Effect of pioglitazone on body composition and bone density in subjects with prediabetes in the ACT NOW trial

G. A. Bray; S. R. Smith; M. A. Banerji; D. Tripathy; S. C. Clement; T. A. Buchanan; R. R. Henry; A. E. Kitabchi; S. Mudaliar; N. Musi; R. E. Ratner; D. C. Schwenke; F. B. Stentz; P. D. Reaven; R. A. Defronzo

doi:10.1111/dom.12099

Effect of pioglitazone on body composition and bone density in subjects with prediabetes in the ACT NOW trial

G. A. Bray, S. R. Smith, M. A. Banerji, D. Tripathy, S. C. Clement, T. A. Buchanan, R. R. Henry, A. E. Kitabchi, S. Mudaliar, N. Musi, R. E. Ratner, D. C. Schwenke, F. B. Stentz, P. D. Reaven, R. A. Defronzo

Research output: Contribution to journal › Article › peer-review

29 Scopus citations

Abstract

Aims: This study examined the effects of pioglitazone on body weight and bone mineral density (BMD) prospectively in patients with impaired glucose tolerance as pioglitazone (TZD) increases body weight and body fat in diabetic patients and increases the risk of bone fractures. Methods: A total of 71 men and 163 women aged 49.3 (10.7) years [mean (s.d.)]; body mass index (BMI), 34.5 (5.9) kg/m² were recruited at five sites for measurements of body composition by dual energy X-ray absorptiometry at baseline and at conversion to diabetes or study end, if they had not converted. Results: Mean follow-up was 33.6months in the pioglitazone group and 32.1months in the placebo group. Body weight increased 4.63±0.60 (m ± s.e.) kg in the pioglitazone group compared to 0.98±0.62kg in the PIO group (p < 0.0001). Body fat rose 4.89±0.42kg in the pioglitazone group compared to 1.41±0.44kg, (p < 0.0001) in placebo-treated subjects. The increase in fat was greater in legs and trunk than in the arms. BMD was higher in all regions in men and significantly so in most. PIO decreased BMD significantly in the pelvis in men and women, decreased BMD in the thoracic spine and ribs of women and the lumbar spine and legs of men. Bone mineral content also decreased significantly in arms, legs, trunk and in the total body. Conclusions: Pioglitazone increased peripheral fat more than truncal fat and decreased BMD in several regions of the body.

Original language	English (US)
Pages (from-to)	931-937
Number of pages	7
Journal	Diabetes, Obesity and Metabolism
Volume	15
Issue number	10
DOIs	https://doi.org/10.1111/dom.12099
State	Published - Oct 2013
Externally published	Yes

Keywords

Clinical trial
Fat
Glycaemic control

ASJC Scopus subject areas

Internal Medicine
Endocrinology, Diabetes and Metabolism
Endocrinology

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10.1111/dom.12099

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Bray, G. A., Smith, S. R., Banerji, M. A., Tripathy, D., Clement, S. C., Buchanan, T. A., Henry, R. R., Kitabchi, A. E., Mudaliar, S., Musi, N., Ratner, R. E., Schwenke, D. C., Stentz, F. B., Reaven, P. D., & Defronzo, R. A. (2013). Effect of pioglitazone on body composition and bone density in subjects with prediabetes in the ACT NOW trial. Diabetes, Obesity and Metabolism, 15(10), 931-937. https://doi.org/10.1111/dom.12099

Bray, GA, Smith, SR, Banerji, MA, Tripathy, D, Clement, SC, Buchanan, TA, Henry, RR, Kitabchi, AE, Mudaliar, S, Musi, N, Ratner, RE, Schwenke, DC, Stentz, FB, Reaven, PD & Defronzo, RA 2013, 'Effect of pioglitazone on body composition and bone density in subjects with prediabetes in the ACT NOW trial', Diabetes, Obesity and Metabolism, vol. 15, no. 10, pp. 931-937. https://doi.org/10.1111/dom.12099

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title = "Effect of pioglitazone on body composition and bone density in subjects with prediabetes in the ACT NOW trial",

abstract = "Aims: This study examined the effects of pioglitazone on body weight and bone mineral density (BMD) prospectively in patients with impaired glucose tolerance as pioglitazone (TZD) increases body weight and body fat in diabetic patients and increases the risk of bone fractures. Methods: A total of 71 men and 163 women aged 49.3 (10.7) years [mean (s.d.)]; body mass index (BMI), 34.5 (5.9) kg/m2 were recruited at five sites for measurements of body composition by dual energy X-ray absorptiometry at baseline and at conversion to diabetes or study end, if they had not converted. Results: Mean follow-up was 33.6months in the pioglitazone group and 32.1months in the placebo group. Body weight increased 4.63±0.60 (m ± s.e.) kg in the pioglitazone group compared to 0.98±0.62kg in the PIO group (p < 0.0001). Body fat rose 4.89±0.42kg in the pioglitazone group compared to 1.41±0.44kg, (p < 0.0001) in placebo-treated subjects. The increase in fat was greater in legs and trunk than in the arms. BMD was higher in all regions in men and significantly so in most. PIO decreased BMD significantly in the pelvis in men and women, decreased BMD in the thoracic spine and ribs of women and the lumbar spine and legs of men. Bone mineral content also decreased significantly in arms, legs, trunk and in the total body. Conclusions: Pioglitazone increased peripheral fat more than truncal fat and decreased BMD in several regions of the body.",

keywords = "Clinical trial, Fat, Glycaemic control",

author = "Bray, {G. A.} and Smith, {S. R.} and Banerji, {M. A.} and D. Tripathy and Clement, {S. C.} and Buchanan, {T. A.} and Henry, {R. R.} and Kitabchi, {A. E.} and S. Mudaliar and N. Musi and Ratner, {R. E.} and Schwenke, {D. C.} and Stentz, {F. B.} and Reaven, {P. D.} and Defronzo, {R. A.}",

year = "2013",

month = oct,

doi = "10.1111/dom.12099",

language = "English (US)",

volume = "15",

pages = "931--937",

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AU - Bray, G. A.

AU - Smith, S. R.

AU - Banerji, M. A.

AU - Tripathy, D.

AU - Clement, S. C.

AU - Buchanan, T. A.

AU - Henry, R. R.

AU - Kitabchi, A. E.

AU - Mudaliar, S.

AU - Musi, N.

AU - Ratner, R. E.

AU - Schwenke, D. C.

AU - Stentz, F. B.

AU - Reaven, P. D.

AU - Defronzo, R. A.

PY - 2013/10

Y1 - 2013/10

N2 - Aims: This study examined the effects of pioglitazone on body weight and bone mineral density (BMD) prospectively in patients with impaired glucose tolerance as pioglitazone (TZD) increases body weight and body fat in diabetic patients and increases the risk of bone fractures. Methods: A total of 71 men and 163 women aged 49.3 (10.7) years [mean (s.d.)]; body mass index (BMI), 34.5 (5.9) kg/m2 were recruited at five sites for measurements of body composition by dual energy X-ray absorptiometry at baseline and at conversion to diabetes or study end, if they had not converted. Results: Mean follow-up was 33.6months in the pioglitazone group and 32.1months in the placebo group. Body weight increased 4.63±0.60 (m ± s.e.) kg in the pioglitazone group compared to 0.98±0.62kg in the PIO group (p < 0.0001). Body fat rose 4.89±0.42kg in the pioglitazone group compared to 1.41±0.44kg, (p < 0.0001) in placebo-treated subjects. The increase in fat was greater in legs and trunk than in the arms. BMD was higher in all regions in men and significantly so in most. PIO decreased BMD significantly in the pelvis in men and women, decreased BMD in the thoracic spine and ribs of women and the lumbar spine and legs of men. Bone mineral content also decreased significantly in arms, legs, trunk and in the total body. Conclusions: Pioglitazone increased peripheral fat more than truncal fat and decreased BMD in several regions of the body.

AB - Aims: This study examined the effects of pioglitazone on body weight and bone mineral density (BMD) prospectively in patients with impaired glucose tolerance as pioglitazone (TZD) increases body weight and body fat in diabetic patients and increases the risk of bone fractures. Methods: A total of 71 men and 163 women aged 49.3 (10.7) years [mean (s.d.)]; body mass index (BMI), 34.5 (5.9) kg/m2 were recruited at five sites for measurements of body composition by dual energy X-ray absorptiometry at baseline and at conversion to diabetes or study end, if they had not converted. Results: Mean follow-up was 33.6months in the pioglitazone group and 32.1months in the placebo group. Body weight increased 4.63±0.60 (m ± s.e.) kg in the pioglitazone group compared to 0.98±0.62kg in the PIO group (p < 0.0001). Body fat rose 4.89±0.42kg in the pioglitazone group compared to 1.41±0.44kg, (p < 0.0001) in placebo-treated subjects. The increase in fat was greater in legs and trunk than in the arms. BMD was higher in all regions in men and significantly so in most. PIO decreased BMD significantly in the pelvis in men and women, decreased BMD in the thoracic spine and ribs of women and the lumbar spine and legs of men. Bone mineral content also decreased significantly in arms, legs, trunk and in the total body. Conclusions: Pioglitazone increased peripheral fat more than truncal fat and decreased BMD in several regions of the body.

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KW - Glycaemic control

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Effect of pioglitazone on body composition and bone density in subjects with prediabetes in the ACT NOW trial

Abstract

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