Risk of non-vertebral fractures in men with type 2 diabetes: A systematic review and meta-analysis of cohort studies

Exp Gerontol. 2021 Jul 15:150:111378. doi: 10.1016/j.exger.2021.111378. Epub 2021 Apr 25.

Abstract

Purpose: Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder. Research regarding the risk of non-vertebral fractures in men, especially in elderly men with T2DM, has not been a priority. T2DM is not a known independent risk factor for low-energy fractures in patients. We aimed to explore the relationship between men (especially older men) with T2DM and the risk of non-vertebral fractures and the reasons for the sex differences.

Methods: The PubMed, MEDLINE, and Cochrane Library databases were searched for articles on T2DM and fracture risk. A meta-analysis, including heterogeneity testing, publication bias analysis, and subgroup analysis of the included studies, was performed using STATA software.

Results: Sixteen studies involving 1,758,225 participants, 59,909 non-vertebral fracture events, and 6430 vertebral fracture events were included in this research. The adjusted relative risk of T2DM and non-vertebral fracture in men was 1.20 (95% confidence interval [CI] 1.09-1.31), implying that men with T2DM have a slightly increased risk of non-vertebral fracture.

Conclusion: Male patients with T2DM have a slightly increased risk of non-vertebral fractures. Due to the differences in bone strength, sex steroid hormone levels, bone quality and muscle strength and balance, men with type 2 diabetes have a lower risk of non-vertebral fractures than women.

Keywords: Meta-analysis; Non-vertebral fracture; Sex differences; Type 2 diabetes.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Aged
  • Cohort Studies
  • Diabetes Mellitus, Type 2* / complications
  • Diabetes Mellitus, Type 2* / epidemiology
  • Female
  • Humans
  • Male
  • Osteoporotic Fractures* / epidemiology
  • Osteoporotic Fractures* / etiology
  • Risk Factors
  • Spinal Fractures* / epidemiology
  • Spinal Fractures* / etiology