Zhongguo quanke yixue (Feb 2023)
Associated Factors of Osteoporosis in Postmenopausal Women with Type 2 Diabetic Mellitus in China: a Meta-analysis
Abstract
Background Diabetes and osteoporosis are common diseases in middle-aged and elderly people. Diabetes can lead to various acute and chronic complications, but its related bone changes are often neglected. Osteoporosis is more common in postmenopausal women, and those with type 2 diabetes mellitus (T2DM) have multiple risk factors for osteoporosis. Therefore, it is particularly important to early identify risk factors of osteoporosis in these women, and to provide them with targeted interventions. Objective To explore the associated factors of osteoporosis in Chinese postmenopausal women with T2DM through a meta-analysis. Methods In July 2021, databases of China National Knowledge Infrastructure, CQVIP, WanFang Data, SinoMed, PubMed, EmBase, and the Cochrane Library were searched for literature about factors associated with osteoporosis in Chinese postmenopausal women with T2DM from inception to July 2021. Two researchers independently screened literature and extracted data. RevMan 5.4 and Stata 15.0 were used to conduct a meta-analysis on the data. Results Twenty-one studies were finally included, from which 11 osteoporosis-related factors were extracted. The meta-analysis showed that age〔MD (95%CI) =6.56 (5.24, 7.88) 〕, years of postmenopause〔MD (95%CI) =5.93 (4.23, 7.62) 〕, duration of diabetes〔MD (95%CI) =1.94 (0.89, 2.98) 〕, body mass index〔MD (95%CI) =-1.99 (-2.63, -1.36) 〕, serum calcium〔MD (95%CI) =0.03 (0.01, 0.06) 〕, fasting blood glucose〔MD (95%CI) =0.49 (0.09, 0.90) 〕, glycosylated hemoglobin〔MD (95%CI) =0.37 (0.02, 0.71) 〕, and fasting insulin〔MD (95%CI) =3.65 (1.24, 6.06) 〕 were associated factors for osteoporosis in postmenopausal women with T2DM. But no significant association was found between osteoporosis and serum creatinine〔MD (95%CI) =4.02 (0.00, 8.04) 〕, serum phosphorus〔MD (95%CI) =0.00 (-0.05, 0.05) 〕, or serum alkaline phosphatase〔MD (95%CI) =1.26 (-0.06, 2.57) 〕 in these women. Sensitivity analysis revealed that the association of all the above-mentioned factors (except for serum creatinine) with osteoporosis was relatively robust. Conclusion Older age, long years of postmenopause, long duration of T2DM, low levels of BMI and serum calcium, and high levels of fasting insulin, fasting blood glucose, and glycosylated hemoglobin are risk factors for osteoporosis in Chinese postmenopausal women with T2DM. But the effects of serum creatinine, phosphorus, and alkaline phosphatase on osteoporosis in this group need to be further verified.
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