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A growing body of evidence has linked thiazolidinediones (TZDs; i.e., rosiglitazone and pioglitazone) to fracture risk. This adverse effect is plausible: Receptors for TZDs are expressed in bone, and rosiglitazone therapy affects bone turnover and reduces bone-mineral density (JW Gen Med Apr 24 2007).
The latest contribution to this literature is a retrospective study of 19,000 patients with type 2 diabetes who received oral antidiabetic drugs while enrolled in a Michigan health maintenance organization; 24% of these patients were prescribed TZDs. In multivariate analyses that were adjusted for numerous potentially confounding variables, women who used TZDs had significantly elevated risk for fractures compared with nonusers (hazard ratio, 1…