Have the glitazones anything to do with fractures?
Objective: Thiazolidinedione (glitazone) (GLT) use was reported to increase frequency of fractures by the ADOPT study. Investigation of this discovery is the aim of the present work.
Materials and methods: The patients and their clinical histories were examined when each ambulatory patient was personally visited by the author, for 6 months: 108 males and 160 females were seen. The GLT group was compared with the OAD and insulin user group. Moreover, the relationships between the fractured and non-fractured groups, with respect to sex, age and duration of treatment, were tested for each type of treatment.
Results: There were 7 fractures in males and 20 in females. The sex association was statistically significant (P<0.01). There were 2 fractures (Colles and cheek bone) in the GLT group (102 patients) and 25 in the OAD+insulin group (166 patients) This difference was statiscally significant (P<0.01). Fracture incidence had nothing to do with age in the OAD and insulin group, but did in the GLT group (P<0.01). It was, as well, unassociated with treatment duration in either the GLT or OAD group, but was so associated in the insulin group (P<0.01). Moreover, the type of fractures observed was also unlike that reported by ADOPT.
Conclusion: For these reasons, GLT is not believed to cause fractures; they have, rather, a protective effect, as was to be expexted by their action on NF-κB and TNF.