Department of Endocrinology, Cangzhou Central Hospital, Cangzhou, Hebei Province, China.
J Orthop Surg Res. 2023 Oct 24;18(1):794. doi: 10.1186/s13018-023-04289-0.
Bone fragility is a recognized complication of type 1 diabetes (T1D). Thus, lower trabecular bone score (TBS) measurements in T1D patients can be predicted. However, the results of current studies on TBS in patients with T1D are inconsistent. In this context, the present study aimed to test the hypothesis that T1D is associated with lower TBS through a meta-analysis.
An electronic search of the literature was conducted using PubMed, Embase and Web of science databases to identify studies related to TBS and T1D, supplemented by an additional manual check of the reference list of relevant original and review articles. All data was analyzed using a random effects model. Results were compared using standardized mean differences (SMD) and 95% confidence intervals (CI). P ≤ 0.05 was considered statistically significant. Review Manager 5.4 software and Stata 17.0 software were used for statistical analysis.
Seven cross-sectional studies involving 848 participants were included. TBS was lower in T1D patients than in healthy controls on random effects analysis, with no heterogeneity (SMD = - 0.39, 95% CI [- 0.53, - 0.24], P < 0.001; I = 0%). In addition, by subgroup analysis, T1D patients were strongly associated with reduced TBS in different regions and age groups, and the results were independent of covariate adjustment.
This study showed that TBS was lower in patients with T1D than in healthy individuals with normal blood glucose levels, suggesting that TBS may be a useful measure to assess fracture risk in T1D.
骨质疏松症是 1 型糖尿病（T1D）的一种公认并发症。因此，可以预测 T1D 患者的低骨小梁骨评分（TBS）测量值。然而，目前关于 T1D 患者 TBS 的研究结果并不一致。在这种情况下，本研究通过荟萃分析检验了 T1D 与较低 TBS 相关的假设。
使用 PubMed、Embase 和 Web of Science 数据库对与 TBS 和 T1D 相关的文献进行电子检索，并补充对相关原始和综述文章的参考文献列表的额外手动检查。使用随机效应模型分析所有数据。使用标准化均数差（SMD）和 95%置信区间（CI）比较结果。P≤0.05 被认为具有统计学意义。使用 Review Manager 5.4 软件和 Stata 17.0 软件进行统计分析。
纳入了 7 项涉及 848 名参与者的横断面研究。随机效应分析显示，T1D 患者的 TBS 低于健康对照组，且无异质性（SMD=-0.39，95%CI[-0.53，-0.24]，P<0.001；I=0%）。此外，通过亚组分析，T1D 患者与不同地区和年龄组的 TBS 降低密切相关，且结果不受协变量调整的影响。
本研究表明，T1D 患者的 TBS 低于血糖正常的健康个体，提示 TBS 可能是评估 T1D 骨折风险的有用指标。
