marginally significantP = 0.073
According to the methodological heterogeneity between studies and their different charactristics, we performed the analysis based on random-effect model that indicated a marginally significant association between DAL and risk of fracture (N event = 5275, Pooled OR: 1.10; 95% CI: 0.99–1.21, P = 0.073) (I 2 = 12.9%; P = 0.321).