Citation

Wang Y, Yu L, Ye Z, Lin R, Sun ARJ, Liu L, Wei J, Deng F, Zhong X, Cui L, Li L, Liu Y. Front. Endocrinol. (Lausanne) 2022; 13: e1038603.

Copyright

(Copyright © 2022, Frontiers Research Foundation)

DOI

10.3389/fendo.2022.1038603

PMID

36714564

PMCID

PMC9874692

Abstract

AIMS: Increasing evidence suggests that metformin can affect bone metabolism beyond its hypoglycemic effects in diabetic patients. However, the effects of metformin on fracture risk in type 2 diabetes mellitus (T2DM) patients remain unclear. A systematic review and meta-analysis were performed in this study to evaluate the association between metformin application and fracture risk in T2DM patients based on previous studies published until June 2021.

METHODS: A systematic search was performed to collect publications on metformin application in T2DM patients based on PubMed, Embase, Cochran, and Web of Science databases. Meta-analysis was performed by using a random-effects model to estimate the summary relative risks (RRs) with 95% confidence intervals (CIs). Subgroup analyses based on cohort/case-control and ethnicity and sensitivity analyses were also performed.

RESULTS: Eleven studies were included in the meta-analysis.

RESULTS demonstrated metformin use was not significantly associated with a decreased risk of fracture (RR, 0.91; 95% CI, 0.81-1.02; I(2 =) 96.8%). Moreover, metformin use also demonstrated similar results in subgroup analyses of seven cohort studies and four case-control studies, respectively (RR, 0.90; 95% CI, 0.76-1.07; I(2 =) 98.0%; RR, 0.96; 96% CI, 0.89-1.03; I(2 =) 53.7%). Sensitivity analysis revealed that there was no publication bias.

CONCLUSION: There was no significant correlation between fracture risk and metformin application in T2DM patients. Due to a limited number of existing studies, further research is needed to make a definite conclusion for clinical consensus.

Language: en

Keywords

Humans; Risk; diabetes; meta-analysis; *Diabetes Mellitus, Type 2/complications/drug therapy/chemically induced; *Fractures, Bone/epidemiology/etiology/prevention & control; *Metformin/therapeutic use; bone; fracture; Hypoglycemic Agents/therapeutic use; metformin