Zhen Zhang1, Yang Cao1, Yujia Tao2, Meng E3, Jiahao Tang1, Yongcui Liu4, Fangping Li5. 1. Department of Endocrinology, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China. 2. Department of Cardiology, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China. 3. Yangzhou Center for Disease Control and Prevention, Yang Zhou, China. 4. The First Affiliated Hospital of Jiamusi University, Jiamusi, China. 5. Department of Endocrinology, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China. Electronic address: zhenmiaomiao1986@163.com.
Abstract
AIMS: This meta-analysis was conducted to investigate the fracture risk among patients with T2DM treated with sulfonylurea. METHODS: The PubMed and other databases were searched for eligible studies. Both randomized controlled trials and observational studies that compared the fracture risk of sulfonylurea to other hypoglycemic agents were included. Pooled risk ratios and 95% confidence intervals were calculated. Subgroup analysis and meta-regression analyses were conducted to explore the source of heterogeneity. RESULTS: A total of 11 studies involving 255,644 individuals were included in our meta-analysis. In comparing sulfonylurea users with patients who had not taken sulfonylurea, the pooled risk ratio for developing fracture was 1.14 (95% confifidence interval, 1.08-1.19). In subgroup analyses, the pooled risk ratio of bone fracture in patients receiving sulfonylurea versus thiazolidinedione, metformin and insulin was 0.90 (95% CI, 0.76-1.06), 1.25 (95% CI, 1.18-1.32) and 0.81 (95% CI, 0.74-0.89) respectively. Meta regression showed that age and gender were not related to the effect of sulfonylurea on fracture. CONCLUSIONS: Sulfonylurea use was associated with 14% increase in the risk of developing fracture in T2DM. The risk of fracture caused by sulfonylurea was similar to thiazolidinedione, higher than metformin and lower than insulin.
AIMS: This meta-analysis was conducted to investigate the fracture risk among patients with T2DM treated with sulfonylurea. METHODS: The PubMed and other databases were searched for eligible studies. Both randomized controlled trials and observational studies that compared the fracture risk of sulfonylurea to other hypoglycemic agents were included. Pooled risk ratios and 95% confidence intervals were calculated. Subgroup analysis and meta-regression analyses were conducted to explore the source of heterogeneity. RESULTS: A total of 11 studies involving 255,644 individuals were included in our meta-analysis. In comparing sulfonylurea users with patients who had not taken sulfonylurea, the pooled risk ratio for developing fracture was 1.14 (95% confifidence interval, 1.08-1.19). In subgroup analyses, the pooled risk ratio of bone fracture in patients receiving sulfonylurea versus thiazolidinedione, metformin and insulin was 0.90 (95% CI, 0.76-1.06), 1.25 (95% CI, 1.18-1.32) and 0.81 (95% CI, 0.74-0.89) respectively. Meta regression showed that age and gender were not related to the effect of sulfonylurea on fracture. CONCLUSIONS:Sulfonylurea use was associated with 14% increase in the risk of developing fracture in T2DM. The risk of fracture caused by sulfonylurea was similar to thiazolidinedione, higher than metformin and lower than insulin.
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