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Meta-Analysis
. 2017 Apr;29(2):301-309.
doi: 10.1007/s40520-016-0562-1. Epub 2016 Apr 12.

Type 2 diabetes and risk of low-energy fractures in postmenopausal women: meta-analysis of observational studies

Joanna Dytfeld  1 , Michał Michalak  2
Affiliations
Meta-Analysis

Type 2 diabetes and risk of low-energy fractures in postmenopausal women: meta-analysis of observational studies

Joanna Dytfeld et al. Aging Clin Exp Res. 2017 Apr.

Abstract

Background: Observational studies on osteoporotic fractures in patients with type 2 diabetes indicate their increased incidence compared to those without diabetes, but results are inconsistent. Currently, type 2 diabetes is not considered as an independent risk factor for low-energy fractures in elder subjects. The aim of the study was to assess the association between type 2 diabetes and risk for hip and vertebral fractures in postmenopausal women.

Materials and methods: We searched Medline, Web of Science and Cochrane databases for articles published before September 2013. Studies assessing fractures in women aged >50 diagnosed with type 2 diabetes, regardless of the diabetes treatment, were deemed eligible. To estimate fracture risk meta-analysis in a random effect model was performed. The results were shown by the odds ratio (OR) and 95 % confidence interval (CI). Heterogeneity was tested using a Q-Cochrane test (significance was analyzed with p < 0.10) and I 2 measure.

Results: A total of 15 observational studies (11 cohort and 4 cross-sectional, 263.006 diabetics and 502.115 controls) were included. Thirteen papers provided information on the incidence of hip fractures, and seven on vertebral ones. The meta-analysis revealed type 2 diabetes was associated with higher risk for hip fracture (OR 1.296, 95 % CI (1.069-1.571), but not vertebral fracture (OR = 1.134, 95 % CI (0.936-1.374). There was significant heterogeneity between hip fracture studies. American origin was identified as a potential source of such heterogeneity.

Conclusions: The results of our meta-analysis indicate there is an increased risk for hip fracture in postmenopausal women with type 2 diabetes.

Keywords: Fracture; Osteoporosis; Type 2 diabetes.

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Conflict of interest statement

Conflict of interest

The authors declare that they had no conflict of interest.

Statement of human and animal rights

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

For this type of study formal consent is not required.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram for inclusion of relevant studies
Fig. 2
Fig. 2
Funnel plot for vertebral (a) and hip (b) fracture studies
Fig. 3
Fig. 3
Meta-analysis for vertebral fractures
Fig. 4
Fig. 4
Meta-analysis for hip fractures
See this image and copyright information in PMC

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