Bone and Muscle Research Group, Ton Duc Thang University, No. 19 Nguyen Huu Tho Street, Tan Phong Ward, District 7, Ho Chi Minh City, 700000, Vietnam.
Faculty of Applied Sciences, Ton Duc Thang University, Ho Chi Minh City, Vietnam.
Osteoporos Int. 2019 Oct;30(10):2079-2085. doi: 10.1007/s00198-019-05053-z. Epub 2019 Jun 18.
Patients with type 2 diabetes have an increased risk of fracture despite having a higher areal bone mineral density. This meta-analysis showed that compared with controls, diabetic patients had a lower trabecular bone score (TBS) than non-diabetic individuals, suggesting that TBS can be a useful measurement for the assessment of fracture risk in diabetic patients.
The association between type 2 diabetes and trabecular bone score (TBS) has not been clear. The present study sought to answer the specific question of whether patients with type 2 diabetes have a lower TBS than those without diabetes.
Using electronic and manual search, we identified 12 studies that had examined the association between type 2 diabetes and TBS between 2013 and 2019. These studies involved 35,546 women and 4962 men aged 30 years and older. We extracted the mean and standard deviation of TBS for patients with and without diabetes. The synthesis of effect sizes was done by the random effects meta-analysis model.
Patients with diabetes had significantly lower TBS than those without diabetes, with standardized mean difference being - 0.31 (95% CI, - 0.45 to - 0.16). The difference was greater in women (- 0.50; 95% CI, - 0.69 to - 0.32) than in men (- 0.04; 95% CI, - 0.17 to 0.10). Compared with normal individuals, those with prediabetes had significantly lower TBS (d = - 0.13; 95% CI, - 0.23 to - 0.04; P = 0.005). There was heterogeneity between the studies, with the index of inconsistency (I) ranging from 92% (in women) to 69.5% (in men).
Patients with type 2 diabetes have a lower TBS than non-diabetic individuals, suggesting that TBS can be a useful measurement for the assessment of fracture risk in diabetic patients.
本研究旨在回答一个具体的问题，即 2 型糖尿病患者的 TBS 是否低于非糖尿病患者。
我们通过电子和手动搜索，确定了 2013 年至 2019 年间有 12 项研究检查了 2 型糖尿病与 TBS 之间的关系。这些研究涉及 35546 名女性和 4962 名年龄在 30 岁及以上的男性。我们提取了糖尿病患者和无糖尿病患者的 TBS 平均值和标准差。采用随机效应荟萃分析模型对效应大小进行合成。
糖尿病患者的 TBS 明显低于无糖尿病患者，标准化均数差为-0.31（95%CI：-0.45 至-0.16）。女性的差异较大（-0.50；95%CI：-0.69 至-0.32），而男性差异较小（-0.04；95%CI：-0.17 至 0.10）。与正常个体相比，前驱糖尿病患者的 TBS 明显较低（d=-0.13；95%CI：-0.23 至-0.04；P=0.005）。各研究之间存在异质性，不一致指数（I）范围为 92%（女性）至 69.5%（男性）。
2 型糖尿病患者的 TBS 低于非糖尿病患者，提示 TBS 可作为评估糖尿病患者骨折风险的有用指标。
