SUN-622 The Risk of Hip and Non-Vertebral Fractures in Diabetes: A Systematic Review and Meta-Analysis Update
Bibliographic record
Abstract
Abstract Background Previous meta-analyses have reported an increase in the risk of hip fractures in diabetes, but the risk of non-vertebral fractures has not been investigated. In addition, it is not known how the risk of fractures is affected by age, body mass index, diabetes duration and insulin use. To investigate these features, we conducted a meta-analysis on the risk of hip and non-vertebral fractures in diabetes. MethodsWe selected a previously published review to be updated. Medline, Embase and Cochrane databases were searched in March 2018 and an update conducted in March 2019 (Pubmed) using relevant MeSH and free text terms such as “diabetes”, “hyperglycaemia” and “fracture”. We selected observational studies with data on the risk of fractures in adults ολδερ τηαν 18 years old with diabetes compared to people without diabetes. Study quality was assessed using the Newcastle Ottawa Scale. We used the random-effects model to calculate the risk estimates and 95% confidence intervals.Results Forty-nine studies were included. Forty-three studies were included in the hip fracture analysis, 40 cohorts and 3 case-control studies, reporting data from 17,575,873 participants, 2,387,899 with diabetes and 321,720 fractures. Eighteen studies reported the risk of fractures in two or more sites and were included in the non-vertebral fracture risk analysis. All but one study were cohorts. These studies reported data from 2,982,622 participants, 414,195 with diabetes and 185,363 fractures. In both analyses, age varies from 20 to 100 years old, including both type 1 and type 2 diabetes. Overall, the study quality was judged to be moderate to good.We found a significant increase in the risk of fracture in diabetes both for hip (RR 1.52, 95% CI 1.42-1.63) and for non-vertebral fracture (RR 1.20, 1.14-1.27). The increase in the risk was greater for insulin users and longer duration of diabetes, at both sites. At the hip, the risk was higher in the younger population, women, and those with T1D. ConclusionThere was an increase in the risk of hip and non-vertebral fractures in diabetes. Although the mechanisms are not established, patients with type 1 diabetes were the population at higher relative risk. The evidence suggest that the skeleton should be considered a site for diabetic complications.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.009 | 0.006 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.002 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".