Thiazolidinedione Treatment Decreases Bone Mineral Density in Type 2 Diabetic Men

  1. Subhashini Yaturu, MD12,
  2. Barbara Bryant, BS1 and
  3. Sushil K. Jain, PHD3
  1. 1Department of Endocrinology, Overton Brooks VA Medical Center, Shreveport, Louisiana
  2. 2Department of Endocrinology, Louisiana State University Health Sciences Center, Shreveport, Louisiana
  3. 3Department of Pediatrics, Louisiana State University Health Sciences Center, Shreveport, Louisiana
  1. Address correspondence and reprint requests to Subhashini Yaturu, MD, Department of Endocrinology, Overton Brooks VA Medical Center/LSUHSC, Shreveport, LA 71101-4295. E-mail: subhashini.yaturu{at} or yaturu{at}

Case-control studies of patients with fractures have found that subjects with diabetes have at least a twofold higher risk of fracture than subjects without diabetes (1), with an increased risk of hip, humerus, and foot fractures in elderly diabetic subjects (2–4). Risk factors that contribute to increased fracture in diabetic subjects include number of falls (5,6), insulin use (7,8), functional disability (9–11), diabetes duration (7,12), and poor vision (7). Recent studies report that older women and African Americans have higher incidence of osteoporotic fractures (13). In addition, lower bone strength (bone mineral density [BMD]) might be expected to increase risk for the development of osteoporosis and fracture.

Type 2 diabetic patients are widely prescribed drugs called thiazolidinediones, which increase insulin sensitivity via activation of peroxisome proliferator–activated receptor (PPAR)-γ receptors. However, it is not known whether thiazolidinedione use has any effect on bone mass and thereby increases risk of fracture in type 2 diabetic patients. In animal studies, thiazolidinedione treatment was associated with bone loss in a mouse model (14,15), which was explained by possible imbalance in bone from increased apoptotic death of osteogenic cells and diminished bone formation (15), and also in ovariectomized rats (16). Other investigators did not find bone loss in troglitazone-treated mice (17). There is limited information on the effect of …

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  1. Diabetes Care vol. 30 no. 6 1574-1576
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