The Use of Alendronate Is Associated with a Decreased Incidence of Type 2 Diabetes Mellitus—A Population-Based Cohort Study in Taiwan

<div><p>Purpose</p><p>Bone remodeling has been linked to glucose metabolism in animal studies, but the results of human trials were inconclusive. Bisphosphonates may play a role in glucose metabolism through their impacts on bone remodeling enzymes. In this study, we aimed to examine the influence of alendronate usage on the incidence of type 2 diabetes mellitus (DM) among osteoporotic patients.</p><p>Methods</p><p>A retrospective cohort study was designed to include osteoporotic patients without DM from a population-based cohort containing 1,000,000 subjects. Patients treated with alendronate (exposed group, N=1,011) were compared with those who received no treatment (age and gender matched non-exposed group, N=3,033). Newly diagnosed DM was identified from medical records by International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9CM) code. The incidence of DM in both groups was calculated for comparison.</p><p>Results</p><p>The non-exposed group had a significantly higher incidence of DM (Odds ratio 1.21, 95% confidence interval 1.03~1.41) when compared with the exposed group. In subgroup analysis, the DM risk reduction in exposed group was only significant among those younger than 65 years and those without hypertension or dyslipidemia. Patients who were prescribed alendronate more than or equal to 3 times had demonstrated a significant reduction in DM risk.</p><p>Conclusions</p><p>Our study showed alendronate might yield a protective effect for incident DM. This effect became insignificant in patients with older age, dyslipidemia or hypertension. The underlying mechanism needs further exploration with prospective data for confirmation of the observed findings.</p></div

Comparison for Incidence of type 2 DM between exposed and non-exposed group.

<p>*IRR: Incidence related risk</p><p>**IR: Incidence Rate, per 10,000 persons per year</p><p>Comparison for Incidence of type 2 DM between exposed and non-exposed group.</p

Flowchart of our study.

<p>Flowchart of our study.</p

Correlation Coefficients for Smoking Habits and Associated Factors in Elderly Males Living in a Rural Community.

a<p><i>P</i><0.05; ^b<i>P</i><0.001. Data were analyzed with pearson correlation analysis.</p><p>HOMA: Homeostatic model assessment; hsCPR: high sensitivity C-reactive protein;</p><p>IPAQ: International Physical Activity Questionnaire.</p>#<p>:Log transformation.</p>*<p>Unfermented tea including green tea (unfermented) and oolong tea (partial fermented).</p><p>Current tea drinking : (No = 0, Fermented = 1, Unfermented = 2).</p><p>Habitual tea consumption : (Non-current tea drinking = 0, Tea drinking years<10 = 1, Tea drinking years≥10 = 2).</p><p>Daily tea consumption: (Non-current tea drinking = 0, Daily amount<240 cc = 1, Daily amount≥240 cc = 2).</p><p>Current smoking habit (Non-smoker = 0, Ex-smoker = 1, Current smoker = 2).</p><p>Total smoking amount (Non-smoker = 0, 0</p><p>Daily smoking amount (Non-smoker = 0, Daily amount<20 = 1, Daily amount ≥20 = 2).</p><p>Physical activity (IPAQ-short form) (Low = 0, Middle = 1, High = 2).</p

Binary Logistic Regression Model for Associated Factors (Focus on Daily Smoking and Tea Consumption Amount) of Metabolic Syndrome in Elderly Males Living in a Rural Community (N = 361).

<p>HOMA: Homeostatic model assessment; hsCPR: high sensitivity C-reactive protein;</p><p>IPAQ: International Physical Activity Questionnaire.</p><p>dependent variable: without vs with metabolic syndrome.</p>#<p>:Log transformation.</p><p>Nagelkerke R square = 0.551; Cox & Snell R square : 0.403.</p

Binary Logistic Regression Model for Associated Factors (Focus on Current Smoking Status and Different types of Tea Drinking Habits) of Metabolic Syndrome in Elderly Males Living in a Rural Community (N = 361).

<p>HOMA: Homeostatic model assessment; hsCPR: high sensitivity C-reactive protein;</p><p>IPAQ: International Physical Activity Questionnaire.</p><p>Dependent variable: without vs with metabolic syndrome.</p>#<p>:Log transformation.</p>*<p>Unfermented tea including green tea (unfermented) and oolong tea (partial fermented).</p><p>Nagelkerke R square = 0.526; Cox & Snell R square : 0.384.</p

Binary Logistic Regression Model for Associated Factors (Focus on Total Smoking Amount and Duration of Habitual Tea Consumption) of Metabolic Syndrome in Elderly Males Living in a Rural Community (N = 361).

<p>HOMA: Homeostatic model assessment; hsCPR: high sensitivity C-reactive protein;</p><p>IPAQ: International Physical Activity Questionnaire.</p><p>Dependent variable: without vs with metabolic syndrome.</p>#<p>:Log transformation.</p><p>Nagelkerke R square = 0.547; Cox & Snell R square : 0.400.</p

Demographic and Laboratory Data for the Without (MetS(−)) and With (MetS(+)) Metabolic Syndrome Groups of Elderly Males Living in a Rural Community (N = 361).

<p>Continuous data were analyzed with independent-sample T test; dichotomous data were analyzed with chi-square test.</p><p>HDLC: high density lipoprotein cholesterol; HOMA: Homeostatic model assessment;</p><p>hsCPR: high sensitivity C-reactive protein;</p><p>IPAQ: International Physical Activity Questionnaire.</p><p>data expressed as: number (percent), mean (standard deviation).</p>#<p>modified ATP III definition of metabolic syndrome.</p>*<p>Unfermented tea including green tea (unfermented) and oolong tea (partial fermented).</p

Baseline clinical characteristics of 91 HIV-infected patients receiving lopinavir/ritonavir - or efavirenz-based antiretroviral therapy.

<p>Data are expressed as numbers (percentages) or mean values ± standard deviations.</p><p>TEE = total energy expenditure; ALT = alanine transaminase.</p>*<p>The number of patients with indicated information.</p

Genetic and metabolic characteristics of 91 HIV-infected patients receiving lopinavir/ritonavir- or efavirenz-based antiretroviral therapy.

<p>LDL = low-density lipoprotein; HDL = high-density lipoprotein.</p