Effect of thiazolidinediones on skeletal health in women with Type 2 diabetes.
Rosiglitazone and pioglitazone are associated with increased fracture risk in women, and, for rosiglitazone, more rapid bone loss. Negative skeletal effects of these thiazolidinediones (TZDs) have also been observed in animal and in vitro models. A central mechanism of action appears to be reduced bone formation, resulting in bone loss. The source of this reduced bone formation may be a shift in the lineage allocation of marrow stems cells away from osteoblasts and towards adipocytes, caused by activation of PPAR-gamma with these TZDs. Research is needed to better understand the mechanisms of bone loss and to identify factors that influence susceptibility to TZD-induced osteoporosis. Clinicians should be aware of the potential for increased fracture risk when prescribing TZDs, particularly in postmenopausal women.
Schwartz
Ann V
AV
University of California San Francisco, Department of Epidemiology and Biostatistics, 185 Berry Street, Suite 5700, San Francisco, CA 94107, USA. aschwartz@psg.ucsf.edu
Sellmeyer
Deborah E
DE
D000818:Animals; D015519:Bone Density / Q000187:drug effects / Q000502:physiology; D001862:Bone Resorption / Q000139:chemically induced / Q000209:etiology; D002986:Clinical Trials as Topic / Q000379:methods; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000188:drug therapy*; D005260:Female; D006801:Humans; D010024:Osteoporosis / Q000139:chemically induced* / Q000209:etiology; D045162:Thiazolidinediones / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use
D045162:Thiazolidinediones