The association between GLP-1 receptor agonists and osteoporosis with pathological fractures was significant in the IVW analysis, yet the Q test in MR Egger regression indicated near-significant heterogeneity (p-value = 0.092489) ( Table 4 ), suggesting potential heterogeneity among instrumental variables for this association.
Although a slight positive effect was observed in certain analysis methods (such as the simple mode), the overall results failed to reach significance, suggesting that the potential impact of this drug on osteoporosis remains unclear ( Table S2 ).
However, while a weak negative correlation was shown in the IVW analysis, the bone-protective effect of SGLT2 inhibitors did not reach statistical significance in other methods, such as the weighted median and MR Egger methods ( Table 3 ).
In both postmenopausal osteoporosis and pharmacological osteoporosis analyses, p-values in the MR Egger and IVW methods did not achieve significance, indicating a limited effect on osteoporosis risk.