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Bone Mineral Density, Osteoporosis, and Fracture Risk in Adult Patients with Psoriasis or Psoriatic Arthritis: A Systematic Review and Meta-Analysis of Observational Studies

1
Department of Medical Education, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970, Taiwan
2
Department of Medical Education, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City 231, Taiwan
3
Department of Medical Research, Buddhist Tzu Chi General Hospital, Hualien 970, Taiwan
4
Division of Rheumatology and Immunology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970, Taiwan
5
School of Medicine, Tzu Chi University, Hualien 970, Taiwan
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(11), 3712; https://doi.org/10.3390/jcm9113712
Received: 19 October 2020 / Revised: 13 November 2020 / Accepted: 16 November 2020 / Published: 19 November 2020
(This article belongs to the Special Issue Osteoporosis and Related Bone Metabolic Disease)
Introduction: Awareness of psoriasis-related comorbidities has been established in the current guidelines; however, evidence regarding the association of bone density or bone fragility with psoriatic disease remains inconclusive. Methods: We conducted a systematic review and meta-analysis to assess bone mineral density and the risk of osteoporosis and fractures in patients with psoriatic disease, including those with cutaneous psoriasis and psoriatic arthritis. We searched electronic databases for published observational studies. A meta-analysis was performed using the random-effect model. Pooled estimates and their confidence intervals (CIs) were calculated. Small-study effects were examined using the Doi plot and Luis Furuya–Kanamori index. Results: The analysis of the standardized mean difference in the absolute value of bone mineral density at different measuring sites (lumbar spine, femoral neck, and total hip) revealed no significant difference between patients with psoriatic disease and non-psoriatic controls. The pooled results of the adjusted odds ratios (ORs) demonstrated no increased risk of osteoporosis in patients with psoriatic disease. Notably, patients with psoriatic disease had a higher OR of developing bone fractures (adjusted OR: 1.09; 95% CI: 1.06 to 1.12; I2: 0%). Conclusion: Patients with psoriatic disease may be more likely to develop fractures compared with non-psoriatic controls. This higher risk for fracture may not necessarily be associated with lower bone mineral density nor a higher risk for osteoporosis. View Full-Text
Keywords: bone mineral density; osteoporosis; fracture; bone fragility; psoriasis; psoriatic arthritis; meta-analysis bone mineral density; osteoporosis; fracture; bone fragility; psoriasis; psoriatic arthritis; meta-analysis
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MDPI and ACS Style

Chen, T.-L.; Lu, J.-W.; Huang, Y.-W.; Wang, J.-H.; Su, K.-Y. Bone Mineral Density, Osteoporosis, and Fracture Risk in Adult Patients with Psoriasis or Psoriatic Arthritis: A Systematic Review and Meta-Analysis of Observational Studies. J. Clin. Med. 2020, 9, 3712. https://doi.org/10.3390/jcm9113712

AMA Style

Chen T-L, Lu J-W, Huang Y-W, Wang J-H, Su K-Y. Bone Mineral Density, Osteoporosis, and Fracture Risk in Adult Patients with Psoriasis or Psoriatic Arthritis: A Systematic Review and Meta-Analysis of Observational Studies. Journal of Clinical Medicine. 2020; 9(11):3712. https://doi.org/10.3390/jcm9113712

Chicago/Turabian Style

Chen, Tai-Li; Lu, Jing-Wun; Huang, Yu-Wen; Wang, Jen-Hung; Su, Kuei-Ying. 2020. "Bone Mineral Density, Osteoporosis, and Fracture Risk in Adult Patients with Psoriasis or Psoriatic Arthritis: A Systematic Review and Meta-Analysis of Observational Studies" J. Clin. Med. 9, no. 11: 3712. https://doi.org/10.3390/jcm9113712

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