1
|
Padilla Apuntate N, Puerto Cabeza CG, Gallego Royo A, Goñi Ros N, Abadía Molina C, Acha Pérez J, Calmarza P. Estudio del efecto del tratamiento con fármacos antidiabéticos sobre el metabolismo óseo. ADVANCES IN LABORATORY MEDICINE 2024; 5:90-95. [PMID: 38634085 PMCID: PMC11019870 DOI: 10.1515/almed-2024-0033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 02/27/2024] [Indexed: 04/19/2024]
Abstract
Objetivos La prevalencia de la diabetes mellitus tipo 2 (DMT2) está aumentando de forma exponencial en todo el mundo, habiéndose comprobado que estos pacientes tienen mayor riesgo de presentar fracturas óseas, con respecto a la población sana, por lo que resulta de gran relevancia el conocimiento del efecto de los fármacos antidiabéticos sobre el metabolismo óseo. Métodos Estudio estadístico descriptivo, retrospectivo, de 106 pacientes en tratamiento con seis grupos de fármacos antidiabéticos: insulina, inhibidores de dipeptidilpeptidasa 4 (iDPP4), agonistas del receptor del péptido similar al glucagón tipo 1 (arGLP1), sulfonilureas, inhibidores del cotransportador de sodio-glucosa tipo 2 (iSGLT2) y pioglitazona, en los que se determinaron osteocalcina (OC), fosfatasa alcalina ósea (FAO) y telopéptido C-terminal del colágeno tipo 1 o beta-crosslaps (β-CTx). Resultados Se encontraron concentraciones más elevadas de β-CTx en los pacientes tratados con pioglitazona que en los tratados con iDPP4 (p=0,035), iSGLT2 (p=0,020) y con arGLP1 (p<0,001), siendo los pacientes tratados con arGLP1 los que presentaron las concentraciones más bajas de β-CTx. Conclusiones El tipo de tratamiento antidiabético recibido en pacientes que padecen DMT2 puede afectar el remodelado óseo. En nuestro estudio los pacientes que fueron tratados con pioglitazona mostraron las concentraciones más elevadas de β-CTx con respecto al resto de grupos de fármacos, lo cual parece indicar la conveniencia de evitar estos fármacos, sobre todo en mujeres postmenopáusicas con DMT2. Los fármacos arGLP1 presentaron los valores más bajos de β-CTx, por lo que podrían ejercer un efecto beneficioso sobre el metabolismo óseo.
Collapse
Affiliation(s)
| | | | - Alba Gallego Royo
- Servicio de Medicina Preventiva, Hospital Universitario Miguel Servet, Zaragoza, España
| | - Nuria Goñi Ros
- Servicio de Bioquímica Clínica, Hospital Universitario Miguel Servet, Zaragoza, España
| | - Claudia Abadía Molina
- Servicio de Bioquímica Clínica, Hospital Universitario Miguel Servet, Zaragoza, España
| | - Javier Acha Pérez
- Servicio de Endocrinología y Nutrición, Hospital Universitario Miguel Servet, Zaragoza, España
| | - Pilar Calmarza
- Servicio de Bioquímica Clínica, Hospital Universitario Miguel Servet, Zaragoza, España
- Instituto de Investigación Sanitaria (IIS) Aragón, Zaragoza, España
- Universidad de Zaragoza, Zaragoza, España
- Centro de Investigación en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto Salud Carlos III, Madrid, España
| |
Collapse
|
2
|
Padilla Apuntate N, Puerto Cabeza CG, Gallego Royo A, Goñi Ros N, Abadía Molina C, Acha Pérez J, Calmarza P. Effects of antidiabetic drugs on bone metabolism. ADVANCES IN LABORATORY MEDICINE 2024; 5:85-89. [PMID: 38634079 PMCID: PMC11019883 DOI: 10.1515/almed-2024-0038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 02/27/2024] [Indexed: 04/19/2024]
Abstract
Objectives The prevalence of diabetes mellitus type 2 (DMT2) is increasing exponentially worldwide. DMT2 patients have been found to be at a higher risk for bone fractures than the healthy population. Hence, improving our understanding of the impact of antidiabetic drugs on bone metabolism is crucial. Methods A descriptive, retrospective study involving 106 patients receiving six groups of antidiabetic drugs: insulin; dipeptidylpeptidase four inhibitors (DPP4i); glucagon-like peptide type 1 receptor agonists (GLP1ra); sulfonylureas; sodium-glucose cotransporter two inhibitors (SGLT2i); and pioglitazone, in which osteocalcin (OC), bone alkaline phosphatase (BAP) and C-terminal telopeptide of collagen type 1 or beta-crosslaps (β-CTx) were determined. Results β-CTx concentrations were higher in the patients treated with pioglitazone, as compared to patients treated with DPP4i (p=0.035), SGLT2i (p=0.020) or GLP1ra (p<0.001). The lowest β-CTx concentrations were observed in the patients treated with GLP1ra. Conclusions Bone remodeling is influenced by the type of antidiabetic drug administered to DMT2 patients. In our study, the patients who received pioglitazone showed higher β-CTx concentrations, as compared to patients treated with other types of antidiabetic drugs. This finding highlights the convenience of avoiding these drugs, especially in postmenopausal women with DMT2. GLP1ra drugs were associated with the lowest β-CTx concentrations, which suggests that these agents could exert beneficial effects on bone metabolism.
Collapse
Affiliation(s)
| | | | - Alba Gallego Royo
- Service of Preventive Medicine, Miguel Servet University Hospital, Zaragoza, Spain
| | - Nuria Goñi Ros
- Service of Clinical Biochemistry, Miguel Servet University Hospital, Zaragoza, Spain
| | - Claudia Abadía Molina
- Service of Clinical Biochemistry, Miguel Servet University Hospital, Zaragoza, Spain
| | - Javier Acha Pérez
- Service of Endocrinology and Nutrition, Miguel Servet University Hospital, Zaragoza, Spain
| | - Pilar Calmarza
- Service of Clinical Biochemistry, Miguel Servet University Hospital, Zaragoza, Spain
- Institute of Biomedical Research (IIS) of Aragón, Zaragoza, Spain
- University of Zaragoza, Zaragoza, Spain
- Spanish Network-Center for Cardiovascular Biomedical Research) (CIBERCV), Carlos III Health Institute, Madrid, Spain
- Member of SEQCML Oxidative Stress Commission and Lipoproteins and Vascular Diseases Commission, Madrid, Spain
| |
Collapse
|
3
|
Shen Y, Shi Q, Zou X, Meng W, Tian H, Du L, Li S. Time-dependent risk of fracture in adults with type 2 diabetes receiving anti-diabetic drug: A one-stage network meta-analysis. Diabetes Metab Res Rev 2024; 40:e3780. [PMID: 38367257 DOI: 10.1002/dmrr.3780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 10/10/2023] [Accepted: 12/31/2023] [Indexed: 02/19/2024]
Abstract
AIMS To assess the time-dependent risk of fracture in adults with type 2 diabetes receiving anti-diabetic drugs. MATERIALS AND METHODS We searched MEDLINE, EMBASE, and Cochrane Library up to 18 November 2021, for randomized controlled trials (RCTs) and propensity-score-matched non-randomized studies (NRSs) comparing all anti-diabetic drugs with standard treatment or with each other on fracture in adults with type 2 diabetes. The study performed a one-stage network meta-analysis using discrete-time hazard regression with reconstructed individual time-to-event data. RESULTS This network meta-analysis involved seven RCTs (65,051 adults with type 2 diabetes) with a median follow-up of 36 months and three propensity-score-based NRSs (17,954 participants) with a median follow-up of 27.3 months. Among anti-diabetic drugs, thiazolidinediones increased the overall hazard of fracture by 42% (95% credible interval [CrI], 3%-97%) and almost tripled the risk after 4 years (hazard ratio [HR], 2.74; 95% CrI, 1.53-4.80). Credible subgroup analysis suggested that thiazolidinediones increased the hazard of fracture only in females (HR, 2.19; 95% CrI, 1.26-3.74) but not among males (HR, 0.81; 95% CrI, 0.45-1.40). Moderate certainty evidence established that thiazolidinediones increase 92 fractures in five years per 1000 female patients. We did not find the risk of fractures with other anti-diabetic drugs including metformin, sulfonylureas, sodium-glucose cotransporter-2 (SGLT2) inhibitors, and dipeptidyl peptidase-4 (DPP-4) inhibitors. CONCLUSIONS Long-term use of thiazolidinediones elevates the risk of fracture among females with type 2 diabetes. There is no evidence eliciting fracture risk associated with other anti-diabetic drugs.
Collapse
Affiliation(s)
- Yanjiao Shen
- Department of Endocrinology and Metabolism, MAGIC China Centre, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- Laboratory of Stem Cell Biology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Qingyang Shi
- Department of Endocrinology and Metabolism, MAGIC China Centre, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- Faculty of Science and Engineering, University of Groningen, Groningen, Netherland
| | - Xinyu Zou
- Department of Endocrinology and Metabolism, MAGIC China Centre, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Wentong Meng
- Laboratory of Stem Cell Biology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Haoming Tian
- Department of Endocrinology and Metabolism, MAGIC China Centre, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Liang Du
- Medical Device Regulatory Research and Evaluation Center, Chinese Evidence-Based Medicine Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Sheyu Li
- Department of Endocrinology and Metabolism, MAGIC China Centre, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| |
Collapse
|
4
|
Kast RE. The OSR9 Regimen: A New Augmentation Strategy for Osteosarcoma Treatment Using Nine Older Drugs from General Medicine to Inhibit Growth Drive. Int J Mol Sci 2023; 24:15474. [PMID: 37895152 PMCID: PMC10607234 DOI: 10.3390/ijms242015474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 10/13/2023] [Accepted: 10/19/2023] [Indexed: 10/29/2023] Open
Abstract
As things stand in 2023, metastatic osteosarcoma commonly results in death. There has been little treatment progress in recent decades. To redress the poor prognosis of metastatic osteosarcoma, the present regimen, OSR9, uses nine already marketed drugs as adjuncts to current treatments. The nine drugs in OSR9 are: (1) the antinausea drug aprepitant, (2) the analgesic drug celecoxib, (3) the anti-malaria drug chloroquine, (4) the antibiotic dapsone, (5) the alcoholism treatment drug disulfiram, (6) the antifungal drug itraconazole, (7) the diabetes treatment drug linagliptin, (8) the hypertension drug propranolol, and (9) the psychiatric drug quetiapine. Although none are traditionally used to treat cancer, all nine have attributes that have been shown to inhibit growth-promoting physiological systems active in osteosarcoma. In their general medicinal uses, all nine drugs in OSR9 have low side-effect risks. The current paper reviews the collected data supporting the role of OSR9.
Collapse
|
5
|
Wu C, Yang C, Wang Y, Wang J, Zhu J. Molecular Characterization and Functional Analysis of the Dipeptidyl Peptidase IV from Venom of the Ectoparasitoid Scleroderma guani. Toxins (Basel) 2023; 15:toxins15050311. [PMID: 37235347 DOI: 10.3390/toxins15050311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 04/13/2023] [Accepted: 04/25/2023] [Indexed: 05/28/2023] Open
Abstract
Dipeptidyl peptidase IV (DPPIV) is a proline-specific serine peptidase that remains poorly investigated in terms of venom composition. Here, we describe the molecular characteristics and possible functions of DPPIV as a major venom component of the ant-like bethylid ectoparasitoid, Scleroderma guani, named SgVnDPPIV. The SgVnDPPIV gene was cloned, which encodes a protein with the conserved catalytic triads and substrate binding sites of mammalian DPPIV. This venom gene is highly expressed in the venom apparatus. Recombinant SgVnDPPIV, produced in Sf9 cells using the baculovirus expression system, has high enzymatic activity, which can be efficiently inhibited by vildagliptin and sitagliptin. Functional analysis revealed that SgVnDPPIV affects genes related to detoxification, lipid synthesis and metabolism, response to stimuli, and ion exchange in pupae of Tenebrio molitor, an envenomated host of S. guani. The present work contributes towards understanding the role of venom DPPIV involved in the interaction between parasitoid wasp and its host.
Collapse
Affiliation(s)
- Chaoyan Wu
- Key Laboratory of Forest Disaster Warning and Control of Yunnan Province, College of Biodiversity Conservation, Southwest Forestry University, Kunming 650224, China
| | - Cheng Yang
- Key Laboratory of Forest Disaster Warning and Control of Yunnan Province, College of Biodiversity Conservation, Southwest Forestry University, Kunming 650224, China
| | - Yuqin Wang
- Key Laboratory of Forest Disaster Warning and Control of Yunnan Province, College of Biodiversity Conservation, Southwest Forestry University, Kunming 650224, China
| | - Jun Wang
- Key Laboratory of Forest Disaster Warning and Control of Yunnan Province, College of Biodiversity Conservation, Southwest Forestry University, Kunming 650224, China
| | - Jiaying Zhu
- Key Laboratory of Forest Disaster Warning and Control of Yunnan Province, College of Biodiversity Conservation, Southwest Forestry University, Kunming 650224, China
- Key Laboratory for Forest Resources Conservation and Utilization in the Southwest Mountains of China, Ministry of Education, College of Biodiversity Conservation, Southwest Forestry University, Kunming 650224, China
| |
Collapse
|
6
|
Abstract
Type 2 diabetes mellitus (T2DM), is a chronic metabolic disease, characterized by the presence of hyperglycemia and insulin resistance. The key treatment strategies for T2DM include modification of lifestyle, medications, and continuous glucose monitoring. DM patients often have DM-associated morbidities and comorbidities; however, disorders of musculoskeletal system are often neglected, compared to other major systems in DM patients. Based on sharing similar pathophysiology of DM and osteoporosis, it is supposed that the use of antidiabetic agents (ADAs) may not only provide the lowering glucose level effect and the maintenance of the sugar homeostasis to directly delay the tissue damage secondary to hyperglycemia but also offer the benefits, such as the prevention of developing osteoporosis and fractures. Based on the current review, evidence shows the positive correlation between DM and osteoporosis or fracture, but the effectiveness of using ADA in the prevention of osteoporosis and subsequent reduction of fracture seems to be inconclusive. Although the benefits of ADA on bone health are uncertain, the potential value of "To do one and to get more" therapeutic strategy should be always persuaded. At least, one of the key treatment strategies as an establishment of healthy lifestyle may work, because it improves the status of insulin resistance and subsequently helps DM control, prevents the DM-related micro- and macrovascular injury, and possibly strengthens the general performance of musculoskeletal system. With stronger musculoskeletal system support, the risk of "fall" may be decreased, because it is associated with fracture. Although the ADA available in the market does not satisfy the policy of "To do one and to get more" yet, we are looking forward to seeing the continuously advanced technology of drug development on diabetic control, and hope to see their extra-sugar-lowering effects.
Collapse
Affiliation(s)
- Wen-Ling Lee
- Department of Medicine, Cheng-Hsin General Hospital, Taipei, Taiwan, ROC
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Department of Nursing, Oriental Institute of Technology, New Taipei City, Taiwan, ROC
| | - Peng-Hui Wang
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan, ROC
- Female Cancer Foundation, Taipei, Taiwan, ROC
| | - Szu-Ting Yang
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Chia-Hao Liu
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Wen-Hsun Chang
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Fa-Kung Lee
- Department of Obstetrics and Gynecology, Cathy General Hospital, Taipei, Taiwan, ROC
| |
Collapse
|