Study: TZDs may increase risk for bone fractures in older women

NEW YORK Women with Type 2 diabetes who take a commonly prescribed class of medications to treat insulin resistance may be at a higher risk for developing bone fractures, according to a study published in the Journal of Clinical Endocrinology & Metabolism.

The study, led by  L. Keoki Williams, M.D., MPH, Center for Health Services Research and Department of Internal Medicine at Henry Ford Hospital and colleagues, sought to determine the relationship between thiazolidinedione use and fracture risk in patients with Type 2 diabetes. Williams and his colleagues conducted a retrospective study from Jan. 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 one prescription fill for a TZD. The researchers used electronically maintained medical claims data to identify nontraumatic bone fractures.

After taking a thiazolidinedione for one year, the women were 50% more likely to have a bone fracture than patients not taking TZDs. Similar findings were observed in treated women 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.

"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 TZDs," said study senior author L. Keoki Williams, M.D., MPH, Center for Health Services Research and Department of Internal Medicine at Henry Ford Hospital.

Williams also suggested that Type 2 diabetics should discuss other suitable treatment options with their doctors.

Such TZDs as pioglitazone and rosiglitazone are designed help keep blood glucose levels on target by decreasing insulin resistance and making body tissues more sensitive to insulin's effects. TZDs also cut down on the amount of glucose made by the liver in patients with Type 2 diabetes.