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Thiazolidinediones (TZD) Bone Loss and the Effects on Bone Marrow Differentiation and Osteoblast Formation (TZDBONE)

This study has been completed.
Information provided by (Responsible Party):
Guillermo Umpierrez, Emory University Identifier:
First received: April 18, 2008
Last updated: March 30, 2015
Last verified: March 2015
Thiazolidinediones (TZDs) are a commonly used antidiabetic drugs currently used by over a million patients in the United States. Recent studies have shown that treatment with TZD may increase the risk of bone fractures. The cause of bone loss is not known. We believe that TZD may cause increased accumulation of fat in the bone marrow, which may cause decrease bone formation and weak bones. .

Condition Intervention
Osteoporosis Procedure: Stromal Cells Sample

Study Type: Observational
Study Design: Observational Model: Case-Only
Time Perspective: Prospective
Official Title: Thiazolidinedione-Induced Bone Loss: Effects on Bone Marrow Stromal Cell Differentiation Capacity and Osteoblast Formation

Further study details as provided by Guillermo Umpierrez, Emory University:

Primary Outcome Measures:
  • To determine whether TZD exposure in vitro alters bone formation and the differentiation capacity of bone marrow stromal cells by promoting adipocyte lineage differentiation and lowering osteoblast formation [ Time Frame: once all subjects have been recruited ]

Biospecimen Retention:   Samples Without DNA
Bone Marrow

Enrollment: 9
Study Start Date: July 2009
Study Completion Date: December 2010
Primary Completion Date: March 2010 (Final data collection date for primary outcome measure)
Groups/Cohorts Assigned Interventions
Stromal Cell Sample Procedure: Stromal Cells Sample
Human Bone Marrow Stromal Cells will be obtained from 5 patients. Stromal cells will be obtained from subjects undergoing bone graft procedure to repair traumatic mandible fractures. Bone graft specimens will be obtained from the ileac crest. This will allow easy access to bone marrow specimen without additional pain or complications. A total of 5 ml of bone marrow will be obtained from each patient.

Detailed Description:

This study aims to determine if TZDs increase the amount of fat and decrease the number of bone producing cells in the bone marrow.

A total of 5 subjects who require surgery for mandible (jaw) fracture and bone graft will be recruited. Some patients who will undergo mandible surgery will require a bone graft. In this procedure, a small piece of bone from the hip is placed in the mandible. In this study, a small amount of bone marrow fluid (5 mL or 1 teaspoon) will be obtained after the bone graft is completed. Obtaining the bone marrow will not result in additional pain or health problems. The effect of TZD on bone marrow and bone forming cells will be studied. The cells obtained during surgery will be grown at Dr Beck's laboratory at Emory University School of Medicine.

A working hypothesis suggests that the increased fracture risk in patients taking TZDs is the result of TZDs altering the differentiation capacity of bone marrow stromal cells pushing them towards the adipocyte lineage at the cost of osteoblast formation thereby decreasing bone formation.

Study AIM:To determine whether TZD exposure in vitro alters bone formation and the differentiation capacity of bone marrow stromal cells by promoting adipocyte lineage differentiation and lowering osteoblast formation.


Ages Eligible for Study:   18 Years to 80 Years   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Sampling Method:   Non-Probability Sample
Study Population
Subjects with 1) traumatic mandibular (jaw) fracture who will undergo bone grafting or 2) trauma patients who will undergo intra-medullary rod placement for traumatic limb fractures will be considered as potential candidates in the study

Inclusion Criteria:

  1. Males or females between the ages of 18 and 80 years undergoing ileac crest bone graft to repair traumatic mandible fracture.
  2. Patients admitted for elective or emergency surgery or trauma.

Exclusion Criteria:

  1. Subjects with history of decompensated diabetes (blood glucose > 200 mg/dl)
  2. Critically ill patients with multi-organ failure, relevant hepatic disease or impaired renal function (serum creatinine ≥ 2.0 mg/dl)
  3. HIV
  4. Hemolytic anemia and/or hematocrit < 28%
  5. Mental condition rendering the subject unable to understand the nature, scope, and possible consequences of the study
  6. Pregnancy
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT00663143

United States, Georgia
Grady Memorial Hospital
Atlanta, Georgia, United States, 30303
Emory Crawford Long Hospital
Atlanta, Georgia, United States, 30308
Emory University Hospital
Atlanta, Georgia, United States, 30322
Sponsors and Collaborators
Emory University
Principal Investigator: Guillermo Umpierrez, MD Emory University SOM
  More Information

Responsible Party: Guillermo Umpierrez, Principal Investigator, Emory University Identifier: NCT00663143     History of Changes
Other Study ID Numbers: IRB00006692
Study First Received: April 18, 2008
Last Updated: March 30, 2015

Keywords provided by Guillermo Umpierrez, Emory University:
TZD exposure
in vitro
bone marrow
stromal cells

Additional relevant MeSH terms:
Bone Diseases, Metabolic
Bone Diseases
Musculoskeletal Diseases
Hypoglycemic Agents
Physiological Effects of Drugs processed this record on August 18, 2017