PMID- 31649868
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220411
IS  - 2229-3485 (Print)
IS  - 2229-5488 (Electronic)
IS  - 2229-3485 (Linking)
VI  - 10
IP  - 4
DP  - 2019 Oct-Dec
TI  - Conventional antidiabetic agents and bone health: A pilot case-control study.
PG  - 177-182
LID - 10.4103/picr.PICR_125_18 [doi]
AB  - BACKGROUND AND OBJECTIVES: The burden of noncommunicable diseases such as 
      diabetes (type 2 diabetes mellitus [T2DM]) and osteoporosis is increasing with 
      increasing longevity. Uncontrolled T2DM is an independent risk factor for 
      osteoporosis explained by the insulin osteocalcin pathway. Due to limited 
      information on the effect of various commonly used antidiabetic agents (ADA) on 
      bone health, our study aims to analyze the association between the two. 
      METHODOLOGY: This is a case-control study, with 100 cases of clinical 
      osteoporosis and 100 age-, sex-, and dietary status-matched controls in whom 
      osteoporosis was ruled out by dual-energy X-ray absorptiometry scan. Prescription 
      details of T2DM, physical activity levels, and disease status were collected 
      using a pretested questionnaire. Exposure to each ADA was compared using the 
      Chi-squared test. Binary logistic regression was performed to adjust the two main 
      confounders, namely glycemic control and physical activity levels, and adjusted 
      risk estimates were calculated. RESULTS: There were a total of 74 T2DM patients, 
      of whom 45 (60.8%) were cases and 29 (39.2%) were controls. Sulfonylureas 
      (adjusted odds ratio [aOR] = 0.164, P = 0.004) and insulin (aOR = 0.248, P = 
      0.042) showed a significant protective effect on bone health. Biguanides (OR = 
      1.994, P = 0.029) and thiazolidinediones (OR: 5.444, P = 0.033), which 
      demonstrated that an increased risk of osteoporosis in univariate analysis became 
      insignificant after multivariate analysis. CONCLUSION: Sulfonylureas and insulin 
      through the insulin osteocalcin pathway show favorable effect on bone health, but 
      the probability of increased fractures secondary to hypoglycemic falls should be 
      borne in mind. We recommend larger prospective studies to confirm this 
      association.
CI  - Copyright: (c) 2019 Perspectives in Clinical Research.
FAU - Raj, Jeffrey Pradeep
AU  - Raj JP
AD  - Department of Pharmacology, St. John's Medical College, Bengaluru, Karnataka, 
      India.
FAU - Venkatachalam, Shreeraam
AU  - Venkatachalam S
AD  - Department of Orthopaedics, St. John's Medical College, Bengaluru, Karnataka, 
      India.
FAU - Shekoba, Mahesh
AU  - Shekoba M
AD  - Department of Orthopaedics, St. John's Medical College, Bengaluru, Karnataka, 
      India.
FAU - Norris, Joshua Jonathan
AU  - Norris JJ
AD  - Medical Student, St. John's Medical College, Bengaluru, Karnataka, India.
FAU - Amaravati, Rajkumar S
AU  - Amaravati RS
AD  - Department of Orthopaedics, St. John's Medical College, Bengaluru, Karnataka, 
      India.
LA  - eng
PT  - Journal Article
PL  - India
TA  - Perspect Clin Res
JT  - Perspectives in clinical research
JID - 101551517
PMC - PMC6801990
OTO - NOTNLM
OT  - Antidiabetic drugs
OT  - bone health
OT  - insulin
OT  - oral hypoglycemic agents
OT  - osteoporosis
COIS- There are no conflicts of interest.
EDAT- 2019/10/28 06:00
MHDA- 2019/10/28 06:01
PMCR- 2019/10/01
CRDT- 2019/10/26 06:00
PHST- 2019/10/26 06:00 [entrez]
PHST- 2019/10/28 06:00 [pubmed]
PHST- 2019/10/28 06:01 [medline]
PHST- 2019/10/01 00:00 [pmc-release]
AID - PCR-10-177 [pii]
AID - 10.4103/picr.PICR_125_18 [doi]
PST - ppublish
SO  - Perspect Clin Res. 2019 Oct-Dec;10(4):177-182. doi: 10.4103/picr.PICR_125_18.