Longitudinal study reveals GLP-1 RAs affect bone metabolism in type 2 diabetes, indicating potential for bone remodeling.
Introduction: Diabetic patients are prone to microvascular and macrovascular complications, and bone is also a target organ of diabetes. We wanted to study the effects of GLP-1RAs on bone mineral density and bone metabolism.Materials and Methods: At baseline and after 12 months, the following were performed: carbohydrate metabolism, calcium-phosphate metabolism, bone turnover markers, adiponectin; measurement of bone mineral density using DXA and REMS methods.Results: BMD measured by DXA at the lumbar spine after 12 months of GL1-RA therapy showed a 4.62% reduction in T-score (p<0.05), while a non-statistically significant decrease of 1.7% was observed with REMS (p=n.s). With both methods, DXA and REMS, a statistically significant reduction in T-score was observed at both the femoral neck and total hip levels (p<0.05). A statistically significant increase in CTX levels was observed at 1 year (p<0.05); while we did not observe significant variations in sclerostin levels and bone alkaline phosphatase isoenzyme levels (p=n.s). However, we observed a statistically significant increase in adiponectin levels.Conclusions: This is the first clinical study to investigate the effect of GLP-1 RAs on bone. Based on the data obtained, it is possible to hypothesize that GLP1-RAs are able to act on bone remodeling by reactivating turnover without having negative effects on microarchitecture. Further randomized controlled studies are needed.
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