Diabetes, bone and glucose-lowering agents: clinical outcomes

Schwartz, Ann V.

doi:10.1007/s00125-017-4283-6

Cited by 60 publications

(52 citation statements)

References 98 publications

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“…(Masillo et al, 1998;Szkudelski, 2012) Bone quality is normally preserved by the process of bone remodeling; that comprises continuous resorption and formation of bone to substitute old tissue with new tissue. Equilibrium between osteoclast-dependent bone resorption and bone formation (which relies on osteoblast activity), is essential for the maintenance of bone mass (Schwartz, 2017). These features were clearly seen in the specimens of control group (I) of our study, through the presence of multiple resting lines; denoting bone formation and reversal lines; denoting bone resorption.…”

Section: Discussion:-supporting

confidence: 54%

Biological Impact of Metformin Versus Thiazolidinedione on Alveolar Bone of Induced Diabetic Rats (A Histological and Immuno-Histomorphometric Study).

Shiekh¹,

Adawy²

2017

IJAR

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Objective: To evaluate how the most currently used anti-diabetic drugs (pioglitazone & metformin) can secondarily affect diabetic alveolar bone. Materials and methods: 70 adult male rats (170-200 g) were obtained. Diabetes was induced in 60 animals by intraperitoneal administration of nicotinamide (NA) (270 mg/kg) 15 min before IV administration of STZ (65 mg/kg). The rats were divided into four groups: Control; Group (I): composed of 10 rats without diabetes. Experimental groups; Group (II) composed of 20 diabetic rats. Group (III): 20 diabetic rats received pioglitazone (4 mg/kg/day). Group (IV): composed of 20 diabetic rats received metformin (250 mg/kg/day). By the end of the experimental period (4 weeks), all rats were sacrificed. The mandibles specimens were processed for histological examination and immunostained by Osteoprotogrin for immunohistomorphometry. Results: The histological results in (group IV) revealed minimal osteoporotic features of alveolar bone in relation to (group III) that showed an obvious deterioration of the alveolar bone. Immunohistochemical results showed mild to strong stained areas in group (IV) and negative immune-stain for all regions except for few areas appeared with very mild stain in group (III). Statistical analysis revealed that no significant difference between group I and group IV. Moreover, the difference between group IV and groups II and III was significant. Conclusion: Our result stands as a source of data regarding the in vivo superior influence of anti-diabetic drug Metformin versus Thiazolidinedione (Pioglitazone) on diabetic alveolar bone health by its inhibitory effect on diabetic bone loss.Copy Right, IJAR, 2017,. All rights reserved.

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Section: Discussion:-supporting

confidence: 54%

Biological Impact of Metformin Versus Thiazolidinedione on Alveolar Bone of Induced Diabetic Rats (A Histological and Immuno-Histomorphometric Study).

Shiekh¹,

Adawy²

2017

IJAR

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“…T2DM is also a risk factor for delayed healing and increased mortality following a hip fracture . Because of these issues, effective fracture prevention strategies are needed for patients with T2DM …”

Section: Introductionmentioning

confidence: 99%

Abaloparatide in Postmenopausal Women With Osteoporosis and Type 2 Diabetes: A Post Hoc Analysis of the ACTIVE Study

et al. 2020

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Type 2 diabetes mellitus (T2DM) increases fracture risk despite normal or increased BMD. Abaloparatide reduces fracture risk in patients with postmenopausal osteoporosis (PMO); however, its efficacy in women with T2DM is unknown. This post hoc analysis evaluated the efficacy and safety of abaloparatide in patients with T2DM. The analysis included patients with T2DM from the Abaloparatide Comparator Trial In Vertebral Endpoints (ACTIVE), a phase 3, double‐blind, randomized, placebo‐ and active‐controlled trial. In ACTIVE, participants were randomized 1:1:1 to daily s.c. injections of placebo, abaloparatide (80 μg), or open‐label teriparatide (20 μg) for 18 months. A total of 198 women with PMO and T2DM from 21 centers in 10 countries were identified from ACTIVE through review of their medical records. The main outcomes measured included effect of abaloparatide versus placebo on BMD and trabecular bone score (TBS), with secondary outcomes of fracture risk and safety, in patients from ACTIVE with T2DM. Significant (p < 0.001) improvements in BMD at total hip (mean change 3.0% versus −0.4%), femoral neck (2.6% versus −0.2%), and lumbar spine (8.9% versus 1.3%) and TBS at lumbar spine (3.72% versus −0.56%) were observed with abaloparatide versus placebo at 18 months. Fracture events were fewer with abaloparatide treatment in patients with T2DM, and differences were not significant between groups except nonvertebral fractures in the abaloparatide versus placebo groups (p = 0.04). Safety was consistent with the ACTIVE population. In conclusion, in women with PMO and T2DM, abaloparatide treatment resulted in significant improvements in BMD and TBS versus placebo, consistent with the overall ACTIVE population © 2020 The Authors. JBMR Plus published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research.

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“…However, what is remarkable is that 6/37 (16.2%) patients in surgery group experienced spontaneous fractures, which occurred in only 1/17 (5.9%) in the control group (8). Weight loss, even with lifestyle changes, is associated with a reduction in BMD, as observed in patients participating in the LookAhead Trial (9). As a matter of fact, bariatric surgery determines a state of controlled malnutrition and thus, in addition to weight reduction, patients commonly present with vitamin D deficiency and difficulty in calcium absorption (4), which occurs preferentially in the duodenum, excluded from food transit in the gastric bypass operation.…”

Section: T His Issue Of the Archives Of Endocrinology Andmentioning

confidence: 89%

“…Not only weight loss is related to increased risk of bone fractures, but also some drugs used in the treatment of DM2 are associated with bone fracture, such as thiazolidinediones (OR 1.94 [95% CI 1.60, 2.35]) and SGLT2 inhibitors (1.32 [95% CI 1.00, 1.74]), particularly canagliflozin (9). While thiazolidinediones possibly inhibit osteoblasts differentiation and stimulate osteoclasts, increasing reabsorption (10), SGLT2 inhibitors may raise serum phosphate levels, implying in an elevation of FGF23 and, consequently, inhibition of the formation of calcitriol (9).…”

Section: T His Issue Of the Archives Of Endocrinology Andmentioning

confidence: 99%

“…While thiazolidinediones possibly inhibit osteoblasts differentiation and stimulate osteoclasts, increasing reabsorption (10), SGLT2 inhibitors may raise serum phosphate levels, implying in an elevation of FGF23 and, consequently, inhibition of the formation of calcitriol (9). In addition, in diabetic patients the occurrence of hypoglycemia and complications related to DM2, like microangiopathy, increase the risk of falls and consequently bone fractures (9).…”

Section: T His Issue Of the Archives Of Endocrinology Andmentioning

confidence: 99%

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The obesity puzzle: focus on bone turnover after bariatric surgery

Melo

2017

Arch. Endocrinol. Metab.

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T his issue of the Archives of Endocrinology andMetabolism encompasses three studies related to obesity. The influence of genetics on the development of metabolic obesity complications, quality of life of obese patients and bone metabolism after bariatric surgery are discussed in order to increase the knowledge of these aspects in this complex disease.The article "Prevalence of musculoskeletal symptoms in obese patients candidates for bariatric surgery and its impact on health related quality of life" by Calenzani and cols. emphasizes the relationship between obesity and musculoskeletal symptoms and their influence on physical and mental aspects linked to the quality of life. In addition to the classical metabolic disorders related to obesity that abbreviate patients' lives, the physical limitation caused by arthritis and joint deformities causes impairment in mobility, increasing sedentary lifestyle, with consequent reduction in energy expenditure (1). Obese patients reported a very high frequency of pain in ankles/feet, knees and lumbar region. These symptoms impair deambulation and, thus obesity withdraws the right to come and go of these patients, determining furthermore impairment in their quality of life (1). Differently from Brilmann and cols. (2), who found a negative correlation between body mass index (BMI) and quality of life scores assessed through SF-36, Calenzani and cols. did not observed this association, that could be consequence of the relatively small and homogenously class 3 obesity sample of patients, as emphasized by the authors (1).The relationship between two main metabolic disorders, diabetes mellitus type 2 (DM2) and systemic arterial hypertension (SAH), with 12 polymorphisms in the genes encoding ghrelin (GHRL, rs26802), uncoupling protein 2 (UCP2, rs659366), uncoupling protein 3 (UCP3, rs1800849), FTO (rs9939609), leptin (LEP, rs7799039), leptin receptor (LEPR, rs1137101), and serotonin receptor (5-HT2C, rs3813929) was investigated by Schnor and cols. and is reported in the paper "Association of 5-HT2C (rs3813929) and UCP3 (rs1800849) gene polymorphisms with type 2 diabetes in obese women candidates for bariatric surgery". The study, which evaluated 351 obese women candidates for bariatric surgery, reports a 5-fold increased risk of having DM2 in T allele carriers of the rs3813929 and a 3-fold increased risk also for DM2 in CC genotype carriers of the rs1800849 (3). Analyzes of polymorphic variants can frequently lead to conflicting results, either because of the sample size or mainly because of the genetic background. The genetic influence on complex diseases is more associated with the interaction of several polymorphisms than with isolated polymorphisms. Thus, while one single published article reported a similar finding concerning the polymorphism in the UCP3 gene, studies about the polymorphism in the 5-HT2C gene present controversial results (3).

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Diabetes, bone and glucose-lowering agents: clinical outcomes

Cited by 60 publications

References 98 publications

Biological Impact of Metformin Versus Thiazolidinedione on Alveolar Bone of Induced Diabetic Rats (A Histological and Immuno-Histomorphometric Study).

Biological Impact of Metformin Versus Thiazolidinedione on Alveolar Bone of Induced Diabetic Rats (A Histological and Immuno-Histomorphometric Study).

Abaloparatide in Postmenopausal Women With Osteoporosis and Type 2 Diabetes: A Post Hoc Analysis of the ACTIVE Study

The obesity puzzle: focus on bone turnover after bariatric surgery

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