Related Experiment Video
Updated: May 24, 2026

Isolation and Differentiation of Stromal Vascular Cells to Beige/Brite Cells
Published on: March 28, 2013
Pioglitazone increases bone marrow fat in type 2 diabetes: results from a randomized controlled trial
Andrew Grey1, Vaughan Beckley, Anthony Doyle
1Department of Medicine, University of Auckland, Auckland 1142, New Zealand. a.grey@auckland.ac.nz
Objective:
To determine the effect of pioglitazone on bone marrow fat in humans.
Design:
Twenty participants in a double-blind, randomized, placebo-controlled trial of the skeletal effects of pioglitazone 30 mg daily in type 2 diabetes mellitus (T2DM) entered a 6-month substudy evaluating bone marrow fat. Main outcome measures were bone marrow fat in lumbar spine (L4) and proximal femur (intertrochanteric region), measured using magnetic resonance (MR) imaging, and bone mineral density (BMD), measured using dual-energy X-ray absorptiometry.
Results:
after 6 months, change in the fourth lumbar vertebra (l4) bone marrow lipid fraction, assessed using two different methods, was greater in the pioglitazone group than in the placebo group (dixon method: mean (95% CI) change from baseline pioglitazone 1.3% (-0.3, 2.9), placebo -0.2% (-0.8, 0.4), P=0.06; MR spectroscopy: pioglitazone 2.5% (0.4, 4.7), placebo -1.1% (-3.7, 1.4), P=0.02). Similarly, the change in lipid fraction in the intertrochanteric region was greater in the pioglitazone group (Dixon method: mean (95% CI) change from baseline pioglitazone 1.3% (0.6, 1.9), placebo -0.8% (-1.8, 0.2), P=0.001). Within the pioglitazone group, there was no evidence of a significant relationship between change in marrow lipid fraction and BMD.
Conclusions:
Short-term treatment with pioglitazone increases bone marrow fat in patients with T2DM.
Related Concept Videos
Oral Hypoglycemic Agents: Biguanides and Glitazones
Dipeptidyl Peptidase 4 Inhibitors
Type II Diabetes II: Pathophysiology
Oral Hypoglycemic Agents: Glinides
Type I Diabetes III: Clinical Manifestations
Type I Diabetes II: Pathophysiology
