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Multiple sclerosis increases fracture risk: a meta-analysis
Guixian Dong1, Ning Zhang1, Zhanpo Wu1
1Department of Orthopedics, Harrison International Peace Hospital, Hengshui, Hebei 053000, China.
Purpose:
The association between multiple sclerosis (MS) and fracture risk has been reported, but results of previous studies remain controversial and ambiguous. To assess the association between MS and fracture risk, a meta-analysis was performed.
Method:
Based on comprehensive searches of the PubMed, Embase, and Web of Science, we identified outcome data from all articles estimating the association between MS and fracture risk. The pooled risk ratios (RRs) with 95% confidence intervals (CIs) were calculated.
Results:
A significant association between MS and fracture risk was found. This result remained statistically significant when the adjusted RRs were combined. Subgroup analysis stratified by the site of fracture suggested significant associations between MS and tibia fracture risk, femur fracture risk, hip fracture risk, pelvis fracture risk, vertebrae fracture risk, and humerus fracture risk. In the subgroup analysis by gender, female MS patients had increased fracture risk. When stratified by history of drug use, use of antidepressants, hypnotics/anxiolytics, anticonvulsants, and glucocorticoids increased the risk of fracture risk in MS patients.
Conclusions:
This meta-analysis demonstrated that MS was significantly associated with fracture risk.
Insights
Multiple sclerosis (MS) significantly increases fracture risk, particularly in women. Certain medications used by MS patients also elevate this risk, highlighting a critical need for preventative strategies.
Area of Science:
- Neurology
- Orthopedics
- Epidemiology
Background:
- Previous studies on multiple sclerosis (MS) and fracture risk have yielded conflicting results.
- A clear understanding of the association between MS and bone health is crucial.
Purpose of the Study:
- To conduct a meta-analysis to definitively assess the association between multiple sclerosis (MS) and fracture risk.
- To clarify the ambiguous findings from prior research.
Main Methods:
- Comprehensive literature searches were performed across PubMed, Embase, and Web of Science databases.
- Outcome data from relevant articles were pooled to calculate risk ratios (RRs) and 95% confidence intervals (CIs).
Main Results:
- A statistically significant association was confirmed between MS and an increased risk of fractures.
- Subgroup analyses revealed heightened risks for tibia, femur, hip, pelvis, vertebrae, and humerus fractures in MS patients.
- Female MS patients and those using antidepressants, hypnotics/anxiolytics, anticonvulsants, or glucocorticoids exhibited elevated fracture risks.
Conclusions:
- This meta-analysis provides robust evidence that multiple sclerosis is significantly linked to an increased risk of fractures.
- Findings underscore the importance of monitoring bone health and considering medication effects in MS management.
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