Prevalence of Osteoporosis in Patients with Type 2 Diabetes Mellitus in the Chinese Mainland: A Systematic Review and Meta-Analysis
-
Yuhao SI
,
Cenyi WANG
,
Yang GUO
,
Guihua XU
,
Yong MA
Abstract
Background: Some studies have investigated the prevalence of osteoporosis in patients with type 2 diabetes mellitus (T2DM) in China. However, the results were inconsistent. This review was performed to estimate the prevalence of osteoporosis in T2DM patients in the Chinese mainland and to characterize its epidemiology.
Methods: A literature search was conducted utilizing PubMed, Scopus, Web of Science, Cochrane Library, CNKI, Wanfang database from their inception through June 2017. A total of 54 studies evaluating the prevalence rate of osteoporosis in T2DM patients were collected. Prevalence estimates from the individual study were combined utilizing random-effect models in Stata 12.0.
Results: The pooled prevalence rate of osteoporosis in T2DM patients was 37.8%. Notably, osteoporosis was more frequent in females than in males (44.8% vs. 37.0%) and was increased with ageing (over 60: 40.1% vs. below 60: 26.5%). Osteoporosis prevalence was higher in less developed areas than in developed areas (41.0% vs. 32.7%) and almost the same between the southern and northern regions (37.6% vs. 38.2%). The prevalence rate between 2010 and 2017 decreased compared with the period between 2001 and 2009 (42.3% vs. 35.6%). Additionally, the meta-regression suggested that gender and age could significantly influence the estimation of prevalence rates respectively (P = 0.011, P = 0.022).
Conclusion: Osteoporosis affects more than one-third of T2DM patients in China mainland. Females and older adults more likely require clinical prevention due to a higher prevalence. Further studies are needed to be conducted to incorporate and verify previous results.
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2. Shen X, Vaidya A, Wu S, Gao X (2016). The Diabetes Epidemic in China: An Integrated Review of National Surveys. Endocr Pract, 22:1119-1129.
3. Rathmann W, Giani G, Wild SH, Roglic G, Green A, Sicree R, King H (2004). Global prevalence of diabetes: Estimates for the year 2000 and projections for 2030 [8] (multiple letter). Diabetes Care, 27:2568-2569.
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5. Mijnhout GS, Scheltens P, Diamant M, Biessels GJ, Wessels AM, Simsek S, Snoek FJ, Heine RJ (2006). Diabetic encephalopathy: A concept in need of a definition. Diabetologia, 49:1447-1448.
6. Napoli N, Chandran M, Pierroz DD, Abrahamsen B, Schwartz AV, Ferrari SL (2017). Mechanisms of diabetes mellitus-induced bone fragility. Nat Rev Endocrinol, 13:208-219.
7. E C (1996). Pocket guide to critical appraisal. John Wiley&Sons, London.
8. Shan PF, Wu XP, Zhang H, Cao XZ, Yuan LQ, Liao EY (2011). Age-related bone mineral density, osteoporosis rate and risk of vertebral fracture in mainland Chinese women with type 2 diabetes mellitus. J Endocrinol Invest, 34:190-196.
9. Dai N, Yan P, Zhang C, Zhang H (2016). Analysis of related risk factors of diabetes combined with osteoporosis. ZhongGuo Yi Yao Dao Bao, 13:69-71+84.
10. Bai H, Yin SN, Jing DQ (2007). Analysis of bone mineral density change in type 2 diabetic elderly men. Gan Ran Yan Zheng Xiu Fu:107-109.
11. Bai Y, Wu J, Wang G (2015). Risk Factors of Type 2 Diabetes Mellitus Complicated With Osteoporosis. Zhong Wai Yi Liao, 34:20-21.
12. Cao J, Jiang X (2014). Analysis of the Level and Influencing Factors of Bone Mineral Density in Patients with Type 2 Diabetes. Yi Xue Zong Shu, 20:2078-2080.
13. Chen C, Xing X, Chen R, Xing C, Ren A (2008). Bone density changes and its risk factors in patients with type 2 diabetes. Lin Chuang Nei Ke Za Zhi:489-490.
14. Guan M, Xue Y, Zou H (2001). Anaysis of bone mineral density changes in type 2 diabetic patients. Di Yi Jun Yi Da Xue Xue Bao:684-685.
15. Guo R (2013). Relationship between prevalence of osteoporosis and age in elderly female patients with type 2 diabetes mellitus. Shi Yong Tang Niao Bing Za Zhi, 9:29-31.
16. Huang Y (2009). Preliminary study of the relationship between body composition and bone mineral density in postmenopausal patients with type 2 diabetes. MD. Hebei Medical Unversity.
17. Li B, Zhou X, Liang X, Chang W, Zhao S, Zhang Y (2015). The alternation of bone metabolism index and bone mineral density of elderly male type 2 diabetes mellitus combined with depression patients. ZhongGuo Yi Xue Qian Yan Za Zhi, 7:17-20.
18. Li H, Guo Y (2003). BMD examination of elderly patients with type 2 diabetes complicatedwith osteoporosis. ZhongGuo Lin Chuang Kang Fu:2868-2869.
19. Li H, Jiang T (2012). Bone density level and its risk factors in patients with type 2 diabetic nephropathy. ZhongGuo Lao Nian Xue Za Zhi, 32:2711-2713.
20. Plantinga L, Rao MN, Schillinger D (2012). Prevalence of self-reported sleep problems among people with diabetes in the United States, 2005-2008. Prev Chronic Dis, 9 :E76.
21. Li L, Xia S (2014). Analysis of Bone Mineral Density in Elderly Male Inpatients with Type 2 Diabetes in Guizhou Provincial Organ. Gui Yang Zhong Yi Xue Yuan Xue Bao, 36:66-68.
22. Li W, Mai K, Lin W, Zhong Q (2004). Clinical analysis of osteoporosis prevalence in the elderly with type 2 diabetics. Zhonghua Lao Nian Bing Yan Jiu Za Zhi:23-25.
23. Li W (2011) Relevance study of distribution characteristics of type 2 diabetes combined with osteoporosis and its TCM syndrome. MD. Beijing University of Chinese Medicine.
24. Li X, Liu Q, Guo W (2012). Analysis of the Bone Mineral Density and its Influencing Factors in Male Patients with Type 2 Diabetes. ZhongGuo Lao Nian Xue Za Zhi, 32:921-923.
25. Lin H, Huang X, Xiu Q, Cheng G (2012). The Effect of Type 2 Diabetes on Bone Mineral Density of Postmenopausal Women. ZhongGuo Lao Nian Xue Za Zhi, 32:3172-3173.
26. Lu S, WAng C, Huang R (2008). Change of bone mineral density in type 2 diabetes and its influential factors. Chongqing Yi Xue:1200-1202.
27. Mo H, Liu S, Zhou Z, Li J, Chen J (2008). Risk factors of BMD in postmenopausal patients and the prevalence of osteoporosis. ZhongGuo Lao Nian Xue Za Zhi:1921-1924.
28. Pang Y (2013). Analysis of bone mineral density in patients with type 2 diabetes. Shanghai Yi Xue, 34:20-23.
29. Tang Z (2009) Clinical study of bone mineral density in patients with type 2 diabetes and the related factors of complicated osteoporosis. MD. Centeral South University.
30. Tang Z, Qin A, Zhao X, Li W, Li L, Chen K (2013). Relationship between Chronic Complications and Osteoporosis among Postmenopausal Women with Type 2 Diabetes Mellitus. Xian Dai Sheng Wu Yi Xue Jin Zhan, 13:2955-2958.
31. Wang B (2006) The preliminary investigation of the relationship between bone mineral density and the function of islet cell in type 2 diabetic patients. MD. Hebei Medical Unversity.
32. Wang H, Chang X, Zhang H (2010). Analysis of bone mineral density in eldly male type 2 diabetic patient. Xian Dai Yi Xue, 38:474-476.
33. Wang T, Wang Z, Chen C (2014). Correlation Between Metabolism Syndrome and Osteoporosis in Elderly Female Patients with Type 2 Diabetes. ZhongGuo Lao Nian Xue Za Zhi, 34:1760-1762.
34. Wang Y, Liu Y, Zhang W, Li B, Li Y (2011). Factors of Bone mass and bone turnover characteristics in postmenopausal women with type 2 diabetes mellitus. ZhongGuo Lao Nian Xue Za Zhi, 31:1506-1508.
35. Wu A, Zheng W, Zheng X, Xu C, Lin C (2011). Comparative Study on Bone Mineral Density ofLumbar Vertebrae Between Type2 Diabetic Patients and Healthy People. Yi Xue Yan Jiu Za Zhi, 40:111-113.
36. Wu F (2008) Diversification of bone mineral density and TRACP-5b,CTX-Ⅰ,BAP in postmenopausal diabetic women and related factors analyzed. MD. Hebei Medical Unversity.
37. Wu S (2016). Relevance study of bone density and vitamin D level in elderly patients with type 2 diabetes. ZhongGuo Xian Dai Yi Sheng, 54:89-91.
38. Wu X (2014) The relationship between serum Sclerostin, Dkk1 levels and bone mineral density in T2DM patients. MD. Hebei Medical Unversity.
39. Xing Y, Zhao J, Zhang L, Che W (2006). Relationship between osteoporosis and non-insulin dependent diabetes mellitus in elderly. ZhongGuo Gu Zhi Shu Song Za Zhi:482-484+454.
40. Xing Y, Li C, Zhang Q, Yu Q, Yu D (2015). Relationship between serum bilirubin levels and osteoporosis in middle and old aged male patients with type 2 diabetes mellitus. Tianjin Yi Ke Da Xue Xue Bao, 21:426-429.
41. Xu Y, Lv G, Zhang S (2015). Analysis of risk factors of diabetes combined with osteoporosis. Huaihai Yi Yao, 33:464-466.
42. Xu W, Yi Z (2005). Changes of bone mineral density and metabolism in type 2 diabetes mellitus of different traditional Chinese medicine syndrome types. ZhongGuo Lin Chuang Kang Fu:182-184.
43. Xue Y, Hu J, Lin Y, Cheng J (2013). Analysis of Risk Factors of Type 2 Diabetes Mellitus Complicated With Osteoporosis. Shi Yong Lin Chuang Yi Yao Za Zhi, 17:155-156.
44. Yan P, Ouyang F, Ma H, He J, Li J (2016). Relationship of serum cystatin-C levels with osteoporosis in patients with type 2 diabetes mellitus. Shanxi Yi Ke Da Xue Xue Bao, 47:59-63+96.
45. Zhang H, Li C (2015). Relationship between bone density and fasting insulin level in elderly patients with type 2 diabetes. ZhongGuo Lao Nian Xue Za Zhi, 35:4541-4543.
46. Zhang R (2010) The prevalence of osteoporosis and BMD in nonselected female population. MD. Centeral South University.
47. Zhang X, Wu Y, Liu Y, Zhang J, Fu C, Jin L (2013). Correlation analysis of osteoporosis-related risk factors in patients with type 2 diabetes in Dandong area. ZhongGuo Gu Zhi Shu Song Za Zhi, 19:10-13.
48. Zhang Z, Yan P, Zhong H, Li H, He X (2016). Correlation Between Vibrating Perception Threshold and Osteoporosis in Patients with Type 2 Diabetes Peripheral Neuropathy. Chengdu Yi Xue Yuan Xue Bao, 11:182-185+190.
49. Zhang D, Lv X, He X, Liu J (2006). Relationship between bone mineral density and serum insulin-like growth factor-Ⅰ in elder women with type 2 diabetes mellitus. ZhongGuo Gu Zhi Shu Song Za Zhi:142-144.
50. Zhao N, Li S, Fang X, Li C (2014). Study of the relationship between bone mineral density and serum uric acid in senile diabetic patients. ZhongGuo Gu Zhi Shu Song Za Zhi, 20:784-788.
51. Fang X, Lai X, Zheng G (2011). Bone density level and its risk factors in patients with type 2 diabetes. Shandong Yi Yao, 51:41-42.
52. Li G (2010). Effect of type 2 diabetes mellitus and analysis of osteoporosis-related risk factors. ZhongGuo Gu Zhi Shu Song Za Zhi, 16:344-346.
53. Li X, Zhu X, Yu W (2011). Preliminary study of the effect of type 2 diabetes mellitus on bone metabolism in the elderly. ZhongGuo Gu Zhi Shu Song Za Zhi, 17:11-14.
54. Lu Y, Zhang Y, Zhang Z (2015). Bone mineral density analysis of incipient type 2 diabetes. Jilin Yi Xue:3783-3784,3785.
55. Sun W, Wang L (2009). Correlation between Bone Mineral Density and Insulin Level in Type 2 Diabetic Patients. ZhongGuo Quan Ke Yi Xue, 12:2119-2120,2123.
56. Wang T, Wang Z, Chen C (2012). Correlation Between CYS-C in Type 2 Diabetes and Osteoporosis. Hebei Yi Ke Da Xue Xue Bao, 33:1290-1293.
57. Wu Y, Zhao F (2008). Analysis of bone mineral density in female type 2 diabetes patients. ZhongGuo Gu Zhi Shu Song Za Zhi, 14:335-336,340.
58. Zhang C, Xie Y, Zhang G (2015). Relevance study of bone density level in patients with type 2 diabetes. Zhong Wai Yi Xue Yan Jiu:78-79.
59. Zhou X, Zheng L, Jin X (2009). Clinical observation of bone mineral density changes in 106 type 2 diabetes patients. Chongqing Yi Xue, 38:2717-2718.
60. Zhu X, Wu X, Zhou Z, Huang G, Wang W (2002). Bone mineral density comparison of female type 2 diabetes mellitus with healthy women. ZhongGuo Tang Niao Bing Za Zhi, 10:216-218.
61. Liu T (2010) Effect of type 2 diabetes mellitus on osteoporosis incidence and analysis of osteoporosis-related risk factors. MD. Jilin University.
62. Chen P, Li Z, Hu Y (2016). Prevalence of osteoporosis in China: a meta-analysis and systematic review. BMC Public Health, 16: 1039.
63. Russo GT, Giandalia A, Romeo EL, Nunziata M, Muscianisi M, Ruffo MC, Catalano A, Cucinotta D (2016). Fracture Risk in Type 2 Diabetes: Current Perspectives and Gender Differences. Int J Endocrinol, 2016: 1615735.
64. Sosa M, Dominguez M, Navarro MC, Segarra MC, Hernández D, De Pablos P, Betancor P (1996). Bone mineral metabolism is normal in non-insulin-dependent diabetes mellitus. J Diabetes Complications, 10:201-205.
65. Wakasugi M, Wakao R, Tawata M, Gan N, Koizumi K, Onaya T (1993). Bone mineral density measured by dual energy X-ray absorptiometry in patients with non-insulin-dependent diabetes mellitus. Bone, 14:29-33.
66. Asokan AG, Jaganathan J, Philip R, Soman RR, Sebastian ST, Pullishery F (2017). Evaluation of bone mineral density among type 2 diabetes mellitus patients in South Karnataka. J Nat Sci Biol Med, 8:94-98.
67. Maier GS, Jakobs P, Roth KE, Kurth AA, Maus U (2013). Is there an epidemic vitamin D deficiency in German orthopaedic patients? Clin Orthop Relat Res, 471:3029-3035.
68. Nakavachara P, Viprakasit V (2013). Children with hemoglobin E/β-thalassemia have a high risk of being vitamin D deficient even if they get abundant sun exposure: A study from Thailand. Pediatr Blood Cancer, 60:1683-1688.
69. Zeng Q, Huang S, Chen R (1997). 10-year epidemiological study on rheumatic diseases in Shantou area. Zhonghua Nei Ke Za Zhi, 36:193-197. [Article in Chinese].
70. Luo WD, Zhao G, Shu J, Lao HC, Lin F, Guo LM, He SX, Yuan Y (2017). Prevalence and Correlation Factors of Osteoporosis in Middle-aged and Elderly People of Zhuang Nationality in Yunnan Based on A Survey. ZhongGuo Quan Ke Yi Xue, 20:912-917.
71. Yan P, Zhang Z, Feng J, Li H, Gao C, Yang J, Zhong H, Wan Q, Xu Y (2017). Association between serum total bilirubin levels, bone mineral density, and prevalence of osteoporosis in Chinese patients with type 2 diabetes. Int J Clin Exp Pathol, 10:5784-5798.
2. Shen X, Vaidya A, Wu S, Gao X (2016). The Diabetes Epidemic in China: An Integrated Review of National Surveys. Endocr Pract, 22:1119-1129.
3. Rathmann W, Giani G, Wild SH, Roglic G, Green A, Sicree R, King H (2004). Global prevalence of diabetes: Estimates for the year 2000 and projections for 2030 [8] (multiple letter). Diabetes Care, 27:2568-2569.
4. Xiang HD (2003). Chronic diabetic complications and related macro-vascular diseases of in-patients with diabetes in mainland of China—A national retrospective analysis in recent 10 years. ZhongGuo Tang Niao Bing Za Zhi, 4:5-10.
5. Mijnhout GS, Scheltens P, Diamant M, Biessels GJ, Wessels AM, Simsek S, Snoek FJ, Heine RJ (2006). Diabetic encephalopathy: A concept in need of a definition. Diabetologia, 49:1447-1448.
6. Napoli N, Chandran M, Pierroz DD, Abrahamsen B, Schwartz AV, Ferrari SL (2017). Mechanisms of diabetes mellitus-induced bone fragility. Nat Rev Endocrinol, 13:208-219.
7. E C (1996). Pocket guide to critical appraisal. John Wiley&Sons, London.
8. Shan PF, Wu XP, Zhang H, Cao XZ, Yuan LQ, Liao EY (2011). Age-related bone mineral density, osteoporosis rate and risk of vertebral fracture in mainland Chinese women with type 2 diabetes mellitus. J Endocrinol Invest, 34:190-196.
9. Dai N, Yan P, Zhang C, Zhang H (2016). Analysis of related risk factors of diabetes combined with osteoporosis. ZhongGuo Yi Yao Dao Bao, 13:69-71+84.
10. Bai H, Yin SN, Jing DQ (2007). Analysis of bone mineral density change in type 2 diabetic elderly men. Gan Ran Yan Zheng Xiu Fu:107-109.
11. Bai Y, Wu J, Wang G (2015). Risk Factors of Type 2 Diabetes Mellitus Complicated With Osteoporosis. Zhong Wai Yi Liao, 34:20-21.
12. Cao J, Jiang X (2014). Analysis of the Level and Influencing Factors of Bone Mineral Density in Patients with Type 2 Diabetes. Yi Xue Zong Shu, 20:2078-2080.
13. Chen C, Xing X, Chen R, Xing C, Ren A (2008). Bone density changes and its risk factors in patients with type 2 diabetes. Lin Chuang Nei Ke Za Zhi:489-490.
14. Guan M, Xue Y, Zou H (2001). Anaysis of bone mineral density changes in type 2 diabetic patients. Di Yi Jun Yi Da Xue Xue Bao:684-685.
15. Guo R (2013). Relationship between prevalence of osteoporosis and age in elderly female patients with type 2 diabetes mellitus. Shi Yong Tang Niao Bing Za Zhi, 9:29-31.
16. Huang Y (2009). Preliminary study of the relationship between body composition and bone mineral density in postmenopausal patients with type 2 diabetes. MD. Hebei Medical Unversity.
17. Li B, Zhou X, Liang X, Chang W, Zhao S, Zhang Y (2015). The alternation of bone metabolism index and bone mineral density of elderly male type 2 diabetes mellitus combined with depression patients. ZhongGuo Yi Xue Qian Yan Za Zhi, 7:17-20.
18. Li H, Guo Y (2003). BMD examination of elderly patients with type 2 diabetes complicatedwith osteoporosis. ZhongGuo Lin Chuang Kang Fu:2868-2869.
19. Li H, Jiang T (2012). Bone density level and its risk factors in patients with type 2 diabetic nephropathy. ZhongGuo Lao Nian Xue Za Zhi, 32:2711-2713.
20. Plantinga L, Rao MN, Schillinger D (2012). Prevalence of self-reported sleep problems among people with diabetes in the United States, 2005-2008. Prev Chronic Dis, 9 :E76.
21. Li L, Xia S (2014). Analysis of Bone Mineral Density in Elderly Male Inpatients with Type 2 Diabetes in Guizhou Provincial Organ. Gui Yang Zhong Yi Xue Yuan Xue Bao, 36:66-68.
22. Li W, Mai K, Lin W, Zhong Q (2004). Clinical analysis of osteoporosis prevalence in the elderly with type 2 diabetics. Zhonghua Lao Nian Bing Yan Jiu Za Zhi:23-25.
23. Li W (2011) Relevance study of distribution characteristics of type 2 diabetes combined with osteoporosis and its TCM syndrome. MD. Beijing University of Chinese Medicine.
24. Li X, Liu Q, Guo W (2012). Analysis of the Bone Mineral Density and its Influencing Factors in Male Patients with Type 2 Diabetes. ZhongGuo Lao Nian Xue Za Zhi, 32:921-923.
25. Lin H, Huang X, Xiu Q, Cheng G (2012). The Effect of Type 2 Diabetes on Bone Mineral Density of Postmenopausal Women. ZhongGuo Lao Nian Xue Za Zhi, 32:3172-3173.
26. Lu S, WAng C, Huang R (2008). Change of bone mineral density in type 2 diabetes and its influential factors. Chongqing Yi Xue:1200-1202.
27. Mo H, Liu S, Zhou Z, Li J, Chen J (2008). Risk factors of BMD in postmenopausal patients and the prevalence of osteoporosis. ZhongGuo Lao Nian Xue Za Zhi:1921-1924.
28. Pang Y (2013). Analysis of bone mineral density in patients with type 2 diabetes. Shanghai Yi Xue, 34:20-23.
29. Tang Z (2009) Clinical study of bone mineral density in patients with type 2 diabetes and the related factors of complicated osteoporosis. MD. Centeral South University.
30. Tang Z, Qin A, Zhao X, Li W, Li L, Chen K (2013). Relationship between Chronic Complications and Osteoporosis among Postmenopausal Women with Type 2 Diabetes Mellitus. Xian Dai Sheng Wu Yi Xue Jin Zhan, 13:2955-2958.
31. Wang B (2006) The preliminary investigation of the relationship between bone mineral density and the function of islet cell in type 2 diabetic patients. MD. Hebei Medical Unversity.
32. Wang H, Chang X, Zhang H (2010). Analysis of bone mineral density in eldly male type 2 diabetic patient. Xian Dai Yi Xue, 38:474-476.
33. Wang T, Wang Z, Chen C (2014). Correlation Between Metabolism Syndrome and Osteoporosis in Elderly Female Patients with Type 2 Diabetes. ZhongGuo Lao Nian Xue Za Zhi, 34:1760-1762.
34. Wang Y, Liu Y, Zhang W, Li B, Li Y (2011). Factors of Bone mass and bone turnover characteristics in postmenopausal women with type 2 diabetes mellitus. ZhongGuo Lao Nian Xue Za Zhi, 31:1506-1508.
35. Wu A, Zheng W, Zheng X, Xu C, Lin C (2011). Comparative Study on Bone Mineral Density ofLumbar Vertebrae Between Type2 Diabetic Patients and Healthy People. Yi Xue Yan Jiu Za Zhi, 40:111-113.
36. Wu F (2008) Diversification of bone mineral density and TRACP-5b,CTX-Ⅰ,BAP in postmenopausal diabetic women and related factors analyzed. MD. Hebei Medical Unversity.
37. Wu S (2016). Relevance study of bone density and vitamin D level in elderly patients with type 2 diabetes. ZhongGuo Xian Dai Yi Sheng, 54:89-91.
38. Wu X (2014) The relationship between serum Sclerostin, Dkk1 levels and bone mineral density in T2DM patients. MD. Hebei Medical Unversity.
39. Xing Y, Zhao J, Zhang L, Che W (2006). Relationship between osteoporosis and non-insulin dependent diabetes mellitus in elderly. ZhongGuo Gu Zhi Shu Song Za Zhi:482-484+454.
40. Xing Y, Li C, Zhang Q, Yu Q, Yu D (2015). Relationship between serum bilirubin levels and osteoporosis in middle and old aged male patients with type 2 diabetes mellitus. Tianjin Yi Ke Da Xue Xue Bao, 21:426-429.
41. Xu Y, Lv G, Zhang S (2015). Analysis of risk factors of diabetes combined with osteoporosis. Huaihai Yi Yao, 33:464-466.
42. Xu W, Yi Z (2005). Changes of bone mineral density and metabolism in type 2 diabetes mellitus of different traditional Chinese medicine syndrome types. ZhongGuo Lin Chuang Kang Fu:182-184.
43. Xue Y, Hu J, Lin Y, Cheng J (2013). Analysis of Risk Factors of Type 2 Diabetes Mellitus Complicated With Osteoporosis. Shi Yong Lin Chuang Yi Yao Za Zhi, 17:155-156.
44. Yan P, Ouyang F, Ma H, He J, Li J (2016). Relationship of serum cystatin-C levels with osteoporosis in patients with type 2 diabetes mellitus. Shanxi Yi Ke Da Xue Xue Bao, 47:59-63+96.
45. Zhang H, Li C (2015). Relationship between bone density and fasting insulin level in elderly patients with type 2 diabetes. ZhongGuo Lao Nian Xue Za Zhi, 35:4541-4543.
46. Zhang R (2010) The prevalence of osteoporosis and BMD in nonselected female population. MD. Centeral South University.
47. Zhang X, Wu Y, Liu Y, Zhang J, Fu C, Jin L (2013). Correlation analysis of osteoporosis-related risk factors in patients with type 2 diabetes in Dandong area. ZhongGuo Gu Zhi Shu Song Za Zhi, 19:10-13.
48. Zhang Z, Yan P, Zhong H, Li H, He X (2016). Correlation Between Vibrating Perception Threshold and Osteoporosis in Patients with Type 2 Diabetes Peripheral Neuropathy. Chengdu Yi Xue Yuan Xue Bao, 11:182-185+190.
49. Zhang D, Lv X, He X, Liu J (2006). Relationship between bone mineral density and serum insulin-like growth factor-Ⅰ in elder women with type 2 diabetes mellitus. ZhongGuo Gu Zhi Shu Song Za Zhi:142-144.
50. Zhao N, Li S, Fang X, Li C (2014). Study of the relationship between bone mineral density and serum uric acid in senile diabetic patients. ZhongGuo Gu Zhi Shu Song Za Zhi, 20:784-788.
51. Fang X, Lai X, Zheng G (2011). Bone density level and its risk factors in patients with type 2 diabetes. Shandong Yi Yao, 51:41-42.
52. Li G (2010). Effect of type 2 diabetes mellitus and analysis of osteoporosis-related risk factors. ZhongGuo Gu Zhi Shu Song Za Zhi, 16:344-346.
53. Li X, Zhu X, Yu W (2011). Preliminary study of the effect of type 2 diabetes mellitus on bone metabolism in the elderly. ZhongGuo Gu Zhi Shu Song Za Zhi, 17:11-14.
54. Lu Y, Zhang Y, Zhang Z (2015). Bone mineral density analysis of incipient type 2 diabetes. Jilin Yi Xue:3783-3784,3785.
55. Sun W, Wang L (2009). Correlation between Bone Mineral Density and Insulin Level in Type 2 Diabetic Patients. ZhongGuo Quan Ke Yi Xue, 12:2119-2120,2123.
56. Wang T, Wang Z, Chen C (2012). Correlation Between CYS-C in Type 2 Diabetes and Osteoporosis. Hebei Yi Ke Da Xue Xue Bao, 33:1290-1293.
57. Wu Y, Zhao F (2008). Analysis of bone mineral density in female type 2 diabetes patients. ZhongGuo Gu Zhi Shu Song Za Zhi, 14:335-336,340.
58. Zhang C, Xie Y, Zhang G (2015). Relevance study of bone density level in patients with type 2 diabetes. Zhong Wai Yi Xue Yan Jiu:78-79.
59. Zhou X, Zheng L, Jin X (2009). Clinical observation of bone mineral density changes in 106 type 2 diabetes patients. Chongqing Yi Xue, 38:2717-2718.
60. Zhu X, Wu X, Zhou Z, Huang G, Wang W (2002). Bone mineral density comparison of female type 2 diabetes mellitus with healthy women. ZhongGuo Tang Niao Bing Za Zhi, 10:216-218.
61. Liu T (2010) Effect of type 2 diabetes mellitus on osteoporosis incidence and analysis of osteoporosis-related risk factors. MD. Jilin University.
62. Chen P, Li Z, Hu Y (2016). Prevalence of osteoporosis in China: a meta-analysis and systematic review. BMC Public Health, 16: 1039.
63. Russo GT, Giandalia A, Romeo EL, Nunziata M, Muscianisi M, Ruffo MC, Catalano A, Cucinotta D (2016). Fracture Risk in Type 2 Diabetes: Current Perspectives and Gender Differences. Int J Endocrinol, 2016: 1615735.
64. Sosa M, Dominguez M, Navarro MC, Segarra MC, Hernández D, De Pablos P, Betancor P (1996). Bone mineral metabolism is normal in non-insulin-dependent diabetes mellitus. J Diabetes Complications, 10:201-205.
65. Wakasugi M, Wakao R, Tawata M, Gan N, Koizumi K, Onaya T (1993). Bone mineral density measured by dual energy X-ray absorptiometry in patients with non-insulin-dependent diabetes mellitus. Bone, 14:29-33.
66. Asokan AG, Jaganathan J, Philip R, Soman RR, Sebastian ST, Pullishery F (2017). Evaluation of bone mineral density among type 2 diabetes mellitus patients in South Karnataka. J Nat Sci Biol Med, 8:94-98.
67. Maier GS, Jakobs P, Roth KE, Kurth AA, Maus U (2013). Is there an epidemic vitamin D deficiency in German orthopaedic patients? Clin Orthop Relat Res, 471:3029-3035.
68. Nakavachara P, Viprakasit V (2013). Children with hemoglobin E/β-thalassemia have a high risk of being vitamin D deficient even if they get abundant sun exposure: A study from Thailand. Pediatr Blood Cancer, 60:1683-1688.
69. Zeng Q, Huang S, Chen R (1997). 10-year epidemiological study on rheumatic diseases in Shantou area. Zhonghua Nei Ke Za Zhi, 36:193-197. [Article in Chinese].
70. Luo WD, Zhao G, Shu J, Lao HC, Lin F, Guo LM, He SX, Yuan Y (2017). Prevalence and Correlation Factors of Osteoporosis in Middle-aged and Elderly People of Zhuang Nationality in Yunnan Based on A Survey. ZhongGuo Quan Ke Yi Xue, 20:912-917.
71. Yan P, Zhang Z, Feng J, Li H, Gao C, Yang J, Zhong H, Wan Q, Xu Y (2017). Association between serum total bilirubin levels, bone mineral density, and prevalence of osteoporosis in Chinese patients with type 2 diabetes. Int J Clin Exp Pathol, 10:5784-5798.
| Files | ||
| Issue | Vol 48 No 7 (2019) | |
| Section | Review Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v48i7.2942 | |
| Keywords | ||
| Type 2 diabetes mellitus Osteoporosis Prevalence Meta-analysis China | ||
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How to Cite
1.
SI Y, WANG C, GUO Y, XU G, MA Y. Prevalence of Osteoporosis in Patients with Type 2 Diabetes Mellitus in the Chinese Mainland: A Systematic Review and Meta-Analysis. Iran J Public Health. 2019;48(7):1203-1214.
