| Objective To evaluate the effect of GLP-1 receptor agonists on the fracture risk in patients with type 2 diabetes mellitus. Methods PUBMED, MEDLINE, the Cochrane Library, EMBASE, Web of Science, CNKI, and Wanfang data base were searched. The randomized controlled trials (RCT) of GLP-1 receptor agonists for the treatment of type 2 diabetes mellitus were collected according to the inclusion and exclusion criteria. Meta-analysis was performed using RevMan 5.0 software and Stata 12.0 software. Results Thirty-six RCTs were included. The results of meta-analysis showed that the incidence of fracture in liraglutide group was significantly lower than that in the control group, and the difference was statistically significant (OR = 0.47, 95% CI 0.24, 0.91, P = 0.024). No significant difference was shown in the incidence of fracture between control group and GLP-1 receptor agonists group (OR = 0.94, 95% CI 0.64, 1.37, P = 0.735), exenatide (OR = 1.81, 95% CI 0.83, 3.95, P = 0.139), dulaglutide (OR = 1.21, 95% CI 0.57, 2.58, P = 0.616), lixisenatide (OR = 1.27, 95% CI 0.50, 3.24, P = 0.617), and albiglutide (OR = 0.70, 95% CI 0.25, 2.20, P = 0.515), respectively. In the aspects of the risk factors of fracture, bone mineral density and serum calcium, there were no significant differences between GLP-1 receptor agonists group and the control groups (OR = 0.16, 95% CI -0.10, 0.42, P = 0.223 and SMD = 0.17, 95% CI -0.20, 0.55, P = 0.358, respectively). Conclusion The use of liraglutide reduces fracture risk in patients with type 2 diabetes mellitus. However, the use of other antidiabetic drugs or other GLP-1 receptor agonists has similar fracture risk compared with the control group. In addition, the effect of GLP-1 receptor agonists on bone mineral density and serum calcium is similar to that of the control group. |