open access

Vol 72, No 4 (2021)
Original paper
Submitted: 2021-01-29
Accepted: 2021-03-15
Early publication date: 2021-03-31
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Evaluation of the risk of fracture in type 2 diabetes mellitus patients with incretins: an updated meta-analysis

Qing-xin Kong1, Qiao Ruan1, Cheng Fan1, Bi-Lin Liu1, Li-Ping Reng1, Weiping Xu2
DOI: 10.5603/EP.a2021.0031
·
Pubmed: 34010433
·
Endokrynol Pol 2021;72(4):319-328.
Affiliations
  1. Chongqing Chemical Industry Vocational College, Chongqing, China
  2. Hospital of the Southwest University of Political Science and Law, Chongqing, China

open access

Vol 72, No 4 (2021)
Original Paper
Submitted: 2021-01-29
Accepted: 2021-03-15
Early publication date: 2021-03-31

Abstract

Introduction: The effect of incretins including dipeptidyl peptidase 4 inhibitors (DPP4-Is) and glucagon-like peptide1 receptor agonists (GLP1-ras) in the treatment of type 2 diabetes increasing the risk of fracture remains controversial. No meta-analysis has been written to discuss this from the prospective interventional studies.

The objective was to evaluate the association between the use of incretins and fracture risk.

Material and methods: Multiple databases were searched for original articles that investigated the relationship between the use of incretin agents and fracture risk, up to December 2019. Trials using the Mantel-Haenszel method to calculate OR and 95% CI were pooled. The multiple sensitivity, heterogeneity, publication bias, and quality were analysed among the studies to evaluate the robustness of results.

Results: The fixed-effects model was used on account of the I2 test for heterogeneity (I2 = 0.0%). Incretins were not associated with fracture risk [0.97 (95% CI: 0.88–1.08)]. But in the subgroup analysis, when sitagliptin 100 mg per day (OR 0.495, 95% CI: 0.304–0.806) or liraglutide 1.8 mg per day was administered (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 the current use of incretins not only is safe for fracture in type 2 diabetes patients from RCT studies, but also, when sitagliptin 100 mg or liraglutide 1.8 mg per day was administered, it may exhibit protective effects on bone metabolism.

 

Abstract

Introduction: The effect of incretins including dipeptidyl peptidase 4 inhibitors (DPP4-Is) and glucagon-like peptide1 receptor agonists (GLP1-ras) in the treatment of type 2 diabetes increasing the risk of fracture remains controversial. No meta-analysis has been written to discuss this from the prospective interventional studies.

The objective was to evaluate the association between the use of incretins and fracture risk.

Material and methods: Multiple databases were searched for original articles that investigated the relationship between the use of incretin agents and fracture risk, up to December 2019. Trials using the Mantel-Haenszel method to calculate OR and 95% CI were pooled. The multiple sensitivity, heterogeneity, publication bias, and quality were analysed among the studies to evaluate the robustness of results.

Results: The fixed-effects model was used on account of the I2 test for heterogeneity (I2 = 0.0%). Incretins were not associated with fracture risk [0.97 (95% CI: 0.88–1.08)]. But in the subgroup analysis, when sitagliptin 100 mg per day (OR 0.495, 95% CI: 0.304–0.806) or liraglutide 1.8 mg per day was administered (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 the current use of incretins not only is safe for fracture in type 2 diabetes patients from RCT studies, but also, when sitagliptin 100 mg or liraglutide 1.8 mg per day was administered, it may exhibit 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

Vol 72, No 4 (2021)

Article type

Original paper

Pages

319-328

Early publication date

2021-03-31

Page views

911

Article views/downloads

371

DOI

10.5603/EP.a2021.0031

Pubmed

34010433

Bibliographic record

Endokrynol Pol 2021;72(4):319-328.

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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