Type 2 diabetes mellitus and the risk of hip and vertebral fractures: a systematic review and meta-analysis of cohort studies

Background Type 2 diabetes mellitus (T2DM) is a chronic metabolic disease. The association between diabetes mellitus and fracture risk is unclear. Currently, T2DM is not an independent risk factor for low-energy fractures in elderly patients. This study aimed to explore the association between T2DM and the risk of hip and vertebral fractures. Method PubMed, MEDLINE, and Cochrane library databases were searched for articles on T2DM and fracture risk. The final study sample from the literature was determined using predefined inclusion criteria, and a meta-analysis, including heterogeneity testing, publication bias analysis, and subgroup analysis, of relevant data was undertaken using STATA software. Results Seventeen studies, involving 365,185 participants, 6539 hip fracture events, and 1381 vertebral fracture events were included in this research. The adjusted relative risk of T2DM and hip or vertebral fracture were 1.46 (95% confidence interval [CI] 1.31-1.61) and 1.00 (95% CI 0.81-1.18), respectively, which showed that T2DM is positively related to hip fracture although not significantly associated with vertebral fractures. Conclusion T2DM was positively associated with an increased risk of hip fracture but not with vertebral fracture. Bone health in patients with T2DM requires more attention, and further research is warranted.