Diabetes mellitus and the risk of fractures at specific sites: a meta-analysis

Objective: Diabetes mellitus (DM) is associated with an increased fracture risk; however, the impact of DM and subsequent fracture at different sites and the associations according to patient characteristics remain unknown. Design: Meta-analysis. Data Sources: The PubMed, EMBASE, and Cochrane Library databases were searched from inception to March 2018. Eligibility Criteria: We included prospective and retrospective cohort studies on the associations of DM and subsequent fracture risk at different sites. Data extraction and synthesis: Two authors independently extracted data and assessed the study quality. Relative risks (RRs) with 95% confidence intervals (CIs) were calculated using a random-effects model, and the heterogeneity across the included studies was evaluated using I2 and Q statistics. Results: Overall, DM was associated with an increased risk of total (RR: 1.32; 95% CI: 1.17–1.48; P<0.001), hip (RR: 1.77; 95% CI: 1.56–2.02; P<0.001), upper arm (RR: 1.47; 95% CI: 1.02–2...