Thiazolidinedione use and bone loss in older diabetic adults

Ann V. Schwartz, Deborah E. Sellmeyer, Eric Vittinghoff, Lisa Palermo, Beata Lecka-Czernik, Kenneth R. Feingold, Elsa S. Strotmeyer, Helaine E. Resnick, Laura D Carbone, Brock A. Beamer, Won Park Seok, Nancy E. Lane, Tamara B. Harris, Steven R. Cummings

Research output: Contribution to journalArticle

373 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)3349-3354
Number of pages6
JournalJournal of Clinical Endocrinology and Metabolism
Volume91
Issue number9
DOIs
StatePublished - Jan 1 2006
Externally publishedYes

Fingerprint

Thiazolidinediones
Bone
Bone and Bones
Medical problems
Bone Density
Minerals
rosiglitazone
pioglitazone
troglitazone
Confidence Intervals
Spine
Pelvic Bones
Glucose
Peroxisome Proliferator-Activated Receptors
Glucose Tolerance Test
2,4-thiazolidinedione
Body Composition
Hypoglycemic Agents
Femur
Self Report

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical

Cite this

Schwartz, A. V., Sellmeyer, D. E., Vittinghoff, E., Palermo, L., Lecka-Czernik, B., Feingold, K. R., ... Cummings, S. R. (2006). Thiazolidinedione use and bone loss in older diabetic adults. Journal of Clinical Endocrinology and Metabolism, 91(9), 3349-3354. https://doi.org/10.1210/jc.2005-2226

Thiazolidinedione use and bone loss in older diabetic adults. / Schwartz, Ann V.; Sellmeyer, Deborah E.; Vittinghoff, Eric; Palermo, Lisa; Lecka-Czernik, Beata; Feingold, Kenneth R.; Strotmeyer, Elsa S.; Resnick, Helaine E.; Carbone, Laura D; Beamer, Brock A.; Seok, Won Park; Lane, Nancy E.; Harris, Tamara B.; Cummings, Steven R.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 91, No. 9, 01.01.2006, p. 3349-3354.

Research output: Contribution to journalArticle

Schwartz, AV, Sellmeyer, DE, Vittinghoff, E, Palermo, L, Lecka-Czernik, B, Feingold, KR, Strotmeyer, ES, Resnick, HE, Carbone, LD, Beamer, BA, Seok, WP, Lane, NE, Harris, TB & Cummings, SR 2006, 'Thiazolidinedione use and bone loss in older diabetic adults', Journal of Clinical Endocrinology and Metabolism, vol. 91, no. 9, pp. 3349-3354. https://doi.org/10.1210/jc.2005-2226
Schwartz AV, Sellmeyer DE, Vittinghoff E, Palermo L, Lecka-Czernik B, Feingold KR et al. Thiazolidinedione use and bone loss in older diabetic adults. Journal of Clinical Endocrinology and Metabolism. 2006 Jan 1;91(9):3349-3354. https://doi.org/10.1210/jc.2005-2226
Schwartz, Ann V. ; Sellmeyer, Deborah E. ; Vittinghoff, Eric ; Palermo, Lisa ; Lecka-Czernik, Beata ; Feingold, Kenneth R. ; Strotmeyer, Elsa S. ; Resnick, Helaine E. ; Carbone, Laura D ; Beamer, Brock A. ; Seok, Won Park ; Lane, Nancy E. ; Harris, Tamara B. ; Cummings, Steven R. / Thiazolidinedione use and bone loss in older diabetic adults. In: Journal of Clinical Endocrinology and Metabolism. 2006 ; Vol. 91, No. 9. pp. 3349-3354.
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AU - Feingold, Kenneth R.

AU - Strotmeyer, Elsa S.

AU - Resnick, Helaine E.

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AU - Beamer, Brock A.

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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.

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