Evidence map›Paper›PMID 26930183›Full record

ArticleThe Journal of clinical endocrinology and metabolism2016

Does Sitagliptin Affect the Rate of Osteoporotic Fractures in Type 2 Diabetes? Population-Based Cohort Study.

Sumit R Majumdar, Robert G Josse, Mu Lin, Dean T Eurich

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Journal of clinical endocrinology and metabolism, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed, 6 pooled it
5.5field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

23 citing papers in PubMed, 6 syntheses or guidelines pooled it, 43 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Risk of fracture with dipeptidyl peptidase-4 inhibitors, glucagon-like peptide-1 receptor agonists, or sodium-glucose cotransporter-2 inhibitors in real-world use: systematic review and meta-analysis of observational studies.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2019
    Pooled it
  6. Metformin use and risk of fracture: a systematic review and meta-analysis of observational studies.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2019
    Pooled it
  7. Review
  8. To do one and to get more: Part I. Diabetes and bone.Journal of the Chinese Medical Association : JCMA · 2022
    Review
  9. Article
  10. Article
  11. Article
  12. Review
  13. Article
  14. HbA1c variability, in addition to mean HbA1c, predicts incident hip fractures in Chinese people with type 2 diabetes.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2020 · on this map
    Article
  15. Article
  16. Bone health in diabetes and prediabetes.World journal of diabetes · 2019
    Review
  17. Article
  18. Diabetes pharmacotherapy and effects on the musculoskeletal system.Diabetes/metabolism research and reviews · 2019
    Review
  19. The effect of insulin on bone mineral density among women with type 2 diabetes: a SWAN Pharmacoepidemiology study.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2018
    Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 3 institutions in 1 country.

Sumit R MajumdarDepartment of Medicine (S.R.M.), University of Alberta, Edmonton, Alberta T6G 2G3, Canada; Alliance for Health Outcomes Research in Diabetes at the Alberta Diabetes Institute (S.R.M., D.T.E.), Edmonton, Alberta T6G 2G3, Canada; Department of Medicine (R.G.J.), University of Toronto, Toronto, Ontario M5B 1W8, Canada; Li Ka Shing Knowledge Institute (R.G.J.), St Michael's Hospital, Toronto, Ontario M5B 1W8, Canada; and School of Public Health (M.L., D.T.E.), University of Alberta, Edmonton, Alberta T6G 2G3, Canada.
Robert G JosseDepartment of Medicine (S.R.M.), University of Alberta, Edmonton, Alberta T6G 2G3, Canada; Alliance for Health Outcomes Research in Diabetes at the Alberta Diabetes Institute (S.R.M., D.T.E.), Edmonton, Alberta T6G 2G3, Canada; Department of Medicine (R.G.J.), University of Toronto, Toronto, Ontario M5B 1W8, Canada; Li Ka Shing Knowledge Institute (R.G.J.), St Michael's Hospital, Toronto, Ontario M5B 1W8, Canada; and School of Public Health (M.L., D.T.E.), University of Alberta, Edmonton, Alberta T6G 2G3, Canada.
Mu LinDepartment of Medicine (S.R.M.), University of Alberta, Edmonton, Alberta T6G 2G3, Canada; Alliance for Health Outcomes Research in Diabetes at the Alberta Diabetes Institute (S.R.M., D.T.E.), Edmonton, Alberta T6G 2G3, Canada; Department of Medicine (R.G.J.), University of Toronto, Toronto, Ontario M5B 1W8, Canada; Li Ka Shing Knowledge Institute (R.G.J.), St Michael's Hospital, Toronto, Ontario M5B 1W8, Canada; and School of Public Health (M.L., D.T.E.), University of Alberta, Edmonton, Alberta T6G 2G3, Canada.
Dean T EurichDepartment of Medicine (S.R.M.), University of Alberta, Edmonton, Alberta T6G 2G3, Canada; Alliance for Health Outcomes Research in Diabetes at the Alberta Diabetes Institute (S.R.M., D.T.E.), Edmonton, Alberta T6G 2G3, Canada; Department of Medicine (R.G.J.), University of Toronto, Toronto, Ontario M5B 1W8, Canada; Li Ka Shing Knowledge Institute (R.G.J.), St Michael's Hospital, Toronto, Ontario M5B 1W8, Canada; and School of Public Health (M.L., D.T.E.), University of Alberta, Edmonton, Alberta T6G 2G3, Canada.
University of Alberta · CAAlliance for Canadian Health Outcomes Research in Diabetes · CAUniversity of Toronto · CA

Funding

Canadian Institutes of Health Research MOP 126094
6 · The paper itself

Abstract

contextType 2 diabetes and osteoporosis are both common, chronic, and increase with age, whereas type 2 diabetes is also a risk factor for major osteoporotic fractures (MOFs). However, different treatments for type 2 diabetes can affect fracture risk differently, with metaanalyses showing some agents increase risk (eg, thiazolidinediones) and some reduce risk (eg, sitagliptin).

objectiveTo determine the independent association between new use of sitagliptin and MOF in a large population-based cohort study. DESIGN, SETTING, AND SUBJECTS: A sitagliptin new user study design employing a nationally representative Unites States claims database of 72 738 insured patients with type 2 diabetes. We used 90-day time-varying sitagliptin exposure windows and controlled confounding by using multivariable analyses that adjusted for clinical data, comorbidities, and time-updated propensity scores. MAIN OUTCOMES: We compared the incidence of MOF (hip, clinical spine, proximal humerus, distal radius) in new users of sitagliptin vs nonusers over a median 2.2 years follow-up.

resultsAt baseline, the median age was 52 years, 54% were men, and median A1c was 7.5%. There were 8894 new users of sitagliptin and 63 834 nonusers with a total 181 139 person-years of follow-up. There were 741 MOF (79 hip fractures), with 53 fractures (4.8 per 1000 person-years) among new users of sitagliptin vs 688 fractures (4.0 per 1000 person-years) among nonusers (P = .3 for difference). In multivariable analyses, sitagliptin was not associated with fracture (adjusted hazard ratio 1.1, 95% confidence interval 0.8-1.4; P = .7), although insulin (P < .001), sulfonylureas (P < .008), and thiazolidinedione (P = .019) were each independently associated with increased fracture risk.

conclusionsEven in a young population with type 2 diabetes, osteoporotic fractures were not uncommon. New use of sitagliptin was not associated with fracture, but other commonly used second-line agents for type 2 diabetes were associated with increased risk. These data should be considered when making treatment decisions for those with type 2 diabetes at particularly high risk of fractures.

Indexed as

AgedDiabetes Mellitus, Type 2FemaleHumansHypoglycemic AgentsIncidenceInsulinMaleMiddle AgedOsteoporotic FracturesRisk AssessmentRisk FactorsSitagliptin PhosphateSulfonylurea CompoundsThiazolidinediones2,4-thiazolidinedioneHypoglycemic AgentsInsulinSitagliptin PhosphateSulfonylurea CompoundsThiazolidinediones

Identifiers

PMID26930183
PMCPMC4870843
OpenAlexW2288418044

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.