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 Carbone, Brock A. Beamer, Won Park Seok, Nancy E. Lane, Tamara B. Harris, Steven R. Cummings

Research output: Contribution to journalArticle

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

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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., Strotmeyer, E. S., Resnick, H. E., Carbone, L., Beamer, B. A., Seok, W. P., Lane, N. E., Harris, T. B., & 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