Glitazone bone-loss trigger found

The suspected link between glitazones and bone loss may be due to increased production of bone-destroying osteoclasts, studies in mice have suggested.

The findings add to fears that patients taking glitazones for type-2 diabetes could be at increased risk of osteoporosis.

Clinical trials, such as A Diabetes Outcome Progress in Trial, have already shown significant loss in bone density of patients taking glitazones.

A study carried out at the Howard Hughes Medical Institute in California, now offers a potential explanation.

It focused on peroxisome proliferator-activator receptor-gamma (PPAR-gamma), the molecular target that is activated by glitazones.

It is known to block osteoblast differentiation but its effect on osteoclasts is unknown.

Mice were genetically engineered to lack PPAR-gamma in osteoclasts. They went on to develop increased bone mass.

By contrast, when mice were given rosiglitazone, which activates PPAR-gamma, they developed osteoporosis.

The researchers argue that activating PPAR-gamma accelerates osteoclast differentiation and bone resorption.

'These findings have potential clinical implications that long-term rosiglitazone use in treatment of type-2 diabetes and insulin resistance could cause osteoporosis, owing to a combination of decreased bone formation and increased bone resorption,' the researchers commented.

Findings may also offer a novel therapeutic target for osteoporosis and even rheumatoid arthritis. Selective modulators of PPAR-gamma may be able to boost bone mass in these diseases.

Comment below and tell us what you think

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins


Already registered?

Sign in

Just published

Hospital entrance

NHS England issues warning over norovirus and rising winter pressures

Almost three times as many people were in hospital with norovirus last week compared...

BMA Northern Ireland GP committee chair Dr Alan Stout

Northern Ireland GPs face deepest-ever crisis as practices hand back contracts

Northern Ireland's GP leader has warned that general practice in the region is facing...

GP consulting room

GP appointments hit record high of over 34m in October

GP practices delivered a record 34.3m appointments in October this year excluding...

GP consultation

New contract that enforces continuity would make GPs and patients safer, says watchdog

A new GP contract that makes continuity of care an 'essential requirement' for practices...

GP receptionist on the phone

Some practices to receive funding to upgrade digital phone systems

GP practices whose digital phone systems do not meet new NHS England standards will...

Woman using mobile phone

Safety issues with remote GP consultations 'extremely rare', study shows

Safety incidents are 'extremely rare' in remote GP consultations but risk is higher...