Risk of low-energy fracture in type 2 diabetes patients: a meta-analysis of observational studies

被引:57
|
作者
Jia, P. [1 ]
Bao, L. [1 ]
Chen, H. [1 ]
Yuan, J. [2 ]
Liu, W. [2 ]
Feng, F. [1 ]
Li, J. [1 ]
Tang, H. [1 ]
机构
[1] Capital Med Univ, Beijing Friendship Hosp, Dept Orthoped, 95 Yongan Rd, Beijing 100050, Peoples R China
[2] Capital Med Univ, Beijing Tongren Hosp, Dept Endocrinol, 1 Dongjiaominxiang, Beijing 100730, Peoples R China
关键词
Low-energy fracture; Meta-analysis; Type; 2; diabetes; BONE-MINERAL DENSITY; POSTMENOPAUSAL WOMEN; HIP-FRACTURES; VERTEBRAL FRACTURES; MATCHED COHORT; MELLITUS; THIAZOLIDINEDIONES; HEALTH; MEN; OSTEOPOROSIS;
D O I
10.1007/s00198-017-4183-0
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
A Summary In this meta-analysis, evidence of an association between type 2 diabetes mellitus (T2DM) and low-energy fractures has been evaluated including 12 observational studies. The results suggested that T2DM patients had an enhanced risk of low-energy fractures. Introduction Type 1 diabetes mellitus (T1DM) patients have been shown to be at enhanced risk of fracture injury, but less is known about low-energy fractures among patients with T2DM. Methods We performed a meta-analysis of 12 observational studies identified in Medline and EMBASE that included 938,742 participants, including 30,827 low-energy fracture cases. The incidence rate ratios (IRRs) of low-energy fractures were determined using a random-effects model. Results The IRRs of low-energy fracture for men and women were 1.37 (95% confidence interval [CI], 0.94-2.00; p = 0.096) and 1.22 (95% CI, 1.09-1.35; p = 0.000), respectively, and the overall IRR was 1.23 (95% CI, 1.12-1.35; p = 0.000). The IRRs for hip and vertebral fractures were 1.08 (95% CI, 1.02-1.15; p = 0.007) and 1.21 (95% CI, 0.98-1.48; p = 0.073), respectively. The IRRs of low-energy fracture in case-control, prospective, retrospective, and cross-sectional studies were 1.18 (95% CI, 0.81-1.72; p = 0.380), 1.17 (95% CI, 1.05-1.32, p = 0.006), 1.15 (95% CI, 1.021.29; p = 0.020), and 1.60 (95% CI, 1.21-2.12; p = 0.001), respectively. The IRRs of low-energy fracture for less than 5 years, 5 to 10 years, and more than 10 years were 1.30 (95%, CI 1.13-1.50; p = 0.000), 1.05 (95% CI, 1.03-1.08; p = 0.000), and 1.19 (95% CI, 1.00-1.41; p = 0.049), respectively. Conclusions Patients with T2DM had a greater risk of low-energy fracture especially of the hip, compared with that in non-diabetic subjects. However, since according to our funnel plot a publication bias may be present and due to study heterogeneity as well as the limited number of publications, the finding needs to be interpreted with caution.
引用
收藏
页码:3113 / 3121
页数:9
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