Schwartz Ann V, Sellmeyer Deborah E
University of California San Francisco, Department of Epidemiology and Biostatistics, 185 Berry Street, Suite 5700, San Francisco, CA 94107, USA.
Expert Opin Drug Saf. 2008 Jan;7(1):69-78. doi: 10.1517/14740338.7.1.69.
Rosiglitazone and pioglitazone are associated with increased fracture risk in women, and, for rosiglitazone, more rapid bone loss. Negative skeletal effects of these thiazolidinediones (TZDs) have also been observed in animal and in vitro models. A central mechanism of action appears to be reduced bone formation, resulting in bone loss. The source of this reduced bone formation may be a shift in the lineage allocation of marrow stems cells away from osteoblasts and towards adipocytes, caused by activation of PPAR-gamma with these TZDs. Research is needed to better understand the mechanisms of bone loss and to identify factors that influence susceptibility to TZD-induced osteoporosis. Clinicians should be aware of the potential for increased fracture risk when prescribing TZDs, particularly in postmenopausal women.
罗格列酮和吡格列酮与女性骨折风险增加相关，对于罗格列酮而言，还会导致更快速的骨质流失。在动物模型和体外模型中也观察到了这些噻唑烷二酮类药物（TZDs）对骨骼的不良影响。其主要作用机制似乎是骨形成减少，从而导致骨质流失。这种骨形成减少的原因可能是这些TZDs激活了PPAR-γ，导致骨髓干细胞的谱系分配从成骨细胞转向脂肪细胞。需要开展研究以更好地理解骨质流失的机制，并确定影响对TZDs诱导的骨质疏松易感性的因素。临床医生在开具TZDs处方时应意识到骨折风险增加的可能性，尤其是在绝经后女性中。
