P03 | Role of GLP-1 RAs on bone metabolism in patients with type 2 diabetes mellitus: longitudinal study
A. Al Refaie1, L. Baldassini2, C. Mondillo2, R. Tarquini3, L. Gennari2, S. Gonnelli2, C. Caffarelli2 | 1Section of Internal Medicine, Department of Medicine, Surgery and Neuroscience, University of Siena; Division of Internal Medicine I, San Giuseppe Hospital, Empoli, 2Section of Internal Medicine, Department of Medicine, Surgery and Neuroscience, University of Siena, 3Division of Internal Medicine I, San Giuseppe Hospital, Empoli, Italy
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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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