The Use of Alendronate Is Associated with a Decreased Incidence of Type 2 Diabetes Mellitus—A Population-Based Cohort Study in Taiwan

Abstract

PurposeBone remodeling has been linked to glucose metabolism in animal studies, but the results of human trials were inconclusive. Bisphosphonates may play a role in glucose metabolism through their impacts on bone remodeling enzymes. In this study, we aimed to examine the influence of alendronate usage on the incidence of type 2 diabetes mellitus (DM) among osteoporotic patients.MethodsA retrospective cohort study was designed to include osteoporotic patients without DM from a population-based cohort containing 1,000,000 subjects. Patients treated with alendronate (exposed group, N=1,011) were compared with those who received no treatment (age and gender matched non-exposed group, N=3,033). Newly diagnosed DM was identified from medical records by International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9CM) code. The incidence of DM in both groups was calculated for comparison.ResultsThe non-exposed group had a significantly higher incidence of DM (Odds ratio 1.21, 95% confidence interval 1.03~1.41) when compared with the exposed group. In subgroup analysis, the DM risk reduction in exposed group was only significant among those younger than 65 years and those without hypertension or dyslipidemia. Patients who were prescribed alendronate more than or equal to 3 times had demonstrated a significant reduction in DM risk.ConclusionsOur study showed alendronate might yield a protective effect for incident DM. This effect became insignificant in patients with older age, dyslipidemia or hypertension. The underlying mechanism needs further exploration with prospective data for confirmation of the observed findings.

Osteocalcin Level and its Association with Vitamin D Receptor Gene Polymorphisms (TaqI and ApaI) in Iraqi Obese Type 2 Diabetes Mellitus

“…Additional reports found that osteocalcin functions like a hormone which adjusts fat mass and glucose metabolism in genetically modified mouse display reduced insulin resistance, glucose intolerance, and betacell proliferation [3].Moreover, osteocalcin consumption controlled gene expression in adipocytes and betacells and also impacted the improvement of metabolic disease, obesity, as well as type 2 diabetes mellitus in wild type mice [4], accordance to experimental animal scientific studies; osteocalcin concentrations are proven to be reduced in-individuals with type 1 diabetes mellitus and type 2 diabetes mellitus [5]. On the other hands, it would seem there's adverse association between osteocalcin serum levels as well as glycosylated hemoglobin; together with better control diabetes, amounts of osteocalcin is going to be increase [6].Though, a few scientific studies are carried out that don't verify the association [7,8].…”

The Effect of Bisphosphonates and Low-Dose Doxcycline Therapy in Diabetics With Periodontitis: A Review

“…65 In rodent models study, 66 antiresorptive therapy with reductions in ucOC and OC could lead to insulin resistance, lower insulin secretion, weight gain and an increased risk of diabetes. On the contrary, some studies 64,67 found that antiresorptive therapy does not have a clinically important effect on fasting glucose, weight or diabetes risk. Result of observational studies of the longitudinal effects of OC and ucOC levels on glucose metabolism have been inconsistent.…”

“…63 BPs, potent inhibitors of osteoclastic activity, do suppress bone turnover and decrease systemic uOC levels. 64 Therefore, BP therapies, which reduce ucOC levels, may increase the risk of insulin resistance and diabetes. Alendronate has been shown to reduce ucOC by 56%.…”

Mechanisms involved in altered bone metabolism in diabetes: a narrative review

“…Although, some studies are done which do not confirm this association. [96, 97]. Despite the fact that taking alendronate would cause decrease in the OC and ucOC levels, two recently published cohort studies have shown that alendronate might reduce the risk of developing Type 2 diabetes [96, 97].…”

“…[96, 97]. Despite the fact that taking alendronate would cause decrease in the OC and ucOC levels, two recently published cohort studies have shown that alendronate might reduce the risk of developing Type 2 diabetes [96, 97]. One explanation for this paradox could be the not exactly identified role of ucOC in human glucose metabolism [98].…”