PMID- 30983141 OWN - NLM STAT- MEDLINE DCOM- 20200416 LR - 20200416 IS - 1520-7560 (Electronic) IS - 1520-7552 (Linking) VI - 35 IP - 7 DP - 2019 Oct TI - Effects of SGLT2 inhibitors on fractures and bone mineral density in type 2 diabetes: An updated meta-analysis. PG - e3170 LID - 10.1002/dmrr.3170 [doi] AB - BACKGROUND: The aim of the study is to update and determine the effects of sodium glucose cotransporter 2 (SGLT2) inhibitor therapy on fracture and bone mineral density (BMD) in patients with type 2 diabetes mellitus (T2DM). METHODS: We identified 27 eligible randomized controlled trials (RCTs) that compared the efficacy and safety of SGLT2 inhibitors to a placebo in 20 895 T2DM participants, with an average duration of 64.22 weeks. The relative risk (RR) of bone fracture and weighted mean difference (WMD) of changes in the BMD from baseline were determined to evaluate the risk of fracture. The degree of heterogeneity was evaluated by the I(2) statistic, and publication bias was estimated using a funnel plot and Egger test. RESULTS: The pooled RR was 1.02 (95% CI [0.81, 1.28]) with low heterogeneity, indicating that SGLT2 inhibitor treatment was not correlated with a higher risk of fracture. Additionally, no increased risk was found for patients with different ages, sexes, and levels of HbA1c and some biochemical indicators. Three trials with 1303 patients reported a change in the BMD from baseline. SGLT2 inhibitor treatment did not decrease the BMD at four skeletal sites (lumbar spine, femoral neck, total hip, and distal forearm), and the overall WMD was 0.08 (95% CI [-0.09, 0.26]). No significant publication bias was detected. CONCLUSIONS: No increased risk for bone fracture was detected in patients with T2DM treated with SGLT2 inhibitors in this meta-analysis. SGLT2 inhibitor therapy did not appear to affect bone health, but more long-term detailed data are needed to validate this conclusion. CI - (c) 2019 John Wiley & Sons, Ltd. FAU - Li, Xiaoyu AU - Li X AUID- ORCID: 0000-0003-3890-8332 AD - NHC Key Laboratory of Hormones and Development (Tianjin Medical University), Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University Metabolic Diseases Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China. FAU - Li, Ting AU - Li T AD - NHC Key Laboratory of Hormones and Development (Tianjin Medical University), Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University Metabolic Diseases Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China. FAU - Cheng, Ying AU - Cheng Y AD - NHC Key Laboratory of Hormones and Development (Tianjin Medical University), Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University Metabolic Diseases Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China. FAU - Lu, Yunhong AU - Lu Y AD - NHC Key Laboratory of Hormones and Development (Tianjin Medical University), Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University Metabolic Diseases Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China. FAU - Xue, Mei AU - Xue M AD - NHC Key Laboratory of Hormones and Development (Tianjin Medical University), Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University Metabolic Diseases Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China. FAU - Xu, Linxin AU - Xu L AD - NHC Key Laboratory of Hormones and Development (Tianjin Medical University), Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University Metabolic Diseases Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China. FAU - Liu, Xiangyang AU - Liu X AD - NHC Key Laboratory of Hormones and Development (Tianjin Medical University), Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University Metabolic Diseases Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China. FAU - Yu, Xiaochen AU - Yu X AD - NHC Key Laboratory of Hormones and Development (Tianjin Medical University), Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University Metabolic Diseases Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China. FAU - Sun, Bei AU - Sun B AD - NHC Key Laboratory of Hormones and Development (Tianjin Medical University), Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University Metabolic Diseases Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China. FAU - Chen, Liming AU - Chen L AD - NHC Key Laboratory of Hormones and Development (Tianjin Medical University), Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University Metabolic Diseases Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China. LA - eng PT - Journal Article PT - Meta-Analysis PT - Research Support, Non-U.S. Gov't DEP - 20190515 PL - England TA - Diabetes Metab Res Rev JT - Diabetes/metabolism research and reviews JID - 100883450 RN - 0 (SLC5A2 protein, human) RN - 0 (Sodium-Glucose Transporter 2) RN - 0 (Sodium-Glucose Transporter 2 Inhibitors) SB - IM MH - Bone Density/*drug effects MH - Diabetes Mellitus, Type 2/*drug therapy MH - Fractures, Bone/*prevention & control MH - Humans MH - Prognosis MH - Sodium-Glucose Transporter 2/*chemistry MH - Sodium-Glucose Transporter 2 Inhibitors/*therapeutic use OTO - NOTNLM OT - bone mineral density OT - fracture OT - meta-analysis OT - sodium glucose cotransporter 2 OT - type 2 diabetes mellitus EDAT- 2019/04/16 06:00 MHDA- 2020/04/17 06:00 CRDT- 2019/04/16 06:00 PHST- 2018/08/26 00:00 [received] PHST- 2019/04/03 00:00 [revised] PHST- 2019/04/11 00:00 [accepted] PHST- 2019/04/16 06:00 [pubmed] PHST- 2020/04/17 06:00 [medline] PHST- 2019/04/16 06:00 [entrez] AID - 10.1002/dmrr.3170 [doi] PST - ppublish SO - Diabetes Metab Res Rev. 2019 Oct;35(7):e3170. doi: 10.1002/dmrr.3170. Epub 2019 May 15.