Conventional antidiabetic agents and bone health: A pilot case–control study

Autor:	Mahesh Shekoba, Joshua Jonathan Norris, Jeffrey Pradeep Raj, Rajkumar S Amaravati, Shreeraam Venkatachalam
Jazyk:	angličtina
Rok vydání:	2019
Předmět:	medicine.medical_specialty insulin medicine.medical_treatment Osteoporosis lcsh:Medicine 030226 pharmacology & pharmacy 03 medical and health sciences 0302 clinical medicine Diabetes mellitus Internal medicine medicine 030212 general & internal medicine bone health Risk factor Glycemic lcsh:R5-920 business.industry Insulin Antidiabetic drugs lcsh:R Case-control study Type 2 Diabetes Mellitus General Medicine Odds ratio medicine.disease osteoporosis Original Article business lcsh:Medicine (General) oral hypoglycemic agents
Zdroj:	Perspectives in Clinical Research, Vol 10, Iss 4, Pp 177-182 (2019) Perspectives in Clinical Research
ISSN:	2229-3485
Popis:	Background and Objectives: The burden of noncommunicable diseases such as diabetes (type 2 diabetes mellitus [T2DM]) and osteoporosis is increasing with increasing longevity. Uncontrolled T2DM is an independent risk factor for osteoporosis explained by the insulin osteocalcin pathway. Due to limited information on the effect of various commonly used antidiabetic agents (ADA) on bone health, our study aims to analyze the association between the two. Methodology: This is a case–control study, with 100 cases of clinical osteoporosis and 100 age-, sex-, and dietary status-matched controls in whom osteoporosis was ruled out by dual-energy X-ray absorptiometry scan. Prescription details of T2DM, physical activity levels, and disease status were collected using a pretested questionnaire. Exposure to each ADA was compared using the Chi-squared test. Binary logistic regression was performed to adjust the two main confounders, namely glycemic control and physical activity levels, and adjusted risk estimates were calculated. Results: There were a total of 74 T2DM patients, of whom 45 (60.8%) were cases and 29 (39.2%) were controls. Sulfonylureas (adjusted odds ratio [aOR] = 0.164, P = 0.004) and insulin (aOR = 0.248, P = 0.042) showed a significant protective effect on bone health. Biguanides (OR = 1.994, P = 0.029) and thiazolidinediones (OR: 5.444, P = 0.033), which demonstrated that an increased risk of osteoporosis in univariate analysis became insignificant after multivariate analysis. Conclusion: Sulfonylureas and insulin through the insulin osteocalcin pathway show favorable effect on bone health, but the probability of increased fractures secondary to hypoglycemic falls should be borne in mind. We recommend larger prospective studies to confirm this association.
Databáze:	OpenAIRE
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