Berberoglu Zehra, Gursoy Alptekin, Bayraktar Nilufer, Yazici Ayse Canan, Bascil Tutuncu Neslihan, Guvener Demirag Nilgun
Department of Endocrinology and Metabolism, Baskent University Faculty of Medicine, 06490 Bahcelievler, Ankara, Turkey.
J Clin Endocrinol Metab. 2007 Sep;92(9):3523-30. doi: 10.1210/jc.2007-0431. Epub 2007 Jun 26.
Our objectives were to evaluate the effect of rosiglitazone on bone metabolism and to assess the association between changes in bone turnover parameters and plasma cytokine levels in postmenopausal diabetic women.
This was a 12-wk open-label randomized-controlled trial.
A total of 56 obese postmenopausal women with newly diagnosed diabetes and 26 nondiabetic healthy controls matched for age and body mass index were included in the study.
The subjects were instructed to follow a weight-maintenance diet. Half were randomly assigned to receive rosiglitazone 4 mg/d, and the other half remained on diet alone.
Before and after the interventions, metabolic bone markers and serum cytokine levels were assessed.
Serum total alkaline phosphatase (ALP) and bone-specific ALP levels were statistically significantly lower 12 wk after initiation of rosiglitazone treatment. There were no statistically significant changes in osteocalcin levels among the three groups or in deoxypyridinoline levels in the rosiglitazone group. At the end of 12 wk, all patients had statistically significantly decreased IL-1beta and TNF-alpha levels compared with baseline. Changes in bone-specific ALP levels showed a moderate negative correlation with the changes in the TNF-alpha levels after rosiglitazone treatment and after diet in the diabetic control group.
Rosiglitazone use is associated with reduced bone formation at earlier stages in postmenopausal diabetic women. The cytokine-lowering effects of rosiglitazone and lifestyle changes could reverse the early inhibitory effect of rosiglitazone therapy on bone formation. Further studies will clarify the long-term effects of rosiglitazone therapy on bone loss and fracture.
我们的目的是评估罗格列酮对骨代谢的影响，并评估绝经后糖尿病女性骨转换参数变化与血浆细胞因子水平之间的关联。
这是一项为期12周的开放标签随机对照试验。
共有56名新诊断为糖尿病的肥胖绝经后女性以及26名年龄和体重指数相匹配的非糖尿病健康对照者纳入研究。
指导受试者遵循维持体重的饮食。一半患者被随机分配接受4mg/d的罗格列酮治疗，另一半仅维持饮食。
在干预前后，评估代谢骨标志物和血清细胞因子水平。
罗格列酮治疗开始12周后，血清总碱性磷酸酶（ALP）和骨特异性ALP水平在统计学上显著降低。三组之间骨钙素水平以及罗格列酮组中的脱氧吡啶啉水平均无统计学上的显著变化。在12周结束时，与基线相比，所有患者的IL-1β和TNF-α水平在统计学上均显著降低。在糖尿病对照组中，罗格列酮治疗后以及饮食后，骨特异性ALP水平的变化与TNF-α水平的变化呈中度负相关。
在绝经后糖尿病女性的早期阶段，使用罗格列酮与骨形成减少有关。罗格列酮降低细胞因子的作用以及生活方式的改变可能会逆转罗格列酮治疗对骨形成的早期抑制作用。进一步的研究将阐明罗格列酮治疗对骨质流失和骨折的长期影响。
