Introduction. Hypoglycemic drugs affect the bone quality and the risk of fractures in patients with type 2 diabetes mellitus (T2DM). We aimed to investigate the effects of glucagon-like peptide-1 receptor agonists (GLP-1RAs) and insulin on bone mineral density (BMD) in T2DM. Methods. In this single-blinded study, a total of 65 patients with T2DM were randomly assigned into four groups for 52 weeks: the exenatide group (), dulaglutide group (), insulin glargine group (), and placebo (). General clinical data were collected, and BMD was measured by dual-energy X-ray absorptiometry. Results. Compared with baseline, the glycosylated hemoglobin (HbA1c) decreased significantly in the exenatide ( vs. , ), dulaglutide ( vs. , ), and insulin glargine ( vs. , ) groups after treatment. In the exenatide group, the BMD of the total hip increased. In the dulaglutide group, only the BMD of the femoral neck decreased (), but the magnitude of decrease was less than that in the placebo group; the BMD of L1-L4, femoral neck, and total hip decreased significantly () in the placebo group, while in the insulin glargine group, the BMD of L2, L4, and L1-4 increased (). Compared with the placebo group, the BMD of the femoral neck and total hip in the exenatide group and the insulin glargine group were increased significantly (); compared with the exenatide group, the BMD of L4 in the insulin glargine group was also increased (). Conclusions. Compared with the placebo, GLP-1RAs demonstrated an increase of BMD at multiple sites of the body after treatment, which may not exacerbate the consequences of bone fragility. Therefore, GLP-1RAs might be considered for patients with T2DM. This trial is registered with ClinicalTrials.gov NCT01648582.

中文翻译：

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GLP-1 受体激动剂对 2 型糖尿病患者骨矿物质密度的影响：一项为期 52 周的临床研究

简介。降血糖药物会影响 2 型糖尿病 (T2DM) 患者的骨质量和骨折风险。我们旨在研究胰高血糖素样肽-1 受体激动剂 (GLP-1RAs) 和胰岛素对 T2DM 骨矿物质密度 (BMD) 的影响。方法。在这项单盲研究中，共有 65 名 T2DM 患者被随机分为四组，为期 52 周：艾塞那肽组（)、度拉鲁肽组 (),甘精胰岛素组 ()和安慰剂 (）。收集一般临床资料，采用双能X线骨密度仪测定BMD。结果。与基线相比，艾塞那肽组的糖化血红蛋白（HbA1c）显着降低（ 对比 , )、度拉鲁肽 ( 对比 , )和甘精胰岛素 ( 对比 , )治疗后的组。艾塞那肽组全髋骨BMD增加。度拉鲁肽组仅股骨颈骨密度降低（)，但下降幅度小于安慰剂组；L1-L4、股骨颈和全髋的BMD显着下降（)在安慰剂组中，而在甘精胰岛素组中，L2、L4 和 L1-4 的 BMD 增加 (）。与安慰剂组相比，艾塞那肽组和甘精胰岛素组的股骨颈和全髋骨密度显着增加。); 与艾塞那肽组相比，甘精胰岛素组L4的BMD也升高（）。 结论。与安慰剂相比，GLP-1RAs 在治疗后表现出身体多个部位的 BMD 增加，这可能不会加剧骨脆性的后果。因此，T2DM 患者可能会考虑使用 GLP-1RA。该试验已在 ClinicalTrials.gov NCT01648582 注册。