Thiazolidinediones and fractures

Evidence from translating research into action for diabetes

Dori Bilik, Laura N. McEwen, Morton B. Brown, Nathan E. Pomeroy, Catherine Kim, Keiko Asao, Jesse C. Crosson, O. Kenrik Duru, Assiamira Ferrara, Victoria C. Hsiao, Andrew J. Karter, Pearl G. Lee, David Marrero, Joe V. Selby, Usha Subramanian, William H. Herman

Research output: Contribution to journalArticle

64 Citations (Scopus)

Abstract

Background: Thiazolidinedione (TZD) treatment has been associated with fractures. The purpose of this study was to examine the association between TZD treatment and fractures in type 2 diabetic patients. Methods: Using data from Translating Research into Action for Diabetes, a multicenter prospective observational study of diabetes care in managed care, we conducted a matched case-control study to assess the odds of TZD exposure in patients with type 2 diabetes with and without fractures. We identified 786 cases based on fractures detected in health plan administrative data. Up to four controls without any fracture diagnoses were matched to each case. Controls were matched on health plan, date of birth within 5 yr, sex, race/ethnicity, and body mass index within 5 kg/m2. We performed conditional logistic regression for premenopausal and postmenopausal women and men to assess the odds of exposure to potential risk factors for fracture, including medications, self-reported limited mobility, and lower-extremity amputations. Results: We found statistically significant increased odds of exposure to TZDs, glucocorticoids, loop diuretics, and self-reported limited mobility for women 50 yr of age and older with fractures. Exposure to both loop diuretics and TZDs, glucocorticoids, and insulin and limited mobility and lower-extremity amputation were associated with fractures in men. Conclusion: Postmenopausal women taking TZDs and the subset of men taking both loop diuretics and TZDs were at increased risk for fractures. In postmenopausal women, risk was associated with higher TZD dose. No difference between rosiglitazone and pioglitazone was apparent.

Original languageEnglish
Pages (from-to)4560-4565
Number of pages6
JournalJournal of Clinical Endocrinology and Metabolism
Volume95
Issue number10
DOIs
StatePublished - Oct 2010

Fingerprint

Thiazolidinediones
Medical problems
Sodium Potassium Chloride Symporter Inhibitors
rosiglitazone
pioglitazone
Amputation
Research
Glucocorticoids
Lower Extremity
Health
Managed Care Programs
Type 2 Diabetes Mellitus
Observational Studies
Case-Control Studies
Body Mass Index
Logistic Models
Parturition
Prospective Studies
Insulin
2,4-thiazolidinedione

ASJC Scopus subject areas

  • Biochemistry
  • Clinical Biochemistry
  • Endocrinology
  • Biochemistry, medical
  • Endocrinology, Diabetes and Metabolism

Cite this

Bilik, D., McEwen, L. N., Brown, M. B., Pomeroy, N. E., Kim, C., Asao, K., ... Herman, W. H. (2010). Thiazolidinediones and fractures: Evidence from translating research into action for diabetes. Journal of Clinical Endocrinology and Metabolism, 95(10), 4560-4565. https://doi.org/10.1210/jc.2009-2638

Thiazolidinediones and fractures : Evidence from translating research into action for diabetes. / Bilik, Dori; McEwen, Laura N.; Brown, Morton B.; Pomeroy, Nathan E.; Kim, Catherine; Asao, Keiko; Crosson, Jesse C.; Duru, O. Kenrik; Ferrara, Assiamira; Hsiao, Victoria C.; Karter, Andrew J.; Lee, Pearl G.; Marrero, David; Selby, Joe V.; Subramanian, Usha; Herman, William H.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 95, No. 10, 10.2010, p. 4560-4565.

Research output: Contribution to journalArticle

Bilik, D, McEwen, LN, Brown, MB, Pomeroy, NE, Kim, C, Asao, K, Crosson, JC, Duru, OK, Ferrara, A, Hsiao, VC, Karter, AJ, Lee, PG, Marrero, D, Selby, JV, Subramanian, U & Herman, WH 2010, 'Thiazolidinediones and fractures: Evidence from translating research into action for diabetes', Journal of Clinical Endocrinology and Metabolism, vol. 95, no. 10, pp. 4560-4565. https://doi.org/10.1210/jc.2009-2638
Bilik, Dori ; McEwen, Laura N. ; Brown, Morton B. ; Pomeroy, Nathan E. ; Kim, Catherine ; Asao, Keiko ; Crosson, Jesse C. ; Duru, O. Kenrik ; Ferrara, Assiamira ; Hsiao, Victoria C. ; Karter, Andrew J. ; Lee, Pearl G. ; Marrero, David ; Selby, Joe V. ; Subramanian, Usha ; Herman, William H. / Thiazolidinediones and fractures : Evidence from translating research into action for diabetes. In: Journal of Clinical Endocrinology and Metabolism. 2010 ; Vol. 95, No. 10. pp. 4560-4565.
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abstract = "Background: Thiazolidinedione (TZD) treatment has been associated with fractures. The purpose of this study was to examine the association between TZD treatment and fractures in type 2 diabetic patients. Methods: Using data from Translating Research into Action for Diabetes, a multicenter prospective observational study of diabetes care in managed care, we conducted a matched case-control study to assess the odds of TZD exposure in patients with type 2 diabetes with and without fractures. We identified 786 cases based on fractures detected in health plan administrative data. Up to four controls without any fracture diagnoses were matched to each case. Controls were matched on health plan, date of birth within 5 yr, sex, race/ethnicity, and body mass index within 5 kg/m2. We performed conditional logistic regression for premenopausal and postmenopausal women and men to assess the odds of exposure to potential risk factors for fracture, including medications, self-reported limited mobility, and lower-extremity amputations. Results: We found statistically significant increased odds of exposure to TZDs, glucocorticoids, loop diuretics, and self-reported limited mobility for women 50 yr of age and older with fractures. Exposure to both loop diuretics and TZDs, glucocorticoids, and insulin and limited mobility and lower-extremity amputation were associated with fractures in men. Conclusion: Postmenopausal women taking TZDs and the subset of men taking both loop diuretics and TZDs were at increased risk for fractures. In postmenopausal women, risk was associated with higher TZD dose. No difference between rosiglitazone and pioglitazone was apparent.",
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T1 - Thiazolidinediones and fractures

T2 - Evidence from translating research into action for diabetes

AU - Bilik, Dori

AU - McEwen, Laura N.

AU - Brown, Morton B.

AU - Pomeroy, Nathan E.

AU - Kim, Catherine

AU - Asao, Keiko

AU - Crosson, Jesse C.

AU - Duru, O. Kenrik

AU - Ferrara, Assiamira

AU - Hsiao, Victoria C.

AU - Karter, Andrew J.

AU - Lee, Pearl G.

AU - Marrero, David

AU - Selby, Joe V.

AU - Subramanian, Usha

AU - Herman, William H.

PY - 2010/10

Y1 - 2010/10

N2 - Background: Thiazolidinedione (TZD) treatment has been associated with fractures. The purpose of this study was to examine the association between TZD treatment and fractures in type 2 diabetic patients. Methods: Using data from Translating Research into Action for Diabetes, a multicenter prospective observational study of diabetes care in managed care, we conducted a matched case-control study to assess the odds of TZD exposure in patients with type 2 diabetes with and without fractures. We identified 786 cases based on fractures detected in health plan administrative data. Up to four controls without any fracture diagnoses were matched to each case. Controls were matched on health plan, date of birth within 5 yr, sex, race/ethnicity, and body mass index within 5 kg/m2. We performed conditional logistic regression for premenopausal and postmenopausal women and men to assess the odds of exposure to potential risk factors for fracture, including medications, self-reported limited mobility, and lower-extremity amputations. Results: We found statistically significant increased odds of exposure to TZDs, glucocorticoids, loop diuretics, and self-reported limited mobility for women 50 yr of age and older with fractures. Exposure to both loop diuretics and TZDs, glucocorticoids, and insulin and limited mobility and lower-extremity amputation were associated with fractures in men. Conclusion: Postmenopausal women taking TZDs and the subset of men taking both loop diuretics and TZDs were at increased risk for fractures. In postmenopausal women, risk was associated with higher TZD dose. No difference between rosiglitazone and pioglitazone was apparent.

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