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The Extraglycemic Effect of SGLT-2is on Mineral and Bone Metabolism and Bone Fracture

Bingzi Dong1, Ruolin Lv1, Jun Wang1

  • 1Department of Endocrinology and Metabolism, The Affiliated Hospital of Qingdao University, Qingdao, China.

Frontiers in Endocrinology
|July 25, 2022
PubMed

Insights

Sodium-glucose co-transporter 2 inhibitors (SGLT-2is) may not increase fracture risk in type 2 diabetes patients. Further real-world studies are needed to clarify the controversial effects of SGLT-2is on bone health.

Area of Science:

  • Endocrinology
  • Metabolic Diseases
  • Bone Biology

Background:

  • Type 2 diabetes mellitus (T2DM) is a known risk factor for osteoporosis.
  • T2DM and its treatments can impact bone and mineral metabolism.
  • Sodium-glucose co-transporter 2 inhibitors (SGLT-2is) are effective anti-diabetic agents with cardiovascular and kidney benefits.

Purpose of the Study:

  • To review the extraglycemic effects of SGLT-2is on bone and mineral metabolism.
  • To evaluate the impact of SGLT-2is on bone turnover, microarchitecture, and strength.
  • To assess the association between SGLT-2is and bone fracture risk.

Main Methods:

  • Literature review focusing on SGLT-2is and bone metabolism.
  • Analysis of clinical evidence, including meta-analyses.
  • Examination of physiological regulation and extraglycemic effects of SGLT-2is.

Main Results:

  • SGLT-2is appear to indirectly influence bone turnover, microarchitecture, and strength.
  • Meta-analyses suggest SGLT-2is may not elevate bone fracture risk.
  • The impact of SGLT-2is on fracture risk remains controversial, requiring further investigation.

Conclusions:

  • SGLT-2is offer significant benefits for cardiovascular and chronic kidney disease outcomes in T2DM patients.
  • Bone mineral density and fracture risk assessment are crucial for high-risk individuals.
  • Further real-world studies are necessary to definitively establish the effect of SGLT-2is on bone fracture risk.
Keywords:
bone and mineral metabolismbone fracture riskbone turnoversodium–glucose cotransporter-2 inhibitortype 2 diabetes mellitus

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