OBJECTIVE We aimed to assess whether individuals with type 2 diabetes (T2D) have increased risk of vertebral fractures (VFs) and to estimate nonvertebral fracture and mortality risk among individuals with both prevalent T2D and VFs. RESEARCH DESIGN AND METHODS A systematic PubMed search was performed to identify studies that investigated the relationship between T2D and VFs. Cohorts providing individual participant data (IPD) were also included. Estimates from published summary data and IPD cohorts were pooled in a random-effects meta-analysis. Multivariate Cox regression models were used to estimate nonvertebral fracture and mortality risk among individuals with T2D and VFs. RESULTS Across 15 studies comprising 852,705 men and women, individuals with T2D had lower risk of prevalent (odds ratio [OR] 0.84 [95% CI 0.74-0.95]; I 2 = 0.0%; P het = 0.54) but increased risk of incident VFs (OR 1.35 [95% CI 1.27-1.44]; I 2 = 0.6%; P het = 0.43). In the IPD cohorts (N = 19,820), risk of nonvertebral fractures was higher in those with both T2D and VFs compared with those without T2D or VFs (hazard ratio [HR] 2.42 [95% CI 1.86-3.15]) or with VFs (HR 1.73 [95% CI 1.32-2.27]) or T2D (HR 1.94 [95% CI 1.46-2.59]) alone. Individuals with both T2D and VFs had increased mortality compared with individuals without T2D and VFs (HR 2.11 [95% CI 1.72-2.59]) or with VFs alone (HR 1.84 [95% CI 1.49-2.28]) and borderline increased compared with individuals with T2D alone (HR 1.23 [95% CI 0.99-1.52]). CONCLUSIONS Based on our findings, individuals with T2D should be systematically assessed for presence of VFs, and, as in individuals without T2D, their presence constitutes an indication to start osteoporosis treatment for the prevention of future fractures.

中文翻译：

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2型糖尿病患者的椎体骨折：比单独的骨骼并发症更多。

目的我们旨在评估2型糖尿病（T2D）患者是否具有增加的椎体骨折（VFs）风险，并评估T2D和VF普遍存在的非椎体骨折和死亡风险。研究设计和方法进行了系统的PubMed搜索，以鉴定研究T2D和VF之间关系的研究。提供个人参与者数据（IPD）的队列也包括在内。来自已发布的汇总数据和IPD队列的估计值汇总在随机效应荟萃分析中。使用多变量Cox回归模型估计患有T2D和VF的个体的非椎骨骨折和死亡风险。结果在涉及852,705名男性和女性的15项研究中，患有T2D的个体患病的风险较低（优势比[OR] 0.84 [95％CI 0.74-0.95]； I 2 = 0.0％； P het = 0。54），但发生VF的风险增加（OR 1.35 [95％CI 1.27-1.44]； I 2 = 0.6％； P het = 0.43）。在IPD队列中（N = 19,820），与没有T2D或VF的患者（危险比[HR] 2.42 [95％CI 1.86-3.15]）或带有VF的患者相比，同时有T2D和VF的患者非椎骨骨折的风险更高。 HR 1.73 [95％CI 1.32-2.27]）或T2D（HR 1.94 [95％CI 1.46-2.59]）。与没有T2D和VF的个体（HR 2.11 [95％CI 1.72-2.59]）或仅具有VF的个体（HR 1.84 [95％CI 1.49-2.28]）相比，同时患有T2D和VFs的患者死亡率增加。仅使用T2D（HR 1.23 [95％CI 0.99-1.52]）。结论基于我们的发现，应系统评估患有T2D的个体的VF，并且与没有T2D的个体一样，