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| |  Thiazolidinediones Increase Risk for Bone Fractures in Older Women DETROIT -- February 10, 2010 -- A study published in the February issue of The Journal of Clinical Endocrinology & Metabolism finds that women with type 2 diabetes who take thiazolidinediones to treat insulin resistance may be at a higher risk for developing bone fractures. After taking a thiazolidinedione for 1 year, women are 50% more likely to have a bone fracture than patients not taking thiazolidinediones, according to the study results. And those at the greatest risk for fractures from thiazolidinedione use are women aged older than 65 years. “Older women are already at a higher risk of osteoporosis and osteoporosis-related fractures, which might explain why they appeared to be the most affected by thiazolidinediones,” said senior author L. Keoki Williams, MD, Center for Health Services Research and Department of Internal Medicine, Henry Ford Hospital, Detroit, Michigan. In recent years, thiazolidinediones such as pioglitazone and rosiglitazone have been linked to bone loss and increasing fracture risk. Complicating matters, type 2 diabetes and insulin use are also associated with an increased risk for fractures. To determine the relationship between thiazolidinedione use and fracture risk in patients with type 2 diabetes, Dr. Williams and colleagues conducted a retrospective study from January 2, 2000 to May 31, 2007 of 19,070 Henry Ford patients. Among the study group, 9,620 were women and 9,450 were men. During the study period, 4,511 patients had at least 1 prescription fill for a thiazolidinedione. The researchers used electronically maintained medical claims data to identify non-traumatic bone fractures. The increased risk in women appeared after approximately 1 year of thiazolidinedione use. The location of the fractures in this group also was unique. Typically, osteoporosis-related fractures involve the vertebra and hip. This study, however, found thiazolidinedione use in women to be associated with fractures of the upper extremity and distal lower extremity. Similar findings were observed in treated women aged older than 65 years, who were shown to have a 70% increased risk for developing fractures. Men, regardless of age, were not at an increased risk for fractures. “Although 2 recent studies suggest that men may also be at increased risk for fractures after thiazolidinedione exposure, we did not observe this association for men, despite having nearly equal numbers of men and women in our study,” said co-author Zeina A. Habib, MD, Henry Ford Hospital.
SOURCE: Henry Ford Health System
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