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Cited by 9Bone health and osteoporosis researchDiabetes, Cardiovascular Risks, and LipoproteinsHIV-related health complications and treatments

Type 2 diabetes and bone mineral density: a meta-analysis and systematic review

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Li, Minghan, Sun, Hanqiao, Chen, Honggu, Ma, Weiwei, Li, Ying·2024·Medicine
DOI 10.1097/md.0000000000040468PMC PMC11557011
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Abstract

BACKGROUND: Type 2 diabetes (T2D), a widespread chronic metabolic disorder, presents frequently in clinical settings. The relationship between T2D and bone mineral density (BMD) has been subject to ongoing investigation, yielding inconclusive results. METHODS: A systematic literature search was conducted across several databases, including CNKI, VIP, CBM, Wanfang, PubMed, Cochrane Library, and Embase, targeting observational studies that explored the impact of microangiopathy associated with T2D on BMD or bone metabolism. The search spanned from the inception of each database to July 1, 2023. The Newcastle-Ottawa Scale was employed for quality assessment, and RevMan 5.3 software was utilized for data analysis. Stata 14.0 was used for the quantitative evaluation of publication bias regarding outcome measures. RESULTS: The inclusion criteria were met by 30 observational studies, comprising 6470 participants-3121 with diabetes and 3349 without. The meta-analysis revealed no significant difference in overall BMD between the nondiabetic and T2D groups (mean difference [MD] = -0.07, 95% confidence interval [CI] [-0.17, 0.03], Z = 1.45, P = .15). However, BMD at the lumbar vertebrae was significantly higher in nondiabetic individuals compared with those with T2D (MD = -0.14, 95% CI [-0.22, -0.06], Z = 3.32, P = 0.0009), as was the case with femoral neck BMD (MD = -0.11, 95% CI [-0.18, -0.04], Z = 3.08, P = .002). A difference in femoral neck BMD between nondiabetics and individuals with T2D approached but did not reach statistical significance (MD = -0.14, 95% CI [-0.27, 0.00], Z = 1.94, P = .05). An inverted funnel plot analysis suggested possible publication bias, as evidenced by an asymmetrical distribution of studies around the axis of symmetry, with overlap observed in several cases. CONCLUSION: The findings indicate a significant association between T2D and reduced BMD at critical sites such as the lumbar vertebrae and femoral neck, highlighting an increased risk of osteoporosis or osteoporotic fractures in these regions.

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  • Diabetes in the aging population is associated with reduced muscle strength, poor muscle quality, and accelerated loss of muscle mass, which may result in sarcopenia or dynapenia and/or osteopenia.

    “Diabetes in the aging population is associated with reduced muscle strength, poor muscle quality, and accelerated loss of muscle mass, which may result in sarcopenia or dynapenia (84) and/or osteopenia (85).”

    From 13. Older Adults: Standards of Care in Diabetes—2026 (2026) · cites this paper as [85]

    The Discussion reports lower bone mineral density and increased osteoporosis risk in people with type 2 diabetes, which supports the bone-health concern attached to citation (85). It does not specifically establish osteopenia in the aging population. The muscle-related claims are attached to citation (84), not this source. (LLM, conf=0.82)

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Cited by

Sorted by citations

Authors
Li, M., Sun, H., Chen, H., Ma, W., & Li, Y.
Affiliations
  • Hubei University of Chinese Medicine (CN)
  • Affiliated Hospital of Jiangsu University (CN)
Corresponding author
Li, Ying
ORCID
Venue
Medicine
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2024-11-08
Volume
103
Issue
45
Pages
e40468
ISSN
  • 0025-7974 (ISSN-L)
  • 1536-5964
DOI
10.1097/md.0000000000040468
PMC
PMC11557011
OpenAlex
W4404236741
Cited by
9
References
0
Citations by year
2026: 5 · 2025: 4
FWCI
0.96
Type
journal article
Language
en
Open access
Licence
Locations
  • Medicine (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Emergency Medicine › HIV-related health complications and treatments
Keywords
type 2 diabetes, bone mineral density, osteoporosis, bone metabolism, microangiopathy, lumbar vertebrae, femoral neck, osteopenia, fracture risk, publication bias, sex differences, age differences, body mass index, physical activity, smoking, alcohol consumption, vitamin D, calcium supplementation, osteoporosis screening, osteoporosis treatment
MeSH terms
Diabetes Mellitus, Type 2, Femur Neck, Humans, Lumbar Vertebrae, Osteoporosis, Bone Density, Observational Studies as Topic

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