Table 1.
Summary of meta-analyses evaluating risk of fracture in patients with type 2 diabetes mellitus
|
Ref.
|
Fracture site
|
Risk effect (95%CI)
|
P
value
|
Risk factors (site)
|
| Vilaca et al[39], 2020 | Hip | RR 1.33 (1.19-1.49) | S | Younger age, female gender, insulin use, longer duration of diabetes (hip) |
| Nonvertebral | RR 1.19 (1.11-1.28) | S | ||
| Koromani et al[43], 2020 | Vertebral (incident) | OR 1.35(1.27-1.44) | S | |
| Vertebral (prevalent) | OR 0.84 (0.74-0.95) | S | ||
| Wang et al[36], 2019 | All | RR 1.22 (1.13-1.31) | S | |
| Hip | RR 1.27 (1.16-1.39) | S | ||
| Distal forearm | RR 0.97 (0.66-1.09) | NS | ||
| Upper arm | RR 1.54 (1.19-1.99) | S | ||
| Ankle | RR 1.15 (1.01-1.31) | S | ||
| Vertebrae | RR 1.74 (0.96-3.16) | NS | ||
| Liu et al[44], 2018 | Limb | RR 1.18 (1.02-1.35) | S | Female gender (leg/ankle) |
| Leg/Ankle | RR 1.80 (1.13-2.87) | S | ||
| Humerus | RR 1.27 (0.60-2.68) | NS | ||
| Wrist/hand/foot | RR 1.26 (0.94-1.71) | NS | ||
| Forearm | RR 0.98 (0.78-1.23) | NS | ||
| Vilaca et al[45], 20191 | Ankle | RR 1.30 (1.15-1.48) | S | |
| Wrist | RR 0.85 (0.77-0.95) | S | ||
| Moayeri et al[37], 2017 | All | RR 1.05 (1.04-1.06) | S | Older age, male gender, duration of diabetes. Insulin use, Corticosteroid use (overall) |
| Hip | RR 1.20 (1.17-1.23) | S | ||
| Vertebral | RR 1.16 (1.05-1.28) | S | ||
| Foot | RR 1.37 (1.21-1.54) | S | ||
| Wrist | RR 0.98 (0.88-1.07) | NS | ||
| Proximal humerus | RR 1.09 (0.86-1.31) | NS | ||
| Ankle | RR 1.13 (0.95-1.32) | NS | ||
| Jia et al[38], 20172 | All | IRR 1.23 (1.12-1.35) | S | |
| Hip | IRR 1.08 (1.02-1.15) | S | ||
| Vertebrae | IRR 1.21 (0.98-1.48) | NS | ||
| Ni and Fan[42], 2017 | All LBMF | RR 1.24 (1.09-1.41) | S | Female gender |
| Dytfeld and Michalak[40], 20173 | Hip | OR 1.30 (1.07-1.57) | S | Cohort studies, Studies conducted in Asia (hip) |
| Vertebral | OR 1.13 (0.94-1.37) | NS | ||
| Fan et al[41], 2016 | Hip | RR 1.34 (1.19-1.51) | S | |
| Vestergaard[16], 2007 | Hip | RR 1.38 (1.25-1.53) | S | |
| Wrist | RR 1.19 (1.01-1.41) | S | ||
| Vertebrae | RR 0.93 (0.63-1.37) | NS | ||
| All | RR 0.96 (0.57-1.61) | NS | ||
| Janghorbani et al[14], 2007 | Hip | RR 1.7 (1.3-2.2) | S |
1
Study included both type 1 and type 2 diabetes.
2
Low energy fractures.
3
Low energy fractures in postmenopausal women. CI: Confidence interval; IRR: Incidence rate ratio; LBMF: Low bone mass-related fractures; NS: Not significant; OR: Odds ratio; RR: Relative risk; S: Statistically significant.