Risk of non-vertebral fractures in men with type 2 diabetes: A systematic review and meta-analysis of cohort studies

Gao, Yang; Chai, Fang

doi:10.1016/j.exger.2021.111378

Cited by 9 publications

(6 citation statements)

References 59 publications

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“…And compared to subjects without DM, the risk of hip fracture was 6.94 and 1.38 times higher in T1DM and T2DM individuals, respectively. Apart from hip fracture, similar conclusions were reached from several other large sample meta-analyses on the association between DM and fracture risk at other sites including vertebra, upper arm, distal forearm, and ankle (5)(6)(7). Since then, osteoporosis and related fractures are the main bone metabolic diseases of greatest concern in this field (8,9).…”

Section: Introductionsupporting

confidence: 59%

Mapping Knowledge Landscapes and Emerging Trends of the Links Between Bone Metabolism and Diabetes Mellitus: A Bibliometric Analysis From 2000 to 2021

Cheng

Guo

Yang

et al. 2022

Front. Public Health

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BackgroundDiabetes mellitus (DM) have become seriously threatens to human health and life quality worldwide. As a systemic metabolic disease, multiple studies have revealed that DM is related to metabolic bone diseases and always induces higher risk of fracture. In view of this, the links between bone metabolism (BM) and DM (BMDM) have gained much attention and numerous related papers have been published. Nevertheless, no prior studies have yet been performed to analyze the field of BMDM research through bibliometric approach. To fill this knowledge gap, we performed a comprehensive bibliometric analysis of the global scientific publications in this field.MethodsArticles and reviews regarding BMDM published between 2000 and 2021 were obtained from the Web of Science after manually screening. VOSviewer 1.6.16, CiteSpace V 5.8.R3, Bibliometrix, and two online analysis platforms were used to conduct the bibliometric and visualization analyses.ResultsA total of 2,525 documents including 2,255 articles and 270 reviews were retrieved. Our analysis demonstrated a steady increasing trend in the number of publications over the past 22 years (R2 = 0.989). The United States has occupied the leading position with the largest outputs and highest H-index. University of California San Francisco contributed the most publications, and Schwartz AV was the most influential author. Collaboration among institutions from different countries was relatively few. The journals that published the most BMDM-related papers were Bone and Osteoporosis International. Osteoporosis and related fractures are the main bone metabolic diseases of greatest concern in this field. According to co-cited references result, “high glucose environment,” “glycation end-product” and “sodium-glucose co-transporter” have been recognized as the current research focus in this domain. The keywords co-occurrence analysis indicated that “diabetic osteoporosis,” “osteoarthritis,” “fracture risk,” “meta-analysis,” “osteogenic differentiation,” “bone regeneration,” “osteogenesis,” and “trabecular bone score” might remain the research hotspots and frontiers in the near future.ConclusionAs a cross-discipline research field, the links between bone metabolism and diabetes mellitus are attracting increased attention. Osteoporosis and related fractures are the main bone metabolic diseases of greatest concern in this field. These insights may be helpful for clinicians to recognize diabetic osteopenia and provide more attention and support to such patients.

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Section: Introductionsupporting

confidence: 59%

Mapping Knowledge Landscapes and Emerging Trends of the Links Between Bone Metabolism and Diabetes Mellitus: A Bibliometric Analysis From 2000 to 2021

Cheng

Guo

Yang

et al. 2022

Front. Public Health

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“…In the general population, meta-analysis of clinical studies suggests T2DM imparts a 1.7-fold (1.3, 2.2) increased RR for hip fracture, 42 and for T1DM, the risk for any fracture increases to 6.3-fold (2.6, 15.1), 42 with vertebral fracture risk reported to be 1.2fold (1.09, 1.31) that of the general population. 43 Comparing DXA parameters between patients with ESKD due to T1DM and other causes, BMD z-scores at the lumbar spine, femoral neck, and ultradistal radius are significantly lower in patients with T1DM, and cortical parameters assessed by advanced hip analysis are more abnormal in T1DM patients. 44 During the first year following transplantation, the body mass index (BMI) of many patients increases.…”

Section: Fracture Rates After Transplantationmentioning

confidence: 97%

Current Status of Mineral and Bone Disorders in Transplant Recipients

Elder

2023

Transplantation

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Most patients with end-stage kidney disease undergoing kidney transplantation are affected by the chronic kidney disease–mineral and bone disorder. This entity encompasses laboratory abnormalities, calcification of soft tissues, and the bone abnormalities of renal osteodystrophy that together result in an increased risk of fracture, cardiovascular events, and mortality. Although many biochemical disturbances associated with end-stage kidney disease improve in the first year after transplantation, hyperparathyroidism commonly persists, and residual changes of renal osteodystrophy are slow to resolve. When superimposed on common, traditional risk factors, post-transplant glucocorticoid treatment, the possibility of tubular disturbances and post-transplant chronic kidney disease, rates of incident fracture remain high. This review examines hormonal and biochemical changes before and after kidney transplantation, fracture risk assessment tools and imaging modalities, a staged approach to management and concerns associated with antiresorptive and anabolic therapies. A multidisciplinary approach is proposed as the best means to improve patient-level outcomes.

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“…It reported 59,909 nonvertebral fracture events and 6430 vertebral fracture events. The regulated relative risk of T2DM and nonvertebral fractures in men was 1.20 (95% CI: 1.09-1.31) (26). Similarly, another meta-analysis including observational studies showed that adults with diabetes had a higher risk of fractures for both hip fractures (RR 4.93, 3.06-7.95 in T1DM and RR 1.33, 1.19-1.49 in T2DM) and nonvertebral fractures (RR 1.92, 0.92-3.99, in type 1 and RR 1.19, 1,11-1.28 in type 2) compared with adults without diabetes (27).…”

Section: Bmdmentioning

confidence: 98%

Fracture risk assessment in diabetes mellitus

et al. 2022

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Growing evidence suggests that diabetes mellitus is associated with an increased risk of fracture. Bone intrinsic factors (such as accumulation of glycation end products, low bone turnover, and bone microstructural changes) and extrinsic factors (such as hypoglycemia caused by treatment, diabetes peripheral neuropathy, muscle weakness, visual impairment, and some hypoglycemic agents affecting bone metabolism) probably contribute to damage of bone strength and the increased risk of fragility fracture. Traditionally, bone mineral density (BMD) measured by dual x-ray absorptiometry (DXA) is considered to be the gold standard for assessing osteoporosis. However, it cannot fully capture the changes in bone strength and often underestimates the risk of fracture in diabetes. The fracture risk assessment tool is easy to operate, giving it a certain edge in assessing fracture risk in diabetes. However, some parameters need to be regulated or replaced to improve the sensitivity of the tool. Trabecular bone score, a noninvasive tool, indirectly evaluates bone microstructure by analyzing the texture sparsity of trabecular bone, which is based on the pixel gray level of DXA. Trabecular bone score combined with BMD can effectively improve the prediction ability of fracture risk. Quantitative computed tomography is another noninvasive examination of bone microstructure. High-resolution peripheral quantitative computed tomography can measure volume bone mineral density. Quantitative computed tomography combined with microstructure finite element analysis can evaluate the mechanical properties of bones. Considering the invasive nature, the use of microindentation and histomorphometry is limited in clinical settings. Some studies found that the changes in bone turnover markers in diabetes might be associated with fracture risk, but further studies are needed to confirm this. This review focused on summarizing the current development of these assessment tools in diabetes so as to provide references for clinical practice. Moreover, these tools can reduce the occurrence of fragility fractures in diabetes through early detection and intervention.

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Risk of non-vertebral fractures in men with type 2 diabetes: A systematic review and meta-analysis of cohort studies

Cited by 9 publications

References 59 publications

Mapping Knowledge Landscapes and Emerging Trends of the Links Between Bone Metabolism and Diabetes Mellitus: A Bibliometric Analysis From 2000 to 2021

Mapping Knowledge Landscapes and Emerging Trends of the Links Between Bone Metabolism and Diabetes Mellitus: A Bibliometric Analysis From 2000 to 2021

Current Status of Mineral and Bone Disorders in Transplant Recipients

Fracture risk assessment in diabetes mellitus

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