Comparison of the Effects of Various Antidiabetic Medication on Bone Mineral Density in Patients with Type 2 Diabetes Mellitus
Background Prospective comparative studies on the effects of various antidiabetic agents on bone metabolism are limited. This study aimed to assess changes in bone mass and biochemical bone markers in postmenopausal patients with type 2 diabetes mellitus (T2DM). Methods This prospective, multicenter...
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| Format: | Article |
| Language: | English |
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Korean Endocrine Society
2021-08-01
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| Series: | Endocrinology and Metabolism |
| Subjects: | |
| Online Access: | http://www.e-enm.org/upload/pdf/enm-2021-1026.pdf |
| _version_ | 1818754801711710208 |
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| author | Jeonghoon Ha Yejee Lim Mee Kyoung Kim Hyuk-Sang Kwon Ki-Ho Song Seung Hyun Ko Moo Il Kang Sung Dae Moon Ki-Hyun Baek |
| author_facet | Jeonghoon Ha Yejee Lim Mee Kyoung Kim Hyuk-Sang Kwon Ki-Ho Song Seung Hyun Ko Moo Il Kang Sung Dae Moon Ki-Hyun Baek |
| author_sort | Jeonghoon Ha |
| collection | DOAJ |
| description | Background Prospective comparative studies on the effects of various antidiabetic agents on bone metabolism are limited. This study aimed to assess changes in bone mass and biochemical bone markers in postmenopausal patients with type 2 diabetes mellitus (T2DM). Methods This prospective, multicenter, open-label, comparative trial included 264 patients with T2DM. Patients who had received a metformin, or sulfonylurea/metformin combination (Group 1); a thiazolidinedione combination (Group 2); a dipeptidyl peptidase-4 inhibitor (gemigliptin) combination (Group 3); or an sodium-glucose cotransporter 2 inhibitor (empagliflozin) combination (Group 4) were prospectively treated for 12 months; bone mineral density (BMD) and bone turnover marker (BTM) changes were evaluated. Results The femoral neck BMD percentage changes were −0.79%±2.86% (Group 1), −2.50%±3.08% (Group 2), −1.05%±2.74% (Group 3), and −1.24%±2.91% (Group 4) (P<0.05). The total hip BMD percentage changes were −0.57%±1.79% (Group 1), −1.74%±1.48% (Group 2), −0.75%±1.87% (Group 3), and −1.27%±1.72% (Group 4) (P<0.05). Mean serum BTM (C-terminal type 1 collagen telopeptide and procollagen type 1 amino-terminal propeptide) levels measured during the study period did not change over time or differ between groups. Conclusion Significant bone loss in the femoral neck and total hip was associated with thiazolidinedione combination regimens. However, bone loss was not significantly associated with combination regimens including gemigliptin or empagliflozin. Caution should be exercised during treatment with antidiabetic medications that adversely affect the bone in patients with diabetes at a high risk of bone loss. |
| first_indexed | 2024-12-18T05:29:02Z |
| format | Article |
| id | doaj.art-aa6b91e895c34ba6bc2aef3b30ab02b1 |
| institution | Directory Open Access Journal |
| issn | 2093-596X 2093-5978 |
| language | English |
| last_indexed | 2024-12-18T05:29:02Z |
| publishDate | 2021-08-01 |
| publisher | Korean Endocrine Society |
| record_format | Article |
| series | Endocrinology and Metabolism |
| spelling | doaj.art-aa6b91e895c34ba6bc2aef3b30ab02b12022-12-21T21:19:29ZengKorean Endocrine SocietyEndocrinology and Metabolism2093-596X2093-59782021-08-0136489590310.3803/EnM.2021.10262192Comparison of the Effects of Various Antidiabetic Medication on Bone Mineral Density in Patients with Type 2 Diabetes MellitusJeonghoon Ha0Yejee Lim1Mee Kyoung Kim2Hyuk-Sang Kwon3Ki-Ho Song4Seung Hyun Ko5Moo Il Kang6Sung Dae Moon7Ki-Hyun Baek8 Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea Division of General Internal Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Seoul, Korea Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Seoul, Korea Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Seoul, Korea Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Seoul, Korea Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon, Seoul, Korea Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea Division of Endocrinology and Metabolism, Department of Internal Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Seoul, KoreaBackground Prospective comparative studies on the effects of various antidiabetic agents on bone metabolism are limited. This study aimed to assess changes in bone mass and biochemical bone markers in postmenopausal patients with type 2 diabetes mellitus (T2DM). Methods This prospective, multicenter, open-label, comparative trial included 264 patients with T2DM. Patients who had received a metformin, or sulfonylurea/metformin combination (Group 1); a thiazolidinedione combination (Group 2); a dipeptidyl peptidase-4 inhibitor (gemigliptin) combination (Group 3); or an sodium-glucose cotransporter 2 inhibitor (empagliflozin) combination (Group 4) were prospectively treated for 12 months; bone mineral density (BMD) and bone turnover marker (BTM) changes were evaluated. Results The femoral neck BMD percentage changes were −0.79%±2.86% (Group 1), −2.50%±3.08% (Group 2), −1.05%±2.74% (Group 3), and −1.24%±2.91% (Group 4) (P<0.05). The total hip BMD percentage changes were −0.57%±1.79% (Group 1), −1.74%±1.48% (Group 2), −0.75%±1.87% (Group 3), and −1.27%±1.72% (Group 4) (P<0.05). Mean serum BTM (C-terminal type 1 collagen telopeptide and procollagen type 1 amino-terminal propeptide) levels measured during the study period did not change over time or differ between groups. Conclusion Significant bone loss in the femoral neck and total hip was associated with thiazolidinedione combination regimens. However, bone loss was not significantly associated with combination regimens including gemigliptin or empagliflozin. Caution should be exercised during treatment with antidiabetic medications that adversely affect the bone in patients with diabetes at a high risk of bone loss.http://www.e-enm.org/upload/pdf/enm-2021-1026.pdfosteoporosisdiabetes mellitusbone densitythiazolidinedionessodium-glucose transporter 2 inhibitors |
| spellingShingle | Jeonghoon Ha Yejee Lim Mee Kyoung Kim Hyuk-Sang Kwon Ki-Ho Song Seung Hyun Ko Moo Il Kang Sung Dae Moon Ki-Hyun Baek Comparison of the Effects of Various Antidiabetic Medication on Bone Mineral Density in Patients with Type 2 Diabetes Mellitus Endocrinology and Metabolism osteoporosis diabetes mellitus bone density thiazolidinediones sodium-glucose transporter 2 inhibitors |
| title | Comparison of the Effects of Various Antidiabetic Medication on Bone Mineral Density in Patients with Type 2 Diabetes Mellitus |
| title_full | Comparison of the Effects of Various Antidiabetic Medication on Bone Mineral Density in Patients with Type 2 Diabetes Mellitus |
| title_fullStr | Comparison of the Effects of Various Antidiabetic Medication on Bone Mineral Density in Patients with Type 2 Diabetes Mellitus |
| title_full_unstemmed | Comparison of the Effects of Various Antidiabetic Medication on Bone Mineral Density in Patients with Type 2 Diabetes Mellitus |
| title_short | Comparison of the Effects of Various Antidiabetic Medication on Bone Mineral Density in Patients with Type 2 Diabetes Mellitus |
| title_sort | comparison of the effects of various antidiabetic medication on bone mineral density in patients with type 2 diabetes mellitus |
| topic | osteoporosis diabetes mellitus bone density thiazolidinediones sodium-glucose transporter 2 inhibitors |
| url | http://www.e-enm.org/upload/pdf/enm-2021-1026.pdf |
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