Padilla Apuntate Nuria, Puerto Cabeza Carmen G, Gallego Royo Alba, Goñi Ros Nuria, Abadía Molina Claudia, Acha Pérez Javier, Calmarza Pilar
Service of Clinical Biochemistry, Miguel Servet University Hospital, Zaragoza, Spain.
Service of Preventive Medicine, Miguel Servet University Hospital, Zaragoza, Spain.
Adv Lab Med. 2024 Apr 3;5(1):85-89. doi: 10.1515/almed-2024-0038. eCollection 2024 Mar.
The prevalence of diabetes mellitus type 2 (DMT2) is increasing exponentially worldwide. DMT2 patients have been found to be at a higher risk for bone fractures than the healthy population. Hence, improving our understanding of the impact of antidiabetic drugs on bone metabolism is crucial.
A descriptive, retrospective study involving 106 patients receiving six groups of antidiabetic drugs: insulin; dipeptidylpeptidase four inhibitors (DPP4i); glucagon-like peptide type 1 receptor agonists (GLP1ra); sulfonylureas; sodium-glucose cotransporter two inhibitors (SGLT2i); and pioglitazone, in which osteocalcin (OC), bone alkaline phosphatase (BAP) and C-terminal telopeptide of collagen type 1 or beta-crosslaps (β-CTx) were determined.
β-CTx concentrations were higher in the patients treated with pioglitazone, as compared to patients treated with DPP4i (p=0.035), SGLT2i (p=0.020) or GLP1ra (p<0.001). The lowest β-CTx concentrations were observed in the patients treated with GLP1ra.
Bone remodeling is influenced by the type of antidiabetic drug administered to DMT2 patients. In our study, the patients who received pioglitazone showed higher β-CTx concentrations, as compared to patients treated with other types of antidiabetic drugs. This finding highlights the convenience of avoiding these drugs, especially in postmenopausal women with DMT2. GLP1ra drugs were associated with the lowest β-CTx concentrations, which suggests that these agents could exert beneficial effects on bone metabolism.
2型糖尿病（DMT2）在全球的患病率正呈指数级增长。已发现DMT2患者比健康人群有更高的骨折风险。因此，加深我们对抗糖尿病药物对骨代谢影响的理解至关重要。
一项描述性回顾性研究，涉及106例接受六组抗糖尿病药物治疗的患者：胰岛素；二肽基肽酶4抑制剂（DPP4i）；胰高血糖素样肽-1受体激动剂（GLP1ra）；磺脲类药物；钠-葡萄糖协同转运蛋白2抑制剂（SGLT2i）；以及吡格列酮，测定了这些患者的骨钙素（OC）、骨碱性磷酸酶（BAP）和I型胶原C端肽或β-交联C端肽（β-CTx）。
与接受DPP4i（p = 0.035）、SGLT2i（p = 0.020）或GLP1ra（p < 0.001）治疗的患者相比，接受吡格列酮治疗的患者β-CTx浓度更高。接受GLP1ra治疗的患者β-CTx浓度最低。
DMT2患者所使用的抗糖尿病药物类型会影响骨重塑。在我们的研究中，与接受其他类型抗糖尿病药物治疗的患者相比，接受吡格列酮治疗的患者β-CTx浓度更高。这一发现凸显了避免使用这些药物的便利性，尤其是对于患有DMT2的绝经后女性。GLP1ra药物与最低的β-CTx浓度相关，这表明这些药物可能对骨代谢产生有益影响。
