open access

Ahead of print
Original paper
Published online: 2021-03-31
Submitted: 2021-01-29
Accepted: 2021-03-15
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Evaluation of the risk of fracture in type 2 diabetes mellitus patients with incretins: an updated meta-analysis.

Qing-xin KONG, Qiao Ruan, Cheng Fan, Bi-Lin Liu, Li-Ping Reng, weiping Xu
DOI: 10.5603/EP.a2021.0031
·
Pubmed: 34010433

open access

Ahead of print
Original Paper
Published online: 2021-03-31
Submitted: 2021-01-29
Accepted: 2021-03-15

Abstract

Context: Effect of incretins including DPP4-Is and GLP1-ras in the treatment of type 2 diabetes increases the risk of fracture remains controversial. And no meta-analysis has been written to discuss this from the prospective interventional studies. Objective:To evaluate the association between the using of incretins and fracture risk. Methods: Multiple databases were search for original articles that investigated the relationship between the use of incretin agents and fractures risk up to December 2019. Trials were pooled using the Mantel-Haenszel method to calculate OR and 95% CI. The multiple sensitivity, heterogeneity, publication bias and quality were analyzed to evaluate the robustness of results among studies. Results: The fixed-effects model was used on account of the I2 test for heterogeneity (I2 = 0.0%). Incretins were not associated with fracture risks. [0.97 (95% CI: 0.88~1.08)]. But in the subgroup analysis, when sitagliptin 100mg (OR 0.495, 95% CI: 0.304~0.806) or liraglutide 1.8mg was administered per day (OR 0.621, 95% CI: 0.413~0.933), it reduced fracture risk. The sensitivity analysis and publication bias prompted the robustness of results. Conclusions: This meta-analysis suggested that current use of incretins not only is safe for fracture in type 2 diabetes patients from RCT studies, but also when sitagliptin 100mg or liraglutide 1.8mg per day was administered, they may have exhibited protective effects on bone metabolism.

Abstract

Context: Effect of incretins including DPP4-Is and GLP1-ras in the treatment of type 2 diabetes increases the risk of fracture remains controversial. And no meta-analysis has been written to discuss this from the prospective interventional studies. Objective:To evaluate the association between the using of incretins and fracture risk. Methods: Multiple databases were search for original articles that investigated the relationship between the use of incretin agents and fractures risk up to December 2019. Trials were pooled using the Mantel-Haenszel method to calculate OR and 95% CI. The multiple sensitivity, heterogeneity, publication bias and quality were analyzed to evaluate the robustness of results among studies. Results: The fixed-effects model was used on account of the I2 test for heterogeneity (I2 = 0.0%). Incretins were not associated with fracture risks. [0.97 (95% CI: 0.88~1.08)]. But in the subgroup analysis, when sitagliptin 100mg (OR 0.495, 95% CI: 0.304~0.806) or liraglutide 1.8mg was administered per day (OR 0.621, 95% CI: 0.413~0.933), it reduced fracture risk. The sensitivity analysis and publication bias prompted the robustness of results. Conclusions: This meta-analysis suggested that current use of incretins not only is safe for fracture in type 2 diabetes patients from RCT studies, but also when sitagliptin 100mg or liraglutide 1.8mg per day was administered, they may have exhibited protective effects on bone metabolism.
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Keywords

Incretins, GLP-1, DPP-4, Fracture, Meta-analysis, RCT

About this article
Title

Evaluation of the risk of fracture in type 2 diabetes mellitus patients with incretins: an updated meta-analysis.

Journal

Endokrynologia Polska

Issue

Ahead of print

Article type

Original paper

Published online

2021-03-31

DOI

10.5603/EP.a2021.0031

Pubmed

34010433

Keywords

Incretins
GLP-1
DPP-4
Fracture
Meta-analysis
RCT

Authors

Qing-xin KONG
Qiao Ruan
Cheng Fan
Bi-Lin Liu
Li-Ping Reng
weiping Xu

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