Influence of type 2 diabetes mellitus on bone mineral density response to bisphosphonates in late postmenopausal osteoporosis |
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Authors: | Selcuk Dagdelen Didem Sener Miyase Bayraktar |
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Institution: | (1) Department of Endocrinology and Metabolism, Hacettepe University School of Medicine, Ankara, Turkey;(2) Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey;(3) Hambleden Court 9B, Burrow Road St. Francis Place East Dullwich, SE22 8DE London, UK |
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Abstract: | Bisphosphonates are effective agents for postmenopausal osteoporosis, but their efficacy in patients with type 2 diabetes
mellitus (DM) is not known. The investigators evaluated bone mineral density (BMD) response to alendronate in women with concurrent
late postmenopausal osteoporosis and type 2 DM. In a retrospective, matched case-control study, 26 late postmenopausal osteoporotic
women with type 2 DM (age, 67.6±7.3 y; type 2 DM duration, 12.8±6.8 y; duration of menopause, 10.9±7.4 y; time on alendronate:
4.8±2.3 y; body mass index BMI], 31.4±6.3 kg/m2) were matched with 26 controls according to age, BMI, duration of menopause, and alendronate treatment received. All subjects
were given alendronate 10 mg/d or 70 mg/wk, along with sufficient vitamin D (≥400 IU) and calcium (≥1 g/d) intake, for 4.8
y. Response to alendronate therapy was determined by assessment of mean percent change in BMD of total hip, femoral neck,
forearm, and lateral spine. The presence of type 2 DM resulted in no difference in spinal BMD response to alendronate therapy.
In contrast, BMD in the total hip (mean percent change in BMD, −5.6% vs +1.4%;P=.096), femoral neck (−8.1 % vs +1.1 %;P=.015), and forearm (−3.6% vs +12.7%;P=.013) fell progressively from baseline in subjects with type 2 DM who were taking alendronate for 4.8 y, compared with controls.
Elderly, postmenopausal, osteoporotic obese women with type 2 DM are resistant to long-term bisphosphonates, especially in
regions of the hip, femoral neck, and forearm compared with the spine. The efficacy of bone resorption inhibitors in patients
with type 2 DM, especially in comparison with anabolic agents, should be considered in additional studies. |
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Keywords: | type 2 diabetes osteoporosis bisphosphonates alendronate |
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