Why do thiazolidinediones cause fractures?
Various studies have found that TZD use leads to decreased bone mineral density (BMD) and an elevated risk of fracture [4–10]. TZDs affect the differentiation of mesenchymal stem cells, leading to increased adipogenesis at the expense of the formation of osteoblasts [4, 5].
Which are the contraindications of thiazolidinediones?
Thiazolidinediones are therefore contraindicated in patients with moderate to severe symptoms or signs of angina or heart failure during daily activities or at rest (New York Heart Association (NYHA) class III or IV cardiac functional status).
How does pioglitazone cause fracture?
Thiazolidinediones have been found to cause bone loss in some rodent models. In humans, their effects may occur because of increased bone marrow adiposity, decreased osteoblast activity, or reduced aromatase activity leading to altered estrogen production and increased bone resorption.
What are the side effects of thiazolidinediones?
Adverse Effects
- Edema and Congestive Heart Failure.
- Weight Gain.
- Fractures.
- Bladder Cancer.
- Hepatotoxicity.
- Diabetic Macular Edema.
- Increased Ovulation and Teratogenic Effects.
How do thiazolidinediones cause osteoporosis?
In animal models, TZDs induce bone loss by affecting the bone remodeling process; TZDs suppress new bone formation by osteoblasts and increase bone resorption by osteoclasts. Age and sex steroid status determine which mechanism contributes predominantly to the observed bone loss.
WHO FRAX assessment tool?
The Fracture Risk Assessment Tool, or FRAX, is a free online tool that estimates your risk of having a hip or other major fracture in the next 10 years, especially if you have osteoporosis. The other major fractures are your spine, forearm, and shoulder.
Which of the following side effects commonly occurs with use of TZDs?
Conclusions: Common side effects associated with TZDs include edema, weight gain, macular edema and heart failure. Moreover, they may cause hypoglycemia when combined with other antidiabetic drugs as well as decrease hematocrit and hemoglobin levels.
How do thiazolidinediones cause edema?
TZDs may interact synergistically with insulin to cause arterial vasodilatation, leading to sodium reabsorption with a subsequent increase in extracellular volume, and thereby resulting in pedal edema.
Does pioglitazone cause bone fracture?
Pioglitazone increased the absolute fracture risk by 1.6% to 4.9% and the relative risk by 47% to 60%, depending on fracture classification. Our analysis suggests that treatments to improve bone health and prevent falls may help optimize the risk/benefit ratio for pioglitazone.
What is TZD medication?
D. Thiazolidinediones (TZDs) are used to treat Type 2 diabetes by controlling blood sugar and insulin resistance. Drug Info.
What is considered a high risk FRAX score?
The National Osteoporosis Foundation recommends treating patients with FRAX 10-year risk scores of ‘greater than or equal to 3 percent’ for hip fracture or ‘greater than or equal to 20 percent’ for a major osteoporotic fracture to reduce fracture risk.
What is a significant FRAX score?
greater than -1: normal. -1 to -2.5: low bone mass (called osteopenia, a potential precursor condition to osteoporosis) less than -2.5: typically indicates osteoporosis.