Abstract
Objective Diabetes is a chronic disease caused by defective insulin secretion in the body, resulting in metabolic abnormalities with persistent blood glucose elevation. Osteoporosis is the most common diabetes complication. The aim of this study was to perform a meta-analysis of the effects of alendronate combined with atorvastatin compared with alendronate alone in the treatment of osteoporosis in diabetes mellitus. Methods Two researchers independently used PubMed, ScienceDirect, Cochrane Library, Wanfang Data, CNKI, and VIP databases to search for all relevant studies that met the inclusion criteria and used RevMan 5.3 and STATA 16.0 for data analysis. Results Fourteen studies that met the inclusion criteria were selected, including 1456 patients. Among the data extracted in this meta-analysis, bone mineral density (BMD) was the primary outcome measurement, while total effective rate, VAS, osteoprotegerin (OPG), bone Gla protein (BGP), bone alkaline phosphatase (BAP), blood P and Ca, and adverse effects were secondary outcome measurements. Our results showed that alendronate combined with atorvastatin is more effective than alendronate alone, with higher BMD, OPG, BGP, and BAP, more significant pain relief, and fewer adverse events. Conclusion The results of this meta-analysis indicate that alendronate combined with atorvastatin is a better treatment for osteoporosis in diabetes mellitus, showing more effective and higher BMD and fewer adverse events than alendronate alone.
Highlights
The prevalence of diabetes mellitus has increased significantly with the aging of populations in recent decades [1]
A clinical study showed that 70 mg of alendronate per week was effective in improving bone mineral density (BMD) and reducing bone loss in patients with proximal femur osteoporosis [4]
Given that there are studies in which atorvastatin was given for 6 months and for 12 months, it is discussed in subgroups
Summary
The prevalence of diabetes mellitus has increased significantly with the aging of populations in recent decades [1]. Diabetes causes bone metabolism disorders and reduces bone mineral content, which lead to osteoporosis. If diabetes-caused osteoporosis is left untreated, bone pain will occur, which may lead to disability eventually in severe cases [3]. A clinical study showed that 70 mg of alendronate per week was effective in improving bone mineral density (BMD) and reducing bone loss in patients with proximal femur osteoporosis [4]. Statins have been reported to have multiple effects, such as antioxidant properties, inhibition of inflammatory response, and bone metabolism. A nationwide population-based cohort study showed that atorvastatin had a potential protective effect on osteoporosis [5]. Statins directly affect osteoclasts through a mechanism similar to bisphosphonates. Both statins and bisphosphonates exert their effects through the mevalonate pathway. Alendronate is not highly bioavailable and binds to plasma proteins, resulting in BioMed Research International
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