ABSTRACT: The effect of thiazolidinediones (TZDs) on bone mineral density (BMD) and bone metabolism in patients with type 2 diabetes is still in debate. Accumulating evidence has emerged that long-term administration of TZDs may increase the occurrence of osteoporosis, at least in postmenopausal women. Because little clinical data has been reported on Chinese people, a retrospective study was performed. One-hundred ninety-eight Chinese people, all from our inpatients, were selected for a 24-28 month review (26 +/- 0.5 m). Four groups divided according to gender and TZD use were designated fTZD, mTZD, f and m. Changes of subjects' BMD and bone metabolism markers were noted and analyzed. Compared with group f, bone loss from fTZD in this over 24-month review was more significant in lumbar spine (L1-L4) (0.1 +/- 0.15 vs. 0.06 +/- 0.11) and right hip (0.09 +/- 0.15 vs. 0.05 +/- 0.14) (g/cm(3)) (P < 0.05). However, the opposite result was found in male patients with less bone loss in group mTZD. Two bone metabolism markers, including beta C-terminal telopeptide of type I collagen (beta-CTX) and osteocalcin (OC), in this study did not prove valuable in revealing changes among groups. We concluded that long-term TZD use may increase the risk of bone loss in Chinese postmenopausal patients with type 2 diabetes, which may provide caution on drug treatment in clinical practice. Whether TZD can protect male patients against BMD loss or not awaits further research.
Journal of Bone and Mineral Metabolism 07/2009; 28(1):77-81. · 2.27 Impact Factor