Does metabolic syndrome increase the risk of fracture? A systematic review and meta-analysis

Babagoli, Mazyar; Soleimani, Mohammad Ali; Baghdadi, Soroush; Vatan, Mehrdad Sheikh; Shafiei, Seyyed Hossein

doi:10.1007/s11657-022-01149-y

Cited by 5 publications

(4 citation statements)

References 48 publications

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“…However, in this study, MetS was positively associated with the occurrence of osteoporosis in both obese men and postmenopausal obese women. On the other hand, the recent meta-analysis by Babagoli et al [55] demonstrated that metabolic syndrome had a protective impact on bone fracture rates in males but no net effect on fractures in females.…”

Section: Discussionmentioning

confidence: 98%

The Impact of Metabolic Syndrome on Bone Mass in Men: Systematic Review and Meta-Analysis

et al. 2023

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Studies to date have yielded conflicting results on associations between components of metabolic syndrome (MetS) and bone mineral density (BMD), particularly in men. This current systematic review and meta-analysis addresses the existing gap in the literature and aims to evaluate bone mineral density (BMD) at the femoral neck (FN) and lumbar spine (LS) in men diagnosed with MetS. The two study authors independently searched PubMed, Cinahl, Embase, and Web of Science up to 8 February 2022 for studies in English. The inclusion criteria were (i) diagnosis of MetS according to the NCEP-ATP III 2001 criteria; (ii) adult male demographic; (iii) analyzable data on BMD in at least two sites using dual-energy X-ray absorptiometry (DXA), and (iv) original observational studies. Case reports and non-English articles were excluded. We analyzed the results of seven studies providing data on bone density in men with MetS. Results: Based on random effect weights, the mean BMD of the femoral neck and lumbar spine were 0.84 and 1.02, respectively. The mean lumbar spine T-score was −0.92. In meta-regression analysis, the variances in mean BMD in the lumbar spine and femoral neck could not be significantly explained by BMI (lumbar BMD: Q = 1.10, df = 1, p = 0.29; femoral neck BMD: Q = 0.91, df = 1, p = 0.34). Our meta-analysis suggests normal bone mass in adult males with MetS. Due to the high heterogeneity in the seven analyzed studies and the lack of control groups in these studies, further research is needed to fully elucidate the associations between MetS and its components and BMD in men.

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Section: Discussionmentioning

confidence: 98%

The Impact of Metabolic Syndrome on Bone Mass in Men: Systematic Review and Meta-Analysis

et al. 2023

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“…35 The change of cortical microarchitecture in both thiazolidinediones-exposed animals and human gave another possible explanation for the increased risk of fracture. 36,37 A previous meta-analysis revealed that metabolic syndrome is a protective factor for bone fractures in males but not females, 38 and females with less muscle mass had greater risks for type 2 diabetes and fracture, 39 which may in part explain the increased risk of fracture limited in females but not in males with incidence of fracture increased, calling for a cautious use of thiazolidinediones in the long term, such as more than 4 years. However, the systematic review did not elicit whether the drug effect accumulates after a long stop or whether the intermittent use of the drug remains risky.…”

Section: Discussionmentioning

confidence: 99%

“…The change of cortical microarchitecture in both thiazolidinediones‐exposed animals and human gave another possible explanation for the increased risk of fracture 36,37 . A previous meta‐analysis revealed that metabolic syndrome is a protective factor for bone fractures in males but not females, 38 and females with less muscle mass had greater risks for type 2 diabetes and fracture, 39 which may in part explain the increased risk of fracture limited in females but not in males with type 2 diabetes. Further explorations regarding the sex‐specific changes in bone metabolism among people receiving long‐term thiazolidinediones treatment are still needed.…”

Section: Discussionmentioning

confidence: 99%

Time‐dependent risk of fracture in adults with type 2 diabetes receiving anti‐diabetic drug: A one‐stage network meta‐analysis

Shen,

Shi,

Zou

et al. 2024

Diabetes Metabolism Res

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AimsTo assess the time‐dependent risk of fracture in adults with type 2 diabetes receiving anti‐diabetic drugs.Materials and MethodsWe searched MEDLINE, EMBASE, and Cochrane Library up to 18 November 2021, for randomized controlled trials (RCTs) and propensity‐score‐matched non‐randomized studies (NRSs) comparing all anti‐diabetic drugs with standard treatment or with each other on fracture in adults with type 2 diabetes. The study performed a one‐stage network meta‐analysis using discrete‐time hazard regression with reconstructed individual time‐to‐event data.ResultsThis network meta‐analysis involved seven RCTs (65,051 adults with type 2 diabetes) with a median follow‐up of 36 months and three propensity‐score‐based NRSs (17,954 participants) with a median follow‐up of 27.3 months. Among anti‐diabetic drugs, thiazolidinediones increased the overall hazard of fracture by 42% (95% credible interval [CrI], 3%–97%) and almost tripled the risk after 4 years (hazard ratio [HR], 2.74; 95% CrI, 1.53–4.80). Credible subgroup analysis suggested that thiazolidinediones increased the hazard of fracture only in females (HR, 2.19; 95% CrI, 1.26–3.74) but not among males (HR, 0.81; 95% CrI, 0.45–1.40). Moderate certainty evidence established that thiazolidinediones increase 92 fractures in five years per 1000 female patients. We did not find the risk of fractures with other anti‐diabetic drugs including metformin, sulfonylureas, sodium‐glucose cotransporter‐2 (SGLT2) inhibitors, and dipeptidyl peptidase‐4 (DPP‐4) inhibitors.ConclusionsLong‐term use of thiazolidinediones elevates the risk of fracture among females with type 2 diabetes. There is no evidence eliciting fracture risk associated with other anti‐diabetic drugs.

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“…This disease may stimulate the progression of osteoarthritis (OA), exacerbate the condition, and raise the possibility of fractures. [17][18][19] MS impacts not only bones and cartilage but also the proper maintenance of balance within the internal bodily environment and the restoration of damaged tendons. 20 Further exploration of MS is warranted, standards for distinct nationalities, regions, and ethnic groups.…”

Section: Introductionmentioning

confidence: 99%

Metabolic Syndrome and Tendon Disease: A Comprehensive Review

Lai,

Li,

Tang

et al. 2024

DMSO

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Metabolic syndrome (MS) is a multifaceted pathological condition characterized by the atypical accumulation of various metabolic components such as central obesity or excess weight, hyperlipidemia, low-density lipoprotein (LDL), hypertension, and insulin resistance. Recently, MS has been recognized as a notable contributor to heart and circulatory diseases. In addition, with increasing research, the impact of MS on tendon repair and disease has gradually emerged. Recent studies have investigated the relationship between tendon healing and diseases such as diabetes, dyslipidemia, obesity, and other metabolic disorders. However, diabetes mellitus (DM), hypercholesterolemia, obesity, and various metabolic disorders often coexist and together constitute MS. At present, insulin resistance is considered the major pathological mechanism underlying MS, central obesity is regarded as the predominant factor responsible for it, and dyslipidemia and other metabolic diseases are known as secondary contributors to MS. This review aims to evaluate the current literature regarding the impact of various pathological conditions in MS on tendon recovery and illness, and to present a comprehensive overview of the effects of MS on tendon recovery and diseases, along with the accompanying molecular mechanisms.

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Does metabolic syndrome increase the risk of fracture? A systematic review and meta-analysis

Cited by 5 publications

References 48 publications

The Impact of Metabolic Syndrome on Bone Mass in Men: Systematic Review and Meta-Analysis

The Impact of Metabolic Syndrome on Bone Mass in Men: Systematic Review and Meta-Analysis

Time‐dependent risk of fracture in adults with type 2 diabetes receiving anti‐diabetic drug: A one‐stage network meta‐analysis

Metabolic Syndrome and Tendon Disease: A Comprehensive Review

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