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Insulin use and fracture risk in patients with type 2 diabetes: A meta‑analysis of 138,690 patients

  • Authors:
    • Yuxian Zhang
    • Qiuying Chen
    • Yuying Liang
    • Yuhao Dong
    • Xiaokai Mo
    • Lu Zhang
    • Bin Zhang
  • View Affiliations / Copyright

    Affiliations: Department of Orthopedics, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong 510000, P.R. China, Department of Radiology, The First Affiliated Hospital, Jinan University, Guangzhou, Guangdong 510627, P.R. China, Department of Radiology, The First Affiliated Hospital, Guangdong Pharmaceutical University, Guangzhou, Guangdong 510000, P.R. China, Department of Imaging and Nuclear Medicine, Graduate College, Southern Medical University, Guangzhou, Guangdong 510000, P.R. China
    Copyright: © Zhang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Pages: 3957-3964
    |
    Published online on: April 1, 2019
       https://doi.org/10.3892/etm.2019.7461
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Abstract

Patients with type 2 diabetes mellitus (T2DM) have been reported to have an enhanced risk of bone fracture, however the association between insulin treatment and risk of fracture in patients with T2DM remains to be fully elucidated. The aim of the present meta‑analysis was to examine the possible association between insulin treatment and risk of fracture in patients with T2DM. Relevant studies published prior to and including April 2018 were identified by literature searches in PubMed, Embase and Cochrane Library databases. A meta‑analysis was performed, which included relevant trials of patients with T2DM comparing insulin to oral anti‑diabetic drugs. The combined effect was expressed as a pooled risk ratio (RR) with 95% confidence interval (CI), using a random‑effects model. Subgroup analysis was performed to consolidate the results. A total of 7 studies comprising 138,690 patients were eligible for inclusion in the present meta‑analysis. After exclusion of one study that introduced major heterogeneity, treatment with, insulin was associated with a significantly increased risk of fracture among patients with T2DM (RR=1.24, 95% CI, 1.07‑1.44; P=0.004). Subgroup analysis by sex indicated that the RR for men was 1.04 (95% CI, 0.76‑1.44, P=0.801) and that for women was 1.22 (95% CI, 0.92‑1.62, P=0.175). Subgroup analysis by fracture site indicated that the RR for hip was 1.18 (95% CI, 0.83‑1.68, P=0.363), that for vertebrae was 1.28 (95% CI, 0.90‑1.81, P=0.169) and that for non‑vertebrae was 1.06 (95% CI, 0.80‑1.41, P=0.686). Subgroup analysis by study design suggested that the RR for prospective and retrospective studies was 1.35 (95% CI, 1.06‑1.71, P=0.014) and 1.16 (95% CI, 0.99‑1.35, P=0.059), respectively. Subgroup analysis by region indicated that the RR for Europe was 1.16 (95% CI, 0.91‑1.48, P=0.220), that for North America was 1.24 (95% CI, 0.81‑1.90, P=0.333) and that for Asia was 1.34 (95% CI, 0.91‑1.98, P=0.141). In conclusion, treatment with insulin increased the risk of fractures among patients with T2DM compared with oral anti‑diabetic drugs; however, the association was influenced by various factors, including sex, fracture site, study design and geographical region.
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1 

Janghorbani M, Feskanich D, Willett WC and Hu F: Prospective study of diabetes and risk of hip fracture: The Nurses' Health Study. Diabetes Care. 29:1573–1578. 2006. View Article : Google Scholar : PubMed/NCBI

2 

Lipscombe LL, Jamal SA, Booth GL and Hawker GA: The risk of hip fractures in older individuals with diabetes: A population-based study. Diabetes Care. 30:835–841. 2007. View Article : Google Scholar : PubMed/NCBI

3 

Schwartz AV, Sellmeyer DE, Ensrud KE, Cauley JA, Tabor HK, Schreiner PJ, Jamal SA, Black DM and Cummings SR; Study of Osteoporotic Features Research Group, : Older women with diabetes have an increased risk of fracture: A prospective study. J Clin Endocrinol Metab. 86:32–38. 2001. View Article : Google Scholar : PubMed/NCBI

4 

Ivers RQ, Cumming RG, Mitchell P and Peduto AJ; Blue Mountains Eye Study, : Diabetes and risk of fracture: The blue mountains eye study. Diabetes Care. 24:1198–1203. 2001. View Article : Google Scholar : PubMed/NCBI

5 

Russo GT, Giandalia A, Romeo EL, Nunziata M, Muscianisi M, Ruffo MC, Catalano A and Cucinotta D: Fracture risk in type 2 diabetes: Current perspectives and gender differences. Int J Endocrinol. 2016:16157352016. View Article : Google Scholar : PubMed/NCBI

6 

Thrailkill KM, Lumpkin CK Jr, Bunn RC, Kemp SF and Fowlkes JL: Is insulin an anabolic agent in bone? Dissecting the diabetic bone for clues. Am J Physiol Endocrinol Metab. 289:E735–E745. 2005. View Article : Google Scholar : PubMed/NCBI

7 

Melton LJ III, Leibson CL, Achenbach SJ, Therneau TM and Khosla S: Fracture risk in type 2 diabetes: Update of a population-based study. J Bone Miner Res. 23:1334–1342. 2008. View Article : Google Scholar : PubMed/NCBI

8 

Ahmed LA, Joakimsen RM, Berntsen GK, Fønnebø V and Schirmer H: Diabetes mellitus and the risk of non-vertebral fractures: The Tromsø study. Osteoporos Int. 17:495–500. 2006. View Article : Google Scholar : PubMed/NCBI

9 

Napoli N, Strotmeyer ES, Ensrud KE, Sellmeyer DE, Bauer DC, Hoffman AR, Dam TT, Barrett-Connor E, Palermo L, Orwoll ES, et al: Fracture risk in diabetic elderly men: The MrOS study. Diabetologia. 57:2057–2065. 2014. View Article : Google Scholar : PubMed/NCBI

10 

Vestergaard P, Rejnmark L and Mosekilde L: Relative fracture risk in patients with diabetes mellitus, and the impact of insulin and oral antidiabetic medication on relative fracture risk. Diabetologia. 48:1292–1299. 2005. View Article : Google Scholar : PubMed/NCBI

11 

Monami M, Cresci B, Colombini A, Pala L, Balzi D, Gori F, Chiasserini V, Marchionni N, Rotella CM and Mannucci E: Bone fractures and hypoglycemic treatment in type 2 diabetic patients: A case-control study. Diabetes Care. 31:199–203. 2008. View Article : Google Scholar : PubMed/NCBI

12 

Kennedy RL, Henry J, Chapman AJ, Nayar R, Grant P and Morris AD: Accidents in patients with insulin-treated diabetes: Increased risk of low-impact falls but not motor vehicle crashes-a prospective register-based study. J Trauma. 52:660–666. 2002.PubMed/NCBI

13 

Pscherer S, Kostev K, Dippel FW and Rathmann W: Fracture risk in patients with type 2 diabetes under different antidiabetic treatment regimens: A retrospective database analysis in primary care. Diabetes Metab Syndr Obes. 9:17–23. 2016.PubMed/NCBI

14 

Kanazawa I, Yamaguchi T, Yamamoto M and Sugimoto T: Relationship between treatments with insulin and oral hypoglycemic agents versus the presence of vertebral fractures in type 2 diabetes mellitus. J Bone Miner Metab. 28:554–560. 2010. View Article : Google Scholar : PubMed/NCBI

15 

Hung YC, Lin CC, Chen HJ, Chang MP, Huang KC, Chen YH and Chen CC: Severe hypoglycemia and hip fracture in patients with type 2 diabetes: A nationwide population-based cohort study. Osteoporos Int. 28:2053–2060. 2017. View Article : Google Scholar : PubMed/NCBI

16 

Josse RG, Majumdar SR, Zheng Y, Adler A, Bethel MA, Buse JB, Green JB, Kaufman KD, Rodbard HW, Tankova T, et al: Sitagliptin and risk of fractures in type 2 diabetes: Results from the TECOS trial. Diabetes Obes Metab. 19:78–86. 2017. View Article : Google Scholar : PubMed/NCBI

17 

Hamann C, Kirschner S, Gunther KP and Hofbauer LC: Bone, sweet bone-osteoporotic fractures in diabetes mellitus. Nat Rev Endocrinol. 8:297–305. 2012. View Article : Google Scholar : PubMed/NCBI

18 

Akune T, Ogata N, Hoshi K, Kubota N, Terauchi Y, Tobe K, Takagi H, Azuma Y, Kadowaki T, Nakamura K and Kawaguchi H: Insulin receptor substrate-2 maintains predominance of anabolic function over catabolic function of osteoblasts. J Cell Biol. 159:147–156. 2002. View Article : Google Scholar : PubMed/NCBI

19 

Campos Pastor MM, López-Ibarra PJ, Escobar-Jiménez F, Serrano Pardo MD and García-Cervigón AG: Intensive insulin therapy and bone mineral density in type 1 diabetes mellitus: A prospective study. Osteoporos Int. 11:455–459. 2000. View Article : Google Scholar : PubMed/NCBI

20 

Huang S, Kaw M, Harris MT, Ebraheim N, McInerney MF, Najjar SM and Lecka-Czernik B: Decreased osteoclastogenesis and high bone mass in mice with impaired insulin clearance due to liver-specific inactivation to CEACAM1. Bone. 46:1138–1145. 2010. View Article : Google Scholar : PubMed/NCBI

21 

Srikanthan P, Crandall CJ, Miller-Martinez D, Seeman TE, Greendale GA, Binkley N and Karlamangla AS: Insulin resistance and bone strength: Findings from the study of midlife in the United States. J Bone Miner Res. 29:796–803. 2014. View Article : Google Scholar : PubMed/NCBI

22 

Shah CS, Shah VN, Likhar N, Mothe RK, Kanukula R and Dang A: Association between bone mineral density and type 1 diabetes mellitus: A meta-analysis of observational studies. Value in Health. 18:A582015. View Article : Google Scholar

23 

Klein GL: Insulin and bone: Recent developments. World J Diabetes. 5:14–16. 2014. View Article : Google Scholar : PubMed/NCBI

24 

Vestergaard P: Discrepancies in bone mineral density and fracture risk in patients with type 1 and type 2 diabetes-a meta-analysis. Osteoporos Int. 18:427–444. 2007. View Article : Google Scholar : PubMed/NCBI

25 

Wallander M, Axelsson KF, Nilsson AG, Lundh D and Lorentzon M: Type 2 diabetes and risk of hip fractures and non-skeletal fall injuries in the elderly: A study from the fractures and fall injuries in the elderly cohort (FRAILCO). J Bone Miner Res. 32:449–460. 2017. View Article : Google Scholar : PubMed/NCBI

26 

Ghodsi M, Larijani B, Keshtkar AA, Nasli-Esfahani E, Alatab S and Mohajeri-Tehrani MR: Mechanisms involved in altered bone metabolism in diabetes: A narrative review. Diabetes Metab Disord. 15:522016. View Article : Google Scholar

27 

Adami S: Bone health in diabetes: Considerations for clinical management. Curr Med Res Opin. 25:1057–1072. 2009. View Article : Google Scholar : PubMed/NCBI

28 

de Waard EAC, Koster A, Melai T, van Geel TA, Henry RMA, Schram MT, Dagnelie PC, van der Kallen CJ, Sep SJS, Stehouwer CDA, et al: The association between glucose metabolism status, diabetes severity and a history of fractures and recent falls in participants of 50 years and older-the Maastricht study. Osteoporos Int. 27:3207–3216. 2016. View Article : Google Scholar : PubMed/NCBI

29 

Starup-Linde J, Gregersen S, Frost M and Vestergaard P: Use of glucose-lowering drugs and risk of fracture in patients with type 2 diabetes. Bone. 95:136–142. 2017. View Article : Google Scholar : PubMed/NCBI

30 

Dutta MK, Pakhetra R and Garg MK: Evaluation of bone mineral density in type 2 diabetes mellitus patients before and after treatment. Med J Armed Forces India. 68:48–52. 2012. View Article : Google Scholar : PubMed/NCBI

31 

Yan W and Li X: Impact of diabetes and its treatments on skeletal diseases. Front Med. 7:81–90. 2013. View Article : Google Scholar : PubMed/NCBI

32 

Barrett-Connor E and Kritz-Silverstein D: Does hyperinsulinemia preserve bone? Diabetes Care. 19:1388–1392. 1996. View Article : Google Scholar : PubMed/NCBI

33 

Napoli N, Chandran M, Pierroz DD, Abrahamsen B, Schwartz AV and Ferrari SL; IOF Bone and Diabetes Working Group, : Mechanisms of diabetes mellitus-induced bone fragility. Nat Rev Endocrinol. 13:208–219. 2017. View Article : Google Scholar : PubMed/NCBI

34 

Oei L, Rivadeneira F, Zillikens MC and Oei EH: Diabetes, diabetic complications, and fracture risk. Curr Osteoporos Rep. 13:106–115. 2015. View Article : Google Scholar : PubMed/NCBI

35 

Khan TS and Fraser LA: Type 1 diabetes and osteoporosis: From molecular pathways to bone phenotype. J Osteoporos. 2015:1741862015. View Article : Google Scholar : PubMed/NCBI

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Copy and paste a formatted citation
Spandidos Publications style
Zhang Y, Chen Q, Liang Y, Dong Y, Mo X, Zhang L and Zhang B: Insulin use and fracture risk in patients with type 2 diabetes: A meta‑analysis of 138,690 patients. Exp Ther Med 17: 3957-3964, 2019.
APA
Zhang, Y., Chen, Q., Liang, Y., Dong, Y., Mo, X., Zhang, L., & Zhang, B. (2019). Insulin use and fracture risk in patients with type 2 diabetes: A meta‑analysis of 138,690 patients. Experimental and Therapeutic Medicine, 17, 3957-3964. https://doi.org/10.3892/etm.2019.7461
MLA
Zhang, Y., Chen, Q., Liang, Y., Dong, Y., Mo, X., Zhang, L., Zhang, B."Insulin use and fracture risk in patients with type 2 diabetes: A meta‑analysis of 138,690 patients". Experimental and Therapeutic Medicine 17.5 (2019): 3957-3964.
Chicago
Zhang, Y., Chen, Q., Liang, Y., Dong, Y., Mo, X., Zhang, L., Zhang, B."Insulin use and fracture risk in patients with type 2 diabetes: A meta‑analysis of 138,690 patients". Experimental and Therapeutic Medicine 17, no. 5 (2019): 3957-3964. https://doi.org/10.3892/etm.2019.7461
Copy and paste a formatted citation
x
Spandidos Publications style
Zhang Y, Chen Q, Liang Y, Dong Y, Mo X, Zhang L and Zhang B: Insulin use and fracture risk in patients with type 2 diabetes: A meta‑analysis of 138,690 patients. Exp Ther Med 17: 3957-3964, 2019.
APA
Zhang, Y., Chen, Q., Liang, Y., Dong, Y., Mo, X., Zhang, L., & Zhang, B. (2019). Insulin use and fracture risk in patients with type 2 diabetes: A meta‑analysis of 138,690 patients. Experimental and Therapeutic Medicine, 17, 3957-3964. https://doi.org/10.3892/etm.2019.7461
MLA
Zhang, Y., Chen, Q., Liang, Y., Dong, Y., Mo, X., Zhang, L., Zhang, B."Insulin use and fracture risk in patients with type 2 diabetes: A meta‑analysis of 138,690 patients". Experimental and Therapeutic Medicine 17.5 (2019): 3957-3964.
Chicago
Zhang, Y., Chen, Q., Liang, Y., Dong, Y., Mo, X., Zhang, L., Zhang, B."Insulin use and fracture risk in patients with type 2 diabetes: A meta‑analysis of 138,690 patients". Experimental and Therapeutic Medicine 17, no. 5 (2019): 3957-3964. https://doi.org/10.3892/etm.2019.7461
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