Document Detail


Intensive glycemic control and thiazolidinedione use: effects on cortical and trabecular bone at the radius and tibia.
MedLine Citation:
PMID:  23377193     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Factors that contribute to bone fragility in type 2 diabetes are not well understood. We assessed the effects of intensive glycemic control, thiazolidinediones (TZDs), and A1C levels on bone geometry and strength at the radius and tibia. In a substudy of the Action to Control Cardiovascular Risk in Diabetes trial, peripheral quantitative computed tomographic (pQCT) scans of the radius and tibia were obtained 2 years after randomization on 73 participants (intensive n = 35, standard n = 38). TZD use and A1C levels were measured every 4 months during the trial. Effects of intervention assignment, TZD use, and A1C on pQCT parameters were assessed in linear regression models. Intensive, compared with standard, glycemic control was associated with 1.3 % lower cortical volumetric BMD at the tibia in men (p = 0.02) but not with other pQCT parameters. In women, but not men, each additional year of TZD use was associated with an 11 % lower polar strength strain index (SSIp) at the radius (p = 0.04) and tibia (p = 0.002) in models adjusted for A1C levels. In women, each additional 1 % increase in A1C was associated with an 18 % lower SSIp at the ultradistal radius (p = 0.04) in models adjusted for TZD use. There was no consistent evidence of an effect of intensive, compared with standard, glycemic control on bone strength at the radius or tibia. In women, TZD use may reduce bone strength at these sites. Higher A1C may also be associated with lower bone strength at the radius, but not tibia, in women.
Authors:
Ann V Schwartz; Eric Vittinghoff; Karen L Margolis; Lesley M Scibora; Lisa Palermo; Walter T Ambrosius; Trisha F Hue; Kristine E Ensrud
Related Documents :
24508183 - Self-reported impulsivity, but not behavioral approach or inhibition, mediates the rela...
9058393 - Prevalence and impact of migraine.
18787733 - Is weight loss the optimal target for obesity-related cardiovascular disease risk reduc...
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2013-02-05
Journal Detail:
Title:  Calcified tissue international     Volume:  92     ISSN:  1432-0827     ISO Abbreviation:  Calcif. Tissue Int.     Publication Date:  2013 May 
Date Detail:
Created Date:  2013-04-18     Completed Date:  2013-12-12     Revised Date:  2014-05-07    
Medline Journal Info:
Nlm Unique ID:  7905481     Medline TA:  Calcif Tissue Int     Country:  United States    
Other Details:
Languages:  eng     Pagination:  477-86     Citation Subset:  IM    
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Blood Glucose / metabolism*
Bone Density
Bone and Bones / drug effects*,  pathology
Diabetes Complications / metabolism
Diabetes Mellitus / drug therapy*
Female
Hemoglobin A, Glycosylated / metabolism
Humans
Linear Models
Male
Middle Aged
Radius / drug effects*
Risk Factors
Thiazolidinediones / therapeutic use*
Tibia / drug effects*
Time Factors
Tomography, X-Ray Computed
Grant Support
ID/Acronym/Agency:
IAA-Y1-HC-1010/HC/NHLBI NIH HHS; IAA-Y1-HC-9035/HC/NHLBI NIH HHS; N01-HC-95178/HC/NHLBI NIH HHS; N01-HC-95179/HC/NHLBI NIH HHS; N01-HC-95180/HC/NHLBI NIH HHS; N01-HC-95181/HC/NHLBI NIH HHS; N01-HC-95182/HC/NHLBI NIH HHS; N01-HC-95183/HC/NHLBI NIH HHS; N01-HC-95184/HC/NHLBI NIH HHS; R01 DK069514/DK/NIDDK NIH HHS; R01DK069514/DK/NIDDK NIH HHS
Chemical
Reg. No./Substance:
0/Blood Glucose; 0/Hemoglobin A, Glycosylated; 0/Thiazolidinediones
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Cytotoxicity of chemotherapeutic agents in glyceraldehyde-3-phosphate dehydrogenase-depleted human l...
Next Document:  The effects of drospirenone-ethinyl estradiol and drospirenone-ethinyl estradiol + metformin on ov...