Abstract:
|
The association between depression and risk of fracture remains controversial. We conducted an updated meta-analysis to examine depression on the risk of fracture and bone loss. We searched MEDLINE, EMBASE and PsycINFO et al. and identified 23 eligible cohort studies. Two investigators independently conducted study selection, appraisal, and data abstraction using standardized protocol. Random effect models were used for meta-analysis. Each study was weighted by the reciprocal of its variance. Cochran Q statistics were used to assess heterogeneity. In studies that reported HR (9 studies [n=309,862]), depression was associated with 26% increase in fracture risk (HR=1.26, 95% CI, 1.10-1.43, p< 0.001). Studies that reported RR (7 studies [n=64,975]) suggested that depression was associated with 39% increase in fracture risk (RR= 1.39, 95% CI, 1.19-1.62, p< 0.001). Depression was associated with a reduced mean annual bone loss rate of 0.35% (0.18%-0.53%, p< 0.001) in hip (eight studies [n=15,442]). All estimates are consistent in sensitivity analyses and subgroup analyses. This meta-analysis demonstrated that depression is associated with an increased risk of fracture and bone loss.
|