Use of Thiazolidinediones and Fracture Risk

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Abstract
Osteoporotic fractures are associated with significant morbidity and mortality and a reduction in quality of life. An estimated 30% to 50% of women and 15% to 30% of men will experience a fracture related to osteoporosis in their lifetime. Patients with type 2 diabetes mellitus (DM) have been shown to have higher bone density1-4 and, thus, might be expected to be at lower risk for fracture.5 In contrast, however, studies in community-dwelling individuals have shown an increased risk of fragility fractures, predominantly at nonvertebral sites,5-11 independent of age, body mass index (BMI), and bone density.12 The increased risk might, therefore, be related to other factors, such as diabetic complications, risk of falls, and, potentially, antidiabetic medication use.