Evaluation of bone health and fracture risk in type 2 diabetes: a network meta-analysis of anti-diabetic treatments versus placebo
Abstract
While studies have highlighted the negative effects of certain antidiabetic agents, similar evidence for other antidiabetic agents remains limited. In this study, we aimed to analyze bone fractures and bone mineral densities (BMDs) across patients receiving antidiabetic treatments, considering both overall and specific sites. We comprehensively searched PubMed, Embase, and ClinicalTrials.gov up to March 2024 to determine the effect of antidiabetic agent use on bone health in patients with type 2 diabetes mellitus. The primary outcome was to reveal variations in fractures across different anti-diabetic treatment modalities. The secondary outcome was the differences in BMDs based on treatment type. The fractures were grouped based on the division of specific sites. We also performed a subgroup analysis to identify differences between treatment types by dividing the study by treatment duration. The protocol is registered (CRD42024538789). A total of 234,759 individuals were enrolled in the 242 studies. We observed a trend wherein all anti-diabetic treatments were associated with decreased risk of fracture compared with placebo; however, this was not significant in direct analysis (OR 0.92, 95% CI 0.84-1.01, I2 = 0, P = 0.07). For indirect analysis, glucagon-like peptide-1 receptor agonists (GLP1RAs) demonstrated a significant effect on preventing fractures in non-vertebral fracture, hip fracture, vertebral and hip fracture, and overall fracture (odds ratio [OR] 0.62, 95%…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 234,759 participants or records.
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