Thiazide use and skeletal microstructure: Results from a multi-ethnic study.
Fracture
Microstructure
Stiffness
Thiazide
Journal
Bone reports
ISSN: 2352-1872
Titre abrégé: Bone Rep
Pays: United States
ID NLM: 101646176
Informations de publication
Date de publication:
Jun 2022
Jun 2022
Historique:
received:
07
04
2022
revised:
04
05
2022
accepted:
06
05
2022
entrez:
23
5
2022
pubmed:
24
5
2022
medline:
24
5
2022
Statut:
epublish
Résumé
Thiazide diuretics, a commonly used class of anti-hypertensives, have been associated with increased areal bone mineral density (aBMD). Data regarding effects on fracture are conflicting and no information is available regarding effects on skeletal microstructure and mechanical competence. We compared skeletal microstructure, volumetric BMD (vBMD), stiffness and prevalent fractures in current thiazide diuretic users and non-users from a population-based multiethnic cohort of elderly adults age ≥ 65 years ( Female current thiazide diuretic users had higher weight and BMI and were more likely to be non-Caucasian compared to non-users. There were no differences in age, historical fractures or falls between female users and non-users. Female thiazide users tended to have lower calcium and vitamin d intake compared to non-users. After adjusting for age, weight, race and other covariates, 1/3-radius mean aBMD by dual energy x-ray absorptiometry (DXA) was 3.2% ( Thiazide use was associated with a modestly higher aBMD at the predominantly cortical 1/3-radius site and radial cortical vBMD by HRpQCT in females. The effect on cortical bone may offer skeletal benefits in women taking thiazides for other indications such as hypertension, hypercalciuria or recurrent nephrolithiasis.
Sections du résumé
Background
UNASSIGNED
Thiazide diuretics, a commonly used class of anti-hypertensives, have been associated with increased areal bone mineral density (aBMD). Data regarding effects on fracture are conflicting and no information is available regarding effects on skeletal microstructure and mechanical competence.
Methods
UNASSIGNED
We compared skeletal microstructure, volumetric BMD (vBMD), stiffness and prevalent fractures in current thiazide diuretic users and non-users from a population-based multiethnic cohort of elderly adults age ≥ 65 years (
Results
UNASSIGNED
Female current thiazide diuretic users had higher weight and BMI and were more likely to be non-Caucasian compared to non-users. There were no differences in age, historical fractures or falls between female users and non-users. Female thiazide users tended to have lower calcium and vitamin d intake compared to non-users. After adjusting for age, weight, race and other covariates, 1/3-radius mean aBMD by dual energy x-ray absorptiometry (DXA) was 3.2% (
Conclusions
UNASSIGNED
Thiazide use was associated with a modestly higher aBMD at the predominantly cortical 1/3-radius site and radial cortical vBMD by HRpQCT in females. The effect on cortical bone may offer skeletal benefits in women taking thiazides for other indications such as hypertension, hypercalciuria or recurrent nephrolithiasis.
Identifiants
pubmed: 35601882
doi: 10.1016/j.bonr.2022.101589
pii: S2352-1872(22)00423-5
pmc: PMC9121265
doi:
Types de publication
Journal Article
Langues
eng
Pagination
101589Informations de copyright
© 2022 The Authors.
Déclaration de conflit d'intérêts
All authors declare no conflict of interest.
Références
J Clin Endocrinol Metab. 2016 Mar;101(3):1166-73
pubmed: 26751196
Sci Rep. 2019 Dec 24;9(1):19754
pubmed: 31874989
Obstet Gynecol. 1986 Apr;67(4):457-62
pubmed: 3960416
Am J Epidemiol. 1994 Jun 1;139(11):1107-15
pubmed: 8192143
N Engl J Med. 1990 Feb 1;322(5):286-90
pubmed: 2296269
Scand J Clin Lab Invest. 1959;11:351-7
pubmed: 14413581
PLoS One. 2018 Dec 7;13(12):e0208712
pubmed: 30532245
J Clin Endocrinol Metab. 2016 Apr;101(4):1880-6
pubmed: 26913635
Drug Des Devel Ther. 2018 Nov 14;12:3929-3935
pubmed: 30532521
J Bone Miner Res. 2010 Jul;25(7):1468-86
pubmed: 20533309
J Bone Miner Res. 2009 Dec;24(12):1953-9
pubmed: 20001598
J Bone Miner Res. 2016 Jun;31(6):1137-45
pubmed: 26748479
Bone. 1996 Mar;18(3):277-9
pubmed: 8703584
Nat Rev Endocrinol. 2011 Oct 25;8(1):33-9
pubmed: 22024973
Calcif Tissue Int. 1994 Oct;55(4):266-8
pubmed: 7820777
JAMA. 2014 Feb 5;311(5):507-20
pubmed: 24352797
J Am Soc Nephrol. 2007 Sep;18(9):2509-16
pubmed: 17656470
Am J Med. 2000 Oct 1;109(5):362-70
pubmed: 11020392
J Bone Miner Res. 1993 Sep;8(9):1137-48
pubmed: 8237484
J Clin Endocrinol Metab. 1998 Jun;83(6):1916-20
pubmed: 9626119
J Bone Miner Res. 2011 Aug;26(8):1822-8
pubmed: 21381111
J Clin Epidemiol. 1993 Feb;46(2):153-62
pubmed: 8437031
J Clin Densitom. 2011 Jul-Sep;14(3):302-12
pubmed: 21724435
J Bone Miner Res. 2007 Oct;22(10):1479-91
pubmed: 17663640
Am J Med. 2016 Dec;129(12):1299-1306
pubmed: 27542612
J Bone Miner Res. 1989 Jun;4(3):283-91
pubmed: 2763869
JAMA Intern Med. 2017 Jan 01;177(1):67-76
pubmed: 27893045
J Bone Miner Res. 2016 Aug;31(8):1485-7
pubmed: 27335158
JAMA. 2002 Dec 18;288(23):2981-97
pubmed: 12479763
N Engl J Med. 1983 Aug 11;309(6):344-7
pubmed: 6866070
Am J Physiol. 1997 Jan;272(1 Pt 1):C109-16
pubmed: 9038817
J Intern Med. 2016 Jan;279(1):110-22
pubmed: 26223424
J Int Med Res. 2013 Oct;41(5):1408-17
pubmed: 24051019
Osteoporos Int. 2007 Apr;18(4):479-86
pubmed: 17120180
Ann Intern Med. 1993 May 1;118(9):666-73
pubmed: 8489642
Ann Intern Med. 2000 Oct 3;133(7):516-26
pubmed: 11015164
Calcif Tissue Int. 2005 Mar;76(3):167-75
pubmed: 15719207
Bone. 2020 Sep;138:115475
pubmed: 32531338
Cochrane Database Syst Rev. 2011 Oct 05;(10):CD005185
pubmed: 21975748
J Clin Densitom. 2001 Summer;4(2):105-10
pubmed: 11477303
Neurology. 2001 Jan 9;56(1):49-56
pubmed: 11148235
Z Rheumatol. 2014 May;73(4):323-8
pubmed: 24728601
Osteoporos Int. 2016 Mar;27(3):1181-1189
pubmed: 26449354
J Bone Miner Res. 2014 Jan;29(1):1-23
pubmed: 23712442
Bone. 2020 Nov;140:115552
pubmed: 32730935
J Bone Miner Res. 2013 May;28(5):1029-40
pubmed: 23225022
J Bone Miner Res. 2000 May;15(5):894-901
pubmed: 10804019