Effect of Chiglitazar and Sitagliptin on Bone Mineral Density and Body Composition in Untreated Patients with Type 2 Diabetes

Yuming Wang,1,2,* Yunting Zhou,2,* Xiao Zhou,2,* Xiaofei Su,2,* Xiaohua Xu,2 Huiqin Li,2 Jianhua Ma2 1Department of Geriatrics, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, People’s Republic of China; 2Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210012, People’s Republic of China*These authors contributed equally to this workCorrespondence: Huiqin Li; Jianhua Ma, Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China, Email Lihuiqin496@126.com; majianhua196503@126.comAim: To evaluate the changes in bone mineral density (BMD) and body composition in untreated patients with type 2 diabetes mellitus (T2DM) before and after chiglitazar or sitagliptin treatment.Methods: A total of 81 patients with T2DM were randomly divided to receive chiglitazar or sitagliptin treatment for 24 weeks (54 in the chiglitazar group and 27 in the sitagliptin group). We measured the spine lumbar BMD, hip BMD, fat mass (FM), fat-free mass (FFM), percent body fat (%BF), android FM, gynoid FM and skeleton muscle mass (SMM) using dual-energy X-ray absorptiometry (DEXA) and examined serum adiponectin (ADP) levels at baseline and the end of the study.Results: There were no significant changes in the BMD of the L2-4, femoral neck, trochanter or total hip as well as in the BMC after 24 weeks of treatment with chiglitazar or sitagliptin. After chiglitazar administration, the FM, gynoid FM and gynoid to total FM ratio were higher, while the android to total FM ratio and the android to gynoid FM ratio (AOI) were significantly lower. Sitagliptin intervention did not result in statistically significant differences in total fat loss, but it did cause significant decreases in %BF and AOI as well as increases in the FFM, gynoid to total FM ratio and SMM. The ADP levels had significantly negative associations with AOI in all eligible patients.Conclusion: The chiglitazar had no deleterious effects on BMD and resulted in body fat redistribution in untreated patients with T2DM.Trial Registration: The trial is registered at ClinicalTrials.gov (CT.gov identifier: NCT02173457).Keywords: type 2 diabetes mellitus, chiglitazar, PPAR, bone mineral density, body composition