok, Won Park
AU - Lane, Nancy E.
AU - Harris, Tamara B.
AU - Cummings, Steven R.
N1 - Funding Information:
This work was supported in part by the Intramural Research Program of the National Institutes of Health. National Institute on Aging (NIA) (Grants NIA N01-AG-6-2106, N01-AG-6-2101, N01-ACG-6-2103, N1A R01 AG17482), and an American Diabetes Association Junior Faculty Award (to A.V.S.).
PY - 2006
Y1 - 2006
N2 - Context: Activation of peroxisome proliferator-activated receptor-γ 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 A1c 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.
AB - Context: Activation of peroxisome proliferator-activated receptor-γ 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 A1c 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.
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U2 - 10.1210/jc.2005-2226
DO - 10.1210/jc.2005-2226
M3 - Article
C2 - 16608888
AN - SCOPUS:33748748473
SN - 0021-972X
VL - 91
SP - 3349
EP - 3354
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
IS - 9
ER -