[Thiazolidinediones and skeletal health].
The insulin-sensitizing thiazolidinediones are effective drugs to achieve glycemic control in patients with type 2 diabetes. Results from preclinical studies have demonstrated that activation of PPAR-gamma inhibits primarily bone formation by diverting mesenchymal stem cells to the adipocytic rather than to the osteogenic lineage. In humans studies demonstrated accelerated bone loss, impaired bone mineral density as well as an increased fracture risk for thiazolidinedione users, mostly for women. As a consequence of these observations, clinicians have to carefully assess the fracture risk in patients with type 2 diabetes before starting a therapy with thiazolidinediones.
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Division d'endocrinologie, diabète et nutrition clinique, Hôpital universitaire de Bâle, Bâle. christian.meier@unibas.ch
Bodmer
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D015519:Bone Density / Q000187:drug effects; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000188:drug therapy; D019317:Evidence-Based Medicine; D005260:Female; D050723:Fractures, Bone / Q000139:chemically induced*; D005598:Fractures, Spontaneous / Q000139:chemically induced; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000494:pharmacology; D008297:Male; D010012:Osteogenesis / Q000187:drug effects; D010024:Osteoporosis / Q000139:chemically induced* / Q000150:complications; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D045162:Thiazolidinediones / Q000008:administration & dosage / Q000009:adverse effects* / Q000494:pharmacology
D007004:Hypoglycemic Agents; D045162:Thiazolidinediones