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Decrease in serum leptin by troglitazone is associated with preventing bone loss in type 2 diabetic patients.

Sumiyo Watanabe1, Yasuhiro Takeuchi, Seiji Fukumoto

  • 1Division of Endocrinology, Department of Medicine, University of Tokyo School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.

Journal of Bone and Mineral Metabolism
|April 30, 2003
PubMed
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Thiazolidinediones (TZDs) like troglitazone may prevent bone loss in type 2 diabetes by reducing serum leptin levels. This effect on leptin, not body fat, appears linked to maintaining bone mineral density.

Area of Science:

  • Endocrinology
  • Metabolic Diseases
  • Bone Biology

Background:

  • Thiazolidinedione (TZD) antidiabetic drugs inhibit osteoclast formation and bone resorption.
  • TZDs also reduce leptin expression in adipocytes, and lower leptin is linked to higher bone mass.
  • Type 2 diabetic patients are at increased risk for osteoporosis.

Purpose of the Study:

  • To investigate the effects of 1-year troglitazone treatment on bone mineral density (BMD) and bone metabolism in Japanese type 2 diabetic patients.
  • To explore the relationship between changes in serum leptin, BMD, and bone metabolism markers.

Main Methods:

  • 25 type 2 diabetic patients received 1-year troglitazone treatment.
  • Measurements included BMD, serum leptin, type I collagen N-telopeptide (NTx), bone alkaline phosphatase (ALP), body mass index, and HbA1c.

Related Experiment Videos

  • Patients were categorized into leptin responders and non-responders based on serum leptin levels.

    • Main Results:

    • Troglitazone improved glucose metabolism without altering body mass index or body fat.
    • Decreased serum leptin was negatively correlated with BMD changes.
    • BMD increased significantly in leptin responders compared to non-responders and controls.
    • Bone resorption markers (NTx, ALP) transiently decreased then increased.

    Conclusions:

    • Troglitazone treatment may prevent bone loss in type 2 diabetic patients by decreasing serum leptin, independent of changes in body fat.
    • TZDs could offer a therapeutic advantage for diabetic individuals with osteoporosis risk factors.