Diabetes mellitus and risk of hip fractures: a meta-analysis.
This meta-analysis revealed that diabetic adults had a twofold greater risk of hip fractures compared with non-diabetic populations, and this association was more pronounced in type 1 diabetes.


BACKGROUND
The relationship between diabetes mellitus and risk of hip fracture yielded conflicting results. We conducted a meta-analysis to investigate the association between diabetes mellitus and the risk of hip fractures based on observational studies.


METHODS
We conducted a systematic literature search of PubMed and Embase databases through May 2015. We selected cohort and case-control studies providing at least age-adjusted risk ratio (RR) and corresponding 95 % confidence intervals (CI) of hip fractures among diabetic and non-diabetic subjects. Moreover, we pooled the female-to-male RR of hip fractures from studies that reported gender-specific risk estimate in a single study.


RESULTS
Twenty-one studies involving 82,293 hip fracture events among 6,995,272 participants were identified. Diabetes mellitus was associated with an increased risk of hip fractures (RR 2.07; 95 % CI 1.83-2.33) in a random effects model. Subgroup analysis indicated that excess risk of hip fracture was more pronounced in type 1 diabetes (RR 5.76; 95 % CI 3.66-9.07) than that in type 2 diabetes (RR 1.34; 95 % CI 1.19-1.51). The pooled female-to-male RR of hip fractures was 1.09 (95 % CI 0.93-1.28).


CONCLUSIONS
Individuals with diabetes mellitus have an excessive risk of hip fractures, and this relationship is more pronounced in type 1 diabetes. The association between diabetes and hip fracture risk is similar in men and women.
Institute of Molecular Biology and Translational Medicine, The Affiliated People's Hospital, Jiangsu University, Zhenjiang, Jiangsu, People's Republic of China, 212002.
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Fan
Institute of Molecular Biology and Translational Medicine, The Affiliated People's Hospital, Jiangsu University, Zhenjiang, Jiangsu, People's Republic of China, 212002.
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Wei
Institute of Molecular Biology and Translational Medicine, The Affiliated People's Hospital, Jiangsu University, Zhenjiang, Jiangsu, People's Republic of China, 212002.
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Lang
Department of Endocrinology, The Affiliated People's Hospital, Jiangsu University, No. 8 Dianli Road, Zhenjiang, Jiangsu, People's Republic of China, 212002. liuyingzhaozhj@163.com.
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Liu
D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000453:epidemiology; D005260:Female; D006620:Hip Fractures / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D008297:Male; D064887:Observational Studies as Topic; D058866:Osteoporotic Fractures / Q000453:epidemiology / Q000209:etiology*; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D012737:Sex Factors
Diabetes mellitus; Gender difference; Hip fracture; Meta-analysis; Risk factors