The use of metformin, sulfonylurea compounds and insulin and the risk of hip fractures in diabetic patients: a systematic review and meta-analysis of observational studies

BMC Musculoskeletal Disorders

Research

Elham Rahimi¹  Mansour Bahardoust¹  Ali Delpisheh²  Farshid Monshizadeh Tehrani³  Delaram Naderi⁴  Mohsen Yarali⁵  Ghazaleh Donyadideh⁶ 

[1] Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran;Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran;Safety Promotion and Injury Prevention Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran;Psychiatric Center Ballerup, Copenhagen University Hospital, Copenhagen, Denmark;School of Medicine, Iran University of Medical Sciences, Tehran, Iran;School of Medicine, Kashan University of Medical Sciences, Kashan, Iran;School of Medicine, Mashad University of Medical Sciences, Mashad, Iran;

关键词: Fracture;    Hip fracture;    Insulin;    Metformin;    Sulfonylurea;    Anti-diabetic drugs;   

DOI  :  10.1186/s12891-023-06493-9

 received in 2023-01-03, accepted in 2023-05-04,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundHip fracture is a major health problem that occurs more often in the elderly, especially in diabetic patients. Some studies have been conducted regarding the effect of anti- diabetic drugs on fractures. But so far, no meta-analysis study has been conducted to investigate the effect of diabetic drugs on hip fractures. Therefore, this study investigated the relationship between anti-diabetic drugs (Metformin, Sulfonylurea, and insulin) with hip fractures.MethodsIn this systematic review and meta analysis study, PubMed, Scopus, Google Scholar, and Web of Science databases were searched with specific keywords to find relevant studies. Two researchers included related studies after screening based on the title and full text. Cochran’s Q and I2 tests were used to assess heterogeneity between studies. Publication bias between studies was evaluated for each drug using Egger’s test. A 95% confidence interval was used for effect size significance. Overall, 49 studies, including 6,631,297 participants, were reviewed.ResultsThe results showed that metformin significantly reduced the risk of hip fracture (HR: 0.833, 95% CI: 0.759, 0.914, P:0.001). Consumption of sulfonylurea compounds was significantly associated with an increased risk of hip fracture. (HR: 1.175, 95% CI:1.068,1.293, P:0.001), The risk of hip fracture in patients receiving insulin was significantly higher than in diabetic patients who did not receive insulin. (HR:1.366, 95% CI:1.226,1.522, P:0.001).ConclusionThe results of this study showed that taking metformin reduces the risk of hip fracture, and insulin and Sulfonylurea increase the risk of hip fracture.

【 授权许可】

CC BY   
© The Author(s) 2023

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