Oral anti-diabetic drugs and fracture risk, cut to the bone: safe or dangerous? A narrative review

被引：74
作者：
Palermo, A. [1 ]
D'Onofrio, L. [1 ]
Eastell, R. [2 ]
Schwartz, A. V. [3 ]
Pozzilli, P. [1 ,4 ]
Napoli, N. [1 ,5 ]
机构：
[1] Univ Campus Biomed Rome, Dept Endocrinol & Diabet, I-00128 Rome, Italy
[2] Univ Sheffield, Acad Unit Bone Metab, Sheffield S10 2TN, S Yorkshire, England
[3] Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA
[4] Univ London, Ctr Diabet, Barts & London Sch Med, London, England
[5] Washington Univ, Div Bone & Mineral Dis, St Louis, MO USA
来源：
OSTEOPOROSIS INTERNATIONAL | 2015年 / 26卷 / 08期
关键词：
BMD; Bone turnover markers; Diabetes; Fracture; Oral anti-diabetic drugs; Osteoporosis; GLUCAGON-LIKE PEPTIDE-1; TYPE-2; DIABETES-MELLITUS; DIPEPTIDYL PEPTIDASE-4 INHIBITORS; INDUCE OSTEOCYTE APOPTOSIS; IMPAIRED GLUCOSE-TOLERANCE; MESENCHYMAL STEM-CELLS; MINERAL DENSITY; PPAR-GAMMA; POSTMENOPAUSAL WOMEN; IN-VIVO;
D O I：
10.1007/s00198-015-3123-0
中图分类号：
R5 [内科学];
学科分类号：
1002 ; 100201 ;
摘要：
Fracture risk is higher in older adults with type 2 diabetes and may be influenced by treatments for diabetes. Oral anti-diabetic drugs have different effects on bone metabolism. The purpose of this review is to describe the effects of these drugs on bone metabolism and fracture risk. Osteoporosis is a progressive skeletal disorder that is characterized by compromised bone strength and increased risk of fracture. This condition has become an important global health problem, affecting approximately 200 million people worldwide. Another chronic and highly prevalent condition is diabetes mellitus, which affects more than 380 million people; both type 1 and type 2 diabetes are risk factors for fracture. Type 2 diabetes, in particular, is associated with impaired bone strength, although it is characterized by normal or elevated bone mineral density. Several therapeutic strategies are available to achieve the best outcomes in the management of diabetes mellitus but these have different effects on bone metabolism. The purpose of this narrative review is to describe the effects of oral hypoglycemic agents (metformin, sulfonylureas, thiazolidinediones, meglitinides, dipeptidyl peptidase-4 inhibitors, glucagon-like peptide-1 receptor agonists and sodium-dependent glucose transporter 2 inhibitors) on bone metabolism and on the risk of developing fragility fractures in patients with type 2 diabetes. Both diabetes and osteoporosis represent a significant burden in terms of healthcare costs and quality of life. It is very important to choose therapies for diabetes that ensure good metabolic control whilst preserving skeletal health.
引用
收藏
页码：2073 / 2089
页数：17
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