PMID- 24217934
OWN - NLM
STAT- MEDLINE
DCOM- 20140226
LR  - 20181202
IS  - 1479-683X (Electronic)
IS  - 0804-4643 (Linking)
VI  - 170
IP  - 2
DP  - 2014 Feb
TI  - The skeletal effects of pioglitazone in type 2 diabetes or impaired glucose 
      tolerance: a randomized controlled trial.
PG  - 255-62
LID - 10.1530/EJE-13-0793 [doi]
AB  - OBJECTIVE: Preclinical studies, observational studies, and clinical trials 
      suggest that thiazolidinediones (TZDs) reduce bone mineral density (BMD) and 
      increase fracture risk. Most of the evidence on the skeletal effects of TZDs is 
      from studies of rosiglitazone. We set out to investigate the magnitude and 
      etiology of the adverse skeletal effects of pioglitazone. DESIGN: Double-blind, 
      randomized controlled trial. TRIAL REGISTRATION: AUSTRALIA NEW ZEALAND CLINICAL 
      TRIALS REGISTRY, ACTR.ORG.AU IDENTIFIER: ACTRN12607000610437, date of 
      registration 28/11/07. METHODS: A total of 86 people with type 2 diabetes 
      mellitus (T2DM) or impaired glucose tolerance (IGT), median age 64 years, were 
      randomized to receive either pioglitazone 30 mg/day or placebo for 1 year, in 
      addition to their usual diabetes treatments. The primary outcome was change in 
      lumbar spine BMD; secondary outcomes included changes in BMD at other sites and 
      in biochemical markers of bone turnover. RESULTS: Change in spine BMD was not 
      altered by treatment with pioglitazone (Ptreatmentxtime=0.5). After 1 year, the 
      mean (95% CI) between-groups difference in lumbar spine BMD was -0.7% (-2.1, 
      0.7). Pioglitazone increased bone loss at the proximal femur 
      (Ptreatmentxtime=0.03). After 12 months, the between-groups difference in total 
      hip BMD was -1.2% (-2.1, 0.2). Pioglitazone did not alter change in BMD at other 
      skeletal sites, nor did it affect changes in the levels of either of the 
      biochemical markers of bone turnover, procollagen type 1 N-terminal propeptide, 
      or beta-C-terminal telopeptide of type 1 collagen. CONCLUSIONS: Over 1 year, 
      treatment with pioglitazone 30 mg/day did not produce consistent effects on 
      either BMD or bone turnover in people with T2DM or IGT. The mechanism(s) by which 
      pioglitazone increases fracture risk in T2DM is unclear.
FAU - Grey, Andrew
AU  - Grey A
AD  - Department of Medicine, University of Auckland, Private Bag 92019, Auckland, New 
      Zealand.
FAU - Bolland, Mark
AU  - Bolland M
FAU - Fenwick, Sheryl
AU  - Fenwick S
FAU - Horne, Anne
AU  - Horne A
FAU - Gamble, Greg
AU  - Gamble G
FAU - Drury, Paul L
AU  - Drury PL
FAU - Reid, Ian R
AU  - Reid IR
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20131221
PL  - England
TA  - Eur J Endocrinol
JT  - European journal of endocrinology
JID - 9423848
RN  - 0 (Bone Density Conservation Agents)
RN  - 0 (Thiazolidinediones)
RN  - X4OV71U42S (Pioglitazone)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Bone Density/*drug effects
MH  - Bone Density Conservation Agents/adverse effects
MH  - Bone Remodeling/drug effects
MH  - Diabetes Mellitus, Type 2/*drug therapy
MH  - Double-Blind Method
MH  - Female
MH  - Fractures, Bone/chemically induced
MH  - Glucose Intolerance/*drug therapy
MH  - Humans
MH  - Lumbar Vertebrae/*drug effects
MH  - Male
MH  - Middle Aged
MH  - Pioglitazone
MH  - Risk
MH  - Spine/drug effects
MH  - Thiazolidinediones/*adverse effects
EDAT- 2013/11/13 06:00
MHDA- 2014/02/27 06:00
CRDT- 2013/11/13 06:00
PHST- 2013/11/13 06:00 [entrez]
PHST- 2013/11/13 06:00 [pubmed]
PHST- 2014/02/27 06:00 [medline]
AID - EJE-13-0793 [pii]
AID - 10.1530/EJE-13-0793 [doi]
PST - epublish
SO  - Eur J Endocrinol. 2013 Dec 21;170(2):255-62. doi: 10.1530/EJE-13-0793. Print 2014 
      Feb.