PMID- 36714564 OWN - NLM STAT- MEDLINE DCOM- 20230131 LR - 20230208 IS - 1664-2392 (Print) IS - 1664-2392 (Electronic) IS - 1664-2392 (Linking) VI - 13 DP - 2022 TI - Association of metformin use with fracture risk in type 2 diabetes: A systematic review and meta-analysis of observational studies. PG - 1038603 LID - 10.3389/fendo.2022.1038603 [doi] LID - 1038603 AB - AIMS: Increasing evidence suggests that metformin can affect bone metabolism beyond its hypoglycemic effects in diabetic patients. However, the effects of metformin on fracture risk in type 2 diabetes mellitus (T2DM) patients remain unclear. A systematic review and meta-analysis were performed in this study to evaluate the association between metformin application and fracture risk in T2DM patients based on previous studies published until June 2021. METHODS: A systematic search was performed to collect publications on metformin application in T2DM patients based on PubMed, Embase, Cochran, and Web of Science databases. Meta-analysis was performed by using a random-effects model to estimate the summary relative risks (RRs) with 95% confidence intervals (CIs). Subgroup analyses based on cohort/case-control and ethnicity and sensitivity analyses were also performed. RESULTS: Eleven studies were included in the meta-analysis. Results demonstrated metformin use was not significantly associated with a decreased risk of fracture (RR, 0.91; 95% CI, 0.81-1.02; I(2 =) 96.8%). Moreover, metformin use also demonstrated similar results in subgroup analyses of seven cohort studies and four case-control studies, respectively (RR, 0.90; 95% CI, 0.76-1.07; I(2 =) 98.0%; RR, 0.96; 96% CI, 0.89-1.03; I(2 =) 53.7%). Sensitivity analysis revealed that there was no publication bias. CONCLUSION: There was no significant correlation between fracture risk and metformin application in T2DM patients. Due to a limited number of existing studies, further research is needed to make a definite conclusion for clinical consensus. CI - Copyright (c) 2023 Wang, Yu, Ye, Lin, Sun, Liu, Wei, Deng, Zhong, Cui, Li and Liu. FAU - Wang, Yining AU - Wang Y AD - Zhanjiang Key Laboratory of Orthopaedic Technology and Trauma Treatment, Zhanjiang Central Hospital, Guangdong Medical University, Zhanjiang, China. AD - Guangdong Provincial Key Laboratory for Research and Development of Natural Drug, School of Pharmacy, Guangdong Medical University, Zhanjiang, China. FAU - Yu, Liming AU - Yu L AD - Department of Stomatology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China. FAU - Ye, Zhiqiang AU - Ye Z AD - Guangdong Provincial Key Laboratory for Research and Development of Natural Drug, School of Pharmacy, Guangdong Medical University, Zhanjiang, China. FAU - Lin, Rui AU - Lin R AD - Zhanjiang Key Laboratory of Orthopaedic Technology and Trauma Treatment, Zhanjiang Central Hospital, Guangdong Medical University, Zhanjiang, China. AD - Guangdong Provincial Key Laboratory for Research and Development of Natural Drug, School of Pharmacy, Guangdong Medical University, Zhanjiang, China. FAU - Sun, Antonia RuJia AU - Sun AR AD - Centre for Biomedical Technologies, Queensland University of Technology, Brisbane, Queensland, Australia. AD - Center for Translational Medicine Research and Development, Shenzhen Institute of Advanced Technology, Chinese Academy of Science, Shenzhen, Guangdong, China. FAU - Liu, Lingna AU - Liu L AD - Guangdong Provincial Key Laboratory for Research and Development of Natural Drug, School of Pharmacy, Guangdong Medical University, Zhanjiang, China. AD - Marine Medical Research Institute of Zhanjiang, Zhanjiang, China. FAU - Wei, Jinsong AU - Wei J AD - Department of Orthopedics, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China. FAU - Deng, Feifu AU - Deng F AD - Department of Orthopedics, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China. FAU - Zhong, Xiangxin AU - Zhong X AD - Department of Orthopedics, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China. FAU - Cui, Liao AU - Cui L AD - Guangdong Provincial Key Laboratory for Research and Development of Natural Drug, School of Pharmacy, Guangdong Medical University, Zhanjiang, China. FAU - Li, Li AU - Li L AD - Guangdong Provincial Key Laboratory for Research and Development of Natural Drug, School of Pharmacy, Guangdong Medical University, Zhanjiang, China. FAU - Liu, Yanzhi AU - Liu Y AD - Zhanjiang Key Laboratory of Orthopaedic Technology and Trauma Treatment, Zhanjiang Central Hospital, Guangdong Medical University, Zhanjiang, China. AD - Guangdong Provincial Key Laboratory for Research and Development of Natural Drug, School of Pharmacy, Guangdong Medical University, Zhanjiang, China. AD - Marine Medical Research Institute of Zhanjiang, Zhanjiang, China. LA - eng PT - Meta-Analysis PT - Research Support, Non-U.S. Gov't PT - Systematic Review DEP - 20230111 PL - Switzerland TA - Front Endocrinol (Lausanne) JT - Frontiers in endocrinology JID - 101555782 RN - 9100L32L2N (Metformin) RN - 0 (Hypoglycemic Agents) SB - IM MH - Humans MH - *Metformin/therapeutic use MH - *Diabetes Mellitus, Type 2/complications/drug therapy/chemically induced MH - Hypoglycemic Agents/therapeutic use MH - *Fractures, Bone/epidemiology/etiology/prevention & control MH - Risk PMC - PMC9874692 OTO - NOTNLM OT - bone OT - diabetes OT - fracture OT - meta-analysis OT - metformin COIS- The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2023/01/31 06:00 MHDA- 2023/02/01 06:00 PMCR- 2022/01/01 CRDT- 2023/01/30 04:32 PHST- 2022/09/07 00:00 [received] PHST- 2022/12/21 00:00 [accepted] PHST- 2023/01/30 04:32 [entrez] PHST- 2023/01/31 06:00 [pubmed] PHST- 2023/02/01 06:00 [medline] PHST- 2022/01/01 00:00 [pmc-release] AID - 10.3389/fendo.2022.1038603 [doi] PST - epublish SO - Front Endocrinol (Lausanne). 2023 Jan 11;13:1038603. doi: 10.3389/fendo.2022.1038603. eCollection 2022.