RISK OF FRACTURE IN TYPE 2 DIABETES MELLITUS PATIENTS- META-ANALYSIS OF OBSERVATIONAL STUDIES

Author(s)

Shah C1, Shah R2, Kinra G1, Singuru S1, Vsn M1, Dang A1
1MarksMan Healthcare Solutions LLP (HEOR and RWE Consulting), Navi Mumbai, India, 2S.J.M. College of Pharmacy, Chitradurga, India

OBJECTIVES: Patients with type 2 diabetes mellitus (T2DM) display a unique skeletal phenotype with either normal or more frequently increased, bone mineral density and impaired structural and geometric properties. Alterations in bone material properties seem to be the predominant defect leading to increased bone fragility. A systematic review and meta-analysis of observational studies is conducted to assess the association between T2DM and fracture risk.  METHODS: A systematic literature search was performed in Medline and EMBASE databases. “Abstracts” from annual scientific meeting of various diabetes and bone and mineral societies were also searched to identify relevant studies. Studies reporting fracture risk in subjects with T2DM in comparison with subjects without diabetes were included. Heterogeneity was calculated by performing I statistics. Summary relative risk (RR) estimates and 95% confidence intervals (CIs) were calculated using random-effects model. RESULTS: Twelve studies met the inclusion criteria reporting 25,848 fracture events among 6,12,748 subjects without diabetes (4.2 %) and 8570 fracture events among 2,12,011 subjects with T2DM (4.0 %). The pooled relative risk (RR) of any fracture in subjects with T2DM was 0.91 (95% CI 0.75 – 1.11, p=0.375). The pooled RR for any fractures in women with T2DM was 0.907 (95% CI 0.735- 1.118, 10 studies) compared to subjects without diabetes. The pooled RR for any fractures in men with T2DM was 0.868 (95% CI 0.738 to 1.022) compared to subjects without diabetes. Sensitivity analysis demonstrated stability of result after removing outliers. No publication bias was observed on visual analysis of funnel plot. CONCLUSIONS: Our meta-analysis suggests that patients of T2DM are not at increased risk of incidence of fractures as compared to non diabetic subjects.

Conference/Value in Health Info

2015-11, ISPOR Europe 2015, Milan, Italy

Value in Health, Vol. 18, No. 7 (November 2015)

Code

PDB22

Topic

Epidemiology & Public Health

Disease

Diabetes/Endocrine/Metabolic Disorders

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