Diabetes mellitus and risk of low-energy fracture: a meta-analysis

  • Jing Bai
  • Qian Gao
  • Chen Wang
  • Jia DaiEmail author



Low-energy fracture risk is significantly increased in diabetes mellitus, the purpose of this article is to systematically evaluate the association between diabetes mellitus and risk for low-energy fracture.


We conducted a systematic literature search of Medline, Embase, Science Citation Index, Wiley Online Library database through January 2019. Pooled relative risks (RR) with corresponding 95% confidence intervals (95% CI) were calculated with random-effects model to assess the strength of association.


Thirty-seven studies met the inclusion criteria, which included 3,123,382 participants. The pooled RR of any fracture in people with diabetes mellitus was 1.5 (95% CI 1.3–1.8; P < 0.05). The significant association not found in subgroup analysis of prospective design, follow-up period ≥ 10 year (all P > 0.05). The pooled RR of hip fracture in people with diabetes mellitus was 2.0 (95% CI 1.8–2.3; P < 0.05). In addition, subgroup analysis shown higher risk of hip fracture in type 1 diabetes (RR: 5.3). The pooled RR of vertebral fracture with diabetes mellitus was 1.4 (95% CI 0.9–2.2; P = 0.196). Subgroup analysis by type of diabetes showed that the RR of vertebral fracture for patients with unknown-type diabetes was 2.4 (95% CI 1.4–4.0; P < 0.05). Diabetes mellitus was associated with fractures at other sites, and effect estimates was statically significant.


Diabetes mellitus is an independent risk factor for low-energy fracture, and this relationship is more pronounced in hip fracture.


Diabetes mellitus Low-energy fractures Risk factors Meta-analysis 




Compliance with ethical standards

Conflict of interest

All authors declare that they have no competing interests.

Ethical approval

This article does not contain any studies with human participants performed by any of the authors.

Informed consent

For this type of study inform consent is not required.


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Authors and Affiliations

  1. 1.Department of EndocrinologyCangzhou People’s HospitalCangzhouChina
  2. 2.Department of OrthopedicsCangzhou People’s HospitalCangzhouChina

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