A Salari-Moghaddam1,2, O Sadeghi1, A H Keshteli3,4, B Larijani5, A Esmaillzadeh6,7,8. 1. Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran. 2. Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, P.O. Box 14155-6117, Tehran, Iran. 3. Department of Medicine, University of Alberta, Edmonton, Alberta, Canada. 4. Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. 5. Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. 6. Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, P.O. Box 14155-6117, Tehran, Iran. a-esmaillzadeh@tums.ac.ir. 7. Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. a-esmaillzadeh@tums.ac.ir. 8. Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran. a-esmaillzadeh@tums.ac.ir.
Abstract
INTRODUCTION: No study is available summarizing earlier publications on the association between metformin use and risk of fracture. This systematic review and meta-analysis were conducted to summarize earlier findings on the association between metformin use and risk of fracture. METHODS: We conducted a systematic search on all published articles up to October 2018 using online databases including PubMed/Medline, ISI Web of Science, and Scopus. Observational studies that considered metformin use as the exposure variable and bone fracture as the main outcome variable or as one of the outcome variables and participants included were 18 years and older were included in the systematic review. Publications in which hazard ratios (HRs), rate or risk ratios (RRs), or odds ratios (ORs) were reported as effect size were included in the meta-analysis. RESULTS: Totally, three cohort studies, one cross-sectional study, one nested case-control study, and one case-control study were included in this systematic review and meta-analysis. When seven effect sizes from six studies were combined, a significant inverse association between metformin use and risk of fracture was observed (RR 0.82; 95% CI 0.72, 0.93). No significant between-study heterogeneity was found (I2 = 22.4%, Pheterogeneity = 0.25). In addition, no evidence of publication bias was seen using Egger's test (P = 0.99). CONCLUSION: We found that metformin use was inversely associated with the risk of fracture.
INTRODUCTION: No study is available summarizing earlier publications on the association between metformin use and risk of fracture. This systematic review and meta-analysis were conducted to summarize earlier findings on the association between metformin use and risk of fracture. METHODS: We conducted a systematic search on all published articles up to October 2018 using online databases including PubMed/Medline, ISI Web of Science, and Scopus. Observational studies that considered metformin use as the exposure variable and bone fracture as the main outcome variable or as one of the outcome variables and participants included were 18 years and older were included in the systematic review. Publications in which hazard ratios (HRs), rate or risk ratios (RRs), or odds ratios (ORs) were reported as effect size were included in the meta-analysis. RESULTS: Totally, three cohort studies, one cross-sectional study, one nested case-control study, and one case-control study were included in this systematic review and meta-analysis. When seven effect sizes from six studies were combined, a significant inverse association between metformin use and risk of fracture was observed (RR 0.82; 95% CI 0.72, 0.93). No significant between-study heterogeneity was found (I2 = 22.4%, Pheterogeneity = 0.25). In addition, no evidence of publication bias was seen using Egger's test (P = 0.99). CONCLUSION: We found that metformin use was inversely associated with the risk of fracture.
Authors: Francis de Zegher; Cristina García Beltrán; Abel López-Bermejo; Lourdes Ibáñez Journal: Horm Res Paediatr Date: 2017-11-07 Impact factor: 2.852
Authors: Nicola Napoli; Ann V Schwartz; Anne L Schafer; Eric Vittinghoff; Peggy M Cawthon; Neeta Parimi; Eric Orwoll; Elsa S Strotmeyer; Andrew R Hoffman; Elizabeth Barrett-Connor; Dennis M Black Journal: J Bone Miner Res Date: 2017-12-27 Impact factor: 6.741
Authors: Steven E Kahn; Bernard Zinman; John M Lachin; Steven M Haffner; William H Herman; Rury R Holman; Barbara G Kravitz; Dahong Yu; Mark A Heise; R Paul Aftring; Giancarlo Viberti Journal: Diabetes Care Date: 2008-01-25 Impact factor: 19.112
Authors: H M Colhoun; S J Livingstone; H C Looker; A D Morris; S H Wild; R S Lindsay; C Reed; P T Donnan; B Guthrie; G P Leese; J McKnight; D W M Pearson; E Pearson; J R Petrie; S Philip; N Sattar; F M Sullivan; P McKeigue Journal: Diabetologia Date: 2012-09-04 Impact factor: 10.122
Authors: Bowen Wang; Zehai Wang; Atharva A Poundarik; Mohammed J Zaki; Richard S Bockman; Benjamin S Glicksberg; Girish N Nadkarni; Deepak Vashishth Journal: J Clin Endocrinol Metab Date: 2022-03-24 Impact factor: 5.958
Authors: Elena Castellano; Roberto Attanasio; Alberto Boriano; Valentina Borretta; Francesco Tassone; Giorgio Borretta Journal: Front Endocrinol (Lausanne) Date: 2021-04-19 Impact factor: 5.555