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中华老年骨科与康复电子杂志

中华老年骨科与康复电子杂志 ›› 2021, Vol. 07 ›› Issue (03) : 181 -186. doi: 10.3877/cma.j.issn.2096-0263.2021.03.010

Meta分析

糖尿病与髋部骨折相关性的Meta分析
刘婵1,†(), 朱姗姗1, 张丽2, 李永超1   
  1. 1. 053000　衡水市人民医院烧伤整形外科
    2. 050000　石家庄，河北医科大学第一医院烧伤整形科
  • 收稿日期:2021-04-01 出版日期:2021-06-05
  • 通信作者: 刘婵
  • 基金资助:
    河北省教育厅(QN2015010)

The relationship between diabetes and hip fracture: A Meta-Analysis

Chan Liu1,†(), Shanshan Zhu1, Li Zhang2, Yongchao Li1   

  1. 1. Department of burns orthopaedics, Hengshui people's Hospital, Hengshui 053000, China
    2. Department of burns orthopaedics, The First Hospital of Hebei Medical University, Shijiazhuang 050051, China
  • Received:2021-04-01 Published:2021-06-05
  • Corresponding author: Chan Liu
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引用本文：

刘婵, 朱姗姗, 张丽, 李永超. 糖尿病与髋部骨折相关性的Meta分析[J/OL]. 中华老年骨科与康复电子杂志, 2021, 07(03): 181-186.

Chan Liu, Shanshan Zhu, Li Zhang, Yongchao Li. The relationship between diabetes and hip fracture: A Meta-Analysis[J/OL]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2021, 07(03): 181-186.

目的

研究糖尿病与髋部骨折的相关性，对所有已获得的数据进行系统综述和Meta分析，评价糖尿病是否增加髋部骨折的发生风险。

方法

依据Meta分析要求，对维普、万方、Springer、Science Direct、CBM、PubMed、Embase、Cochrane、Library、和Web of science数据库CBM、CNKI、Embase、中国科技论文统计与分析网、专利数据库等中英文数据库等进行检索，严格评价纳入糖尿病患者与一般人群发生髋部骨折的对照实验研究文献，并收录有效的相关数据资料，检索年限从2018年1月1日至今。分别采用NOS文献质量评价标准对符合纳入排除标准的文献进行质量评价；采用Q检验和I2统计量检验对纳入文献进行异质性研究及leave one out的敏感性分析；采用Egger's检验和Begg's检验评价纳入文献的发表偏倚。

结果

最终纳入29篇文献，受试者共计8 453 193例，6 430 654例一般人群中发生髋部骨折110 752例，2 022 539例糖尿病患者中发生髋部骨折33 954例。经Meta分析得出糖尿病患者的髋部骨折风险高于非糖尿病患者（OR=1.507，95% CI：1.238，1.834，Z=4.09，P<0.1）。

结论

糖尿病可增加患者髋部骨折发生风险。

关键词: 糖尿病, 髋骨折, 骨质疏松
Objective

To investigate the correlation between diabetes and hip fracture, and to systematically review and analyze all available data to evaluate whether diabetes mellitus increases the risk of hip fracture.

Methods

According to the requirements of Meta analysis, we have a wide range of products and services, including Vip, Wanfang, Springer, Science Direct, CBM, PubMed, Embase, Cochrane, Library, and Web of Chinese and English databases such as CBM, CNKI, EMBASE, China Statistical and Analytical Network of Scientific and Technological Papers, Patent Database, etc. The literatures of controlled experimental studies on hip fracture in diabetic patients and the general population were strictly evaluated and valid relevant data were included. The retrieval period was from January 1,2018 to the present. NOS literature quality assessment criteria were used to evaluate the quality of literatures that met the inclusion and exclusion criteria. Q test and I2 statistic test were used to study the heterogeneity of the included literatures and sensitivity analysis of leave one out. Egger's test and Begg's test were used to evaluate the publication bias of the included literatures.

Results

A total of 29 studies were included, including 8,453 193,subjects. There were 6,430,654 subjects from the general population, 110,752 patients with hip fracture, 2,022,539 patients with diabetes, and 33,954 patients with hip fracture. Diabetic patients had a higher risk of hip fracture than non-diabetic patients (OR=1.507, 95% CI: 1.238, 1.834, Z=4.09, P<0.1).

Conclusion

Meta-analysis shows that diabetes may increase the risk of hip fracture.

Key words: Diabetes, Hip fractures, Osteoporosis
图1 文献检索与筛选流程图
表1 纳入文献的基本特征
作者 国别 年份 随访时间（年） 一般人群 糖尿病患者 NOS评分
骨折患者 总人数 骨折患者 总人数
Ahmed Norway 2006 6 209 27159 40 455 7
Berry USA 2017 1.8 10990 419668 3563 119490 10
Chen Taiwan 2008 6 12479 969821 7741 484787 9
de Liefde Netherlands 2005 5.2 671 6655 100 792 8
Dobnig Austria 2006 2 29 1664 81 583 8
Forsen Norway 1999 9 1533 35444 110 1850 7
Gerber USA 2013 21 1598 3808 306 559 7
Hamilton Australia 2017 12.9 328 6450 96 1291 6
Ivers Australia 2001 5 192 3654 59 216 8
Janghorbani USA 2006 19 1255 109983 143 8640 8
Kim Korea 2017 6 1571 51330 245 17110 8
Koh Singapore 2010 12.2 981 63154 232 5668 9
Lee USA 2018 NA 7575 2798309 3601 900402 7
Leslie Canada,Manitoba 2007 NA 15656 318776 1686 82094 7
Leslie Canada,Manitoba 2014 6 428 62413 680 6455 6
Majumdar Canada,Manitoba 2016 7 1109 57938 279 8840 6
Lipscombe Canada 2007 6.1 14684 598812 7583 197412 7
Martinez-Laguna Spain 2015 2.63 776 171931 444 58483 9
Reyes Spain 2014 2.99 1302 186171 416 36865 9
Meyer Norway 1993 10.9 205 52313 7 298 8
Nicodemus USA 2001 9.5 452 32089 43 1729 9
Poor USA 1995 23 212 464 20 42 10
Schwarts USA 2001 9.4 2576 9654 48 657 6
Segal Israel 2009 1 112 238 30 41 6
Strotmeyer USA 2001 10.9 269 3506 65 918 6
Wallander Sweden 2017 1.3 30014 428305 6118 84702 8
Jung Korea 2012 5.7 61 2282 20 1268 8
Keegan USA 2002 5 2443 4528 172 472 7
Oei Nether-lands 2013 12 1042 4135 26 420 7
图4 糖尿病与髋部骨折发生风险相关性分析的发表偏倚漏斗图
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