TY - JOUR
T1 - Epidemiology of fractures in adults of African ancestry with diabetes mellitus
T2 - A systematic review and meta-analysis
AU - Zhang, Simon C.
AU - Makebeh, Tessa
AU - Mesinovic, Jakub
AU - Djopseu, Kevin
AU - Martin, Catherine
AU - Lui, Li Yung
AU - Cawthon, Peggy M.
AU - Schneider, Andrea L.C.
AU - Zmuda, Joseph M.
AU - Strotmeyer, Elsa S.
AU - Schafer, Anne
AU - Ebeling, Peter R.
AU - Zebaze, Roger M.
N1 - Funding Information:
Open access publishing facilitated by Monash University, as part of the Wiley \u2013 Monash University agreement via the Council of Australian University Librarians. The authors wish to thank S. L. Harrison from the University of California for her assistance in providing relevant data from The Osteoporotic Fractures in Men (MrOS) study for this review.
Publisher Copyright:
© 2024 The Authors
PY - 2024/8
Y1 - 2024/8
N2 - Diabetes mellitus (DM) is associated with increased fracture risk in White adults. However, the impact of DM on fractures in Black adults is unknown. This systematic review and meta-analysis investigated the association between DM and fractures in adults of African ancestry. MEDLINE, Scopus, CINAHL and Embase databases were searched from their inception up to November 2023 for all studies in the English language investigating the epidemiology of fractures (prevalence, incidence, or risk) in Black men and women (age ≥ 18 years) with type 1 or type 2 DM. Effect sizes for prevalence of previous fractures (%) and incident fracture risk (hazard ratio [HR]) were calculated using a random-effects model on Stata (version 18.0). There were 13 eligible studies, of which 12 were conducted in Black adults from the United States, while one was conducted in adults of West African ancestry from Trinidad and Tobago. We found no fracture data in Black adults with DM living in Africa. Five studies were included in a meta-analysis of incident fracture risk, reporting data from 2926 Black and 6531 White adults with DM. There was increased risk of fractures in Black adults with DM compared to non-DM (HR = 1.65; 95 % confidence interval [CI]: 1.14, 2.39). The risk of fractures was also higher in White adults with DM compared to non-DM (HR = 1.31; 95 % CI: 1.06, 1.61) among these studies. Five studies were included in a meta-analysis of fracture prevalence, of which three also reported fracture prevalence in White adults. There were 175 previous fractures among 993 Black adults with DM and 384 previous fractures among 1467 White adults with DM, with a pooled prevalence of 17.5 % (95 % CI: 15.4, 19.6) and 25.8 % (95 % CI: 4.8, 46.8), respectively. Our results indicate a high burden of fractures in Black adults with DM.
AB - Diabetes mellitus (DM) is associated with increased fracture risk in White adults. However, the impact of DM on fractures in Black adults is unknown. This systematic review and meta-analysis investigated the association between DM and fractures in adults of African ancestry. MEDLINE, Scopus, CINAHL and Embase databases were searched from their inception up to November 2023 for all studies in the English language investigating the epidemiology of fractures (prevalence, incidence, or risk) in Black men and women (age ≥ 18 years) with type 1 or type 2 DM. Effect sizes for prevalence of previous fractures (%) and incident fracture risk (hazard ratio [HR]) were calculated using a random-effects model on Stata (version 18.0). There were 13 eligible studies, of which 12 were conducted in Black adults from the United States, while one was conducted in adults of West African ancestry from Trinidad and Tobago. We found no fracture data in Black adults with DM living in Africa. Five studies were included in a meta-analysis of incident fracture risk, reporting data from 2926 Black and 6531 White adults with DM. There was increased risk of fractures in Black adults with DM compared to non-DM (HR = 1.65; 95 % confidence interval [CI]: 1.14, 2.39). The risk of fractures was also higher in White adults with DM compared to non-DM (HR = 1.31; 95 % CI: 1.06, 1.61) among these studies. Five studies were included in a meta-analysis of fracture prevalence, of which three also reported fracture prevalence in White adults. There were 175 previous fractures among 993 Black adults with DM and 384 previous fractures among 1467 White adults with DM, with a pooled prevalence of 17.5 % (95 % CI: 15.4, 19.6) and 25.8 % (95 % CI: 4.8, 46.8), respectively. Our results indicate a high burden of fractures in Black adults with DM.
KW - African
KW - Bone
KW - Diabetes
KW - Epidemiology
KW - Fracture
KW - Meta-analysis
UR - http://www.scopus.com/inward/record.url?scp=85193945798&partnerID=8YFLogxK
U2 - 10.1016/j.bone.2024.117133
DO - 10.1016/j.bone.2024.117133
M3 - Review Article
C2 - 38789095
AN - SCOPUS:85193945798
SN - 8756-3282
VL - 185
JO - Bone
JF - Bone
M1 - 117133
ER -
