Abstract
The aim of the study was to explore the clinical efficacy of bisphosphonates in
patients with osteoporosis in diabetes patients by meta-analysis. Six databases
were systematically searched from inception to January 30,2023. Studies
evaluating the treatment of diabetic osteoporosis with bisphosphonates were
included. Key outcome measures, such as bone mineral density (BMD), bone
metabolism markers, pain improvement, and safety assessments, were extracted and
analyzed. STATA MP V17.0 was used to calculate the combined effect size. After
searching Chinese and English databases, 15 studies met the inclusion criteria
of this study. The results of the meta-analysis showed that the BMD of patients
with osteoporosis in diabetes increased significantly after bisphosphonate
treatment, and the lumbar BMD increased by 0.08 g/cm² (95% CI: 0.05–0.11).
Femoral neck BMD increased by 0.06 g/cm² (95% CI: 0.01–0.11); Ward’s triangle
BMD increased 0.07 g/cm² (95% CI: 0.04–0.09); and trochanter BMD increased by
0.06 g/cm² (95% CI: 0.04–0.08). In addition, bone alkaline phosphatase increased
1.95 μg/l (95% CI: 1.18–2.72), while serum tartrate-resistant acid
phosphatase-5b decreased 1.28 U/l (95% CI: –1.81–0.75). Moreover, improvements
in pain were statistically significant. The effects of bisphosphonates on
osteocalcin (MD: –0.07; 95% CI: –1.12–1.25), serum calcium (MD: 0.01; 95% CI:
–0.03–0.04), serum phosphorus (MD: 0.04; 95% CI: –0.03–0.10) and medication
safety (OR: 1.75; 95% CI: 1.29–2.37) were not statistically significant.
Bisphosphonates have a significant positive effect on bone mineral density and
bone metabolism in patients with osteoporosis in diabetes and have good
safety.
Keywords
bone mineral density - bisphosphonates - osteoporosis - bone metabolism
