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Metabolic syndrome associated with overall fracture reduction in men
Metabolic syndrome reduces the risk for overall fracture in men by 24%, possibly due to a beneficial effect on bone mineral density, according to research in Bone.
Libo Yang, of the department of endocrinology at Taian City Central Hospital, China, and colleagues conducted a meta-analysis of five prospective studies conducted in the United States, Norway, France, the Netherlands and Korea between 2006 and 2015 (n = 48,638); four of the studies were population-based. Sample sizes ranged from 762 to 21,159 adults; length of follow-up ranged from 2 to 10 years; three studies broke down results by sex, whereas two studies included only men. Exposure and outcomes assessments came mostly from hospital databases.
Researchers used random-effects models to measure RR for associations between metabolic syndrome and fracture risk.
After combining RRs across studies, researchers found a significant inverse relationship between metabolic syndrome and fracture risk (RR = 0.76; 95% CI, 0.59-0.97) with moderate heterogeneity (I² = 63.8%; P = .064).
However, subgroup analysis revealed significant inverse associations in men only (summarized RR = 0.66; 95% CI, 0.51-0.86) and not in women. The difference of the pooled RRs from the two subgroups did not reach statistical significance with a test of interaction.
Three of the studies examined the association between metabolic syndrome and vertebral fractures; no significant association for nonvertebral fracture was found overall, but significant inverse associations were observed in men (RR = 0.72; 95% CI, 0.52-0.99) and not in women. Researchers found no evidence of publication bias.
“A lack of overall association between [metabolic syndrome] and fracture risk in women had several possible explanations,” the researchers wrote. “One explanation is the modifying effect of age. ... [Another is] that the development of osteoporosis in postmenopausal women overwhelms the benefit of [metabolic syndrome] on bone.”
The researchers noted that results should be interpreted with caution due to the limited number of studies and the nonsignificant difference between gender subgroups. – by Regina Schaffer
Disclosure: The researchers report no relevant financial disclosures.