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The association of diabetes mellitus and gender with risk of bone fractures: A systematic review and meta-analysis

Mansour Amraei, Shahram Mohamadpour, Yaser Seifinejad, Seyedeh Fatemeh Mousavi, Ehsan Shirzadpour, Safoura Mohamadpour, Ardeshir Moayeri

Bone fracture shows a growing trend. This increase is a result of several factors occurs. In this study, a meta-analysis was performed to examine the relationship of fracture risk with Type 2 diabetes mellitus and gender. For this purpose, we searched the credible databases including PubMed, ISI, and Scopus for the related epidemiologic studies that were published up to May 2016. The data provided in these articles was extracted and then analyzed by a random-effects model. Funnel plot was used to check for publication bias. Statistical analyses were carried out by R version 3.2.1 and STATA (version 11.1). After filtering irrelevant articles, 30 studies were selected for meta-analysis. The analyses showed that type 2 diabetes mellitus is positively associated with overall fracture risk (summary RR=1.05, 95% CI: 1.04, 1.06). The incidence of fractures was higher in men than in women (Phet=0.043). The interpretation of the meta-regression showed that no significant relationship exists between the gender risk factor in diabetic patients and years of study (P=0.280). The results highlight the importance of adopting suitable strategies for prevention of bone fracture in T2DM patients.