title: Pioglitazone increases bone marrow fat in type 2 diabetes: results from a randomized controlled trial.
abstract: OBJECTIVE
  To determine the effect of pioglitazone on bone marrow fat in humans.
  
  
  METHODS
  Twenty participants in a double-blind, randomized, placebo-controlled trial of the skeletal effects of pioglitazone 30 mg daily in type 2 diabetes mellitus (T2DM) entered a 6-month substudy evaluating bone marrow fat. Main outcome measures were bone marrow fat in lumbar spine (L4) and proximal femur (intertrochanteric region), measured using magnetic resonance (MR) imaging, and bone mineral density (BMD), measured using dual-energy X-ray absorptiometry.
  
  
  RESULTS
  after 6 months, change in the fourth lumbar vertebra (l4) bone marrow lipid fraction, assessed using two different methods, was greater in the pioglitazone group than in the placebo group (dixon method: mean (95% CI) change from baseline pioglitazone 1.3% (-0.3, 2.9), placebo -0.2% (-0.8, 0.4), P=0.06; MR spectroscopy: pioglitazone 2.5% (0.4, 4.7), placebo -1.1% (-3.7, 1.4), P=0.02). Similarly, the change in lipid fraction in the intertrochanteric region was greater in the pioglitazone group (Dixon method: mean (95% CI) change from baseline pioglitazone 1.3% (0.6, 1.9), placebo -0.8% (-1.8, 0.2), P=0.001). Within the pioglitazone group, there was no evidence of a significant relationship between change in marrow lipid fraction and BMD.
  
  
  CONCLUSIONS
  Short-term treatment with pioglitazone increases bone marrow fat in patients with T2DM.
authors.affiliation: Department of Medicine, University of Auckland, Auckland 1142, New Zealand. a.grey@auckland.ac.nz
authors.forename: Andrew
authors.initials: A
authors.lastname: Grey
authors.forename: Vaughan
authors.initials: V
authors.lastname: Beckley
authors.forename: Anthony
authors.initials: A
authors.lastname: Doyle
authors.forename: Sheryl
authors.initials: S
authors.lastname: Fenwick
authors.forename: Anne
authors.initials: A
authors.lastname: Horne
authors.forename: Greg
authors.initials: G
authors.lastname: Gamble
authors.forename: Mark
authors.initials: M
authors.lastname: Bolland
mesh_terms: D015502:Absorptiometry, Photon; D000273:Adipose Tissue / Q000187:drug effects*; D000328:Adult; D000368:Aged; D015519:Bone Density / Q000187:drug effects*; D001853:Bone Marrow / Q000187:drug effects* / Q000473:pathology; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000473:pathology; D004311:Double-Blind Method; D005260:Female; D005272:Femur Neck; D006801:Humans; D007004:Hypoglycemic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D008159:Lumbar Vertebrae; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D000077205:Pioglitazone; D013057:Spectrum Analysis; D045162:Thiazolidinediones / Q000494:pharmacology / Q000627:therapeutic use*
chemical_list: D007004:Hypoglycemic Agents; D045162:Thiazolidinediones; D000077205:Pioglitazone