The association between anti-diabetic agents and osteoporosis, sarcopenia, and osteosarcopenia among Iranian older adults; Bushehr Elderly Health (BEH) program

Daru. 2024 Jun;32(1):145-159. doi: 10.1007/s40199-023-00497-5. Epub 2023 Dec 22.

Abstract

Purpose: Various risk factors are mentioned for osteoporosis, sarcopenia, and osteosarcopenia. Our aim is to assess the impacts of anti-diabetic drugs on these disorders.

Methods: To perform this study, the participants' data was extracted from the Bushehr Elderly Health (BEH) program in Iran. Afterward, the data were categorized into three subgroups: osteoporosis, sarcopenia, and osteosarcopenia, based on WHO and European Working Group on Sarcopenia in Older People (EWGSOP-2) working group definitions. Demographic characteristics, anthropometric measures, past medical history, and current medications were recorded. Pearson chi-squared and simple/multiple logistic regression using Python (3.11.4) and R (4.3.1) programming software assessed the association between anti-diabetic agents and these bone disorders.

Results: Out of 1995 participants, 820, 848, and 404 had osteoporosis, sarcopenia, or osteosarcopenia, respectively. Among all types of anti-diabetic drugs, a significant protective association between osteoporosis and consumption of second-generation sulfonylureas was found; Adjusted Odd Ratio (AOR) = 0.65 ([95% CI: 0.45-0.94], p-value = 0.023). No associations were found between sarcopenia and consumption of anti-diabetic agents. A significant association was observed between using Meglitinides and the risk of osteosarcopenia; AOR = 4.98 ([95% CI: 1.5-16.55], p-value = 0.009).

Conclusion: In conclusion, a protective association between consumption of second-generation sulfonylureas and osteoporosis was found. Moreover, a positive association was found between the consumption of meglitinides and osteosarcopenia. However, to support these findings, further studies are recommended.

Keywords: Anti-diabetic Drugs; Elderly; Osteoporosis; Osteosarcopenia; Sarcopenia.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Hypoglycemic Agents* / adverse effects
  • Hypoglycemic Agents* / therapeutic use
  • Iran
  • Male
  • Middle Aged
  • Osteoporosis* / chemically induced
  • Osteoporosis* / drug therapy
  • Osteoporosis* / epidemiology
  • Risk Factors
  • Sarcopenia* / chemically induced
  • Sarcopenia* / epidemiology
  • Sulfonylurea Compounds / adverse effects
  • Sulfonylurea Compounds / therapeutic use

Substances

  • Hypoglycemic Agents
  • Sulfonylurea Compounds