Rosiglitazone Decreases Bone Mineral Density and Increases Bone Turnover in Postmenopausal Women With Type 2 Diabetes Mellitus

Abstract

RSG for 52 weeks in postmenopausal women with T2DM was associated with small reductions in FN, total hip, and lumbar spine BMD and increased bone turnover markers. These effects are attenuated after cessation of RSG treatment.

The effect of thiazolidinediones on bone mineral density and bone turnover: systematic review and meta-analysis

“…Three studies extended beyond 12 months, but none were longer than 25 months [13,16,26]. Five studies included follow-up periods after withdrawal of TZD treatment, ranging 24-52 weeks [12,14,15,25,28]. Fourteen studies reported BMD and 14 reported bone turnover marker outcomes.…”

“…The number of studies was insufficient to assess effects in men or in cohorts with HIV. Five studies reported on changes in BMD following withdrawal of TZD treatment for 24-52 weeks [12,14,15,25,28]. Figure 3 shows that there were no statistically significant differences in percentage change in BMD between the TZD group and controls following treatment withdrawal.…”

“…Figure 3 shows that there were no statistically significant differences in percentage change in BMD between the TZD group and controls following treatment withdrawal. 10 studies reporting on CTX, five reported significant increases with TZDs [12,17,18,28,33] and five showed no effect [13-15, 25, 31]. Of the five studies reporting on bsALP, one reported a significant increase with TZDs [12] and no effect was seen in four [13,17,25,28].…”

“…At a cellular level, PPAR-γ acts on mesenchymal stem cells to preferentially promote differentiation into adipogenic cell lineages at the expense of osteoblastogenesis [11]. Some clinical studies report increased loss of bone mineral density (BMD) with TZDs [12][13][14][15], but the effects on bone turnover markers have been inconsistent, with evidence for both reduced bone formation [14,16,17] and increased bone resorption [12,17,18]. It is possible to detect biologically significant effects in surrogate endpoints for fracture, such as BMD and bone turnover, in much smaller cohorts than are required for investigation of effects on fracture incidence.…”

Application of quantitative computed tomography for assessment of trabecular bone mineral density, microarchitecture and mechanical property

“…Osteoporosis is a bone mineral metabolic disorder. Many diseases and conditions can influence the metabolic balance of the bone mineral materials (less absorption or faster turnover), such as renal disease [45,46], rheumatoid arthritis [47,48], heart failure and myocardial infarction [49][50][51][52], diabetes [53,54], chronic obstructive pulmonary disease [55][56][57], menopausal status [54,58], aging [59,60], nutrition disorder [61,62], and others [63,64]. The routine whole-body CT scan is an important medical imaging used for diagnosis and prognosis of these diseases and disorders.…”