Nazanin Zahra Sepehri1, Tahereh Raeisi2, Bahman Razi3, Parisa Janmohammadi4, Mina Darand5, Shahab Alizadeh4. 1. School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. 2. Department of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran. 3. Department of Hematology and Blood Banking, School of Medicine, Tarbiat Modares University (TMU), Tehran, Iran. 4. Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran. 5. Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Abstract
BACKGROUND & AIMS: The possible association between psoriatic/psoriatic arthritis (PsA) and bone loss has been observed, however, studies have yielded inconclusive results. This meta-analysis aimed to assess whether there is an increase in the risk of osteoporosis, osteopenia, and fractures in patients with psoriasis/PsA, compared with healthy individuals. METHODS: PubMed and Scopus were systematically searched from their inception to September 2020 to identify relevant studies. Relative risk, hazard ratio, or odds ratio (OR), with their corresponding 95% confidence intervals (95% CI) were calculated and pooled using a random-effects model. RESULTS: A total of 12 different studies, with a total of 199,389,296 participants, were included. Overall, no significant relationship was observed between psoriasis/PsA and the risk of osteoporosis (psoriasis: OR=1.28, 95%CI=0.86-1.90; PsA: OR=1.32, 95%CI=0.79-2.19) and osteopenia (psoriasis: OR=1.50, 95%CI=0.75-3.02; PsA: OR=1.61, 95%CI=0.67-3.85). However, in the subgroup analysis, psoriasis was significantly associated with an increased risk of osteoporosis in males (OR=1.27, 95%CI=1.02-1.59) and studies with cohort design (OR=1.04, 95%CI=1.003-1.09). Psoriasis was also related to the risk of osteopenia in studies on a combination of both genders (OR=2.86, 95%CI=2.70-3.02). The pooled analysis demonstrated a significantly higher risk of fractures among patients with psoriasis (OR=1.29, 95%CI=1.02-1.63) and PsA (OR=2.88, 95%CI=1.51-5.48), compared with participants without psoriasis/PsA. CONCLUSIONS: Psoriasis/PsA patients have an increased risk of fractures. There is little evidence supporting the relation of psoriasis to osteoporosis/osteopenia. This article is protected by copyright. All rights reserved.
BACKGROUND & AIMS: The possible association between psoriatic/psoriatic arthritis (PsA) and bone loss has been observed, however, studies have yielded inconclusive results. This meta-analysis aimed to assess whether there is an increase in the risk of osteoporosis, osteopenia, and fractures in patients with psoriasis/PsA, compared with healthy individuals. METHODS: PubMed and Scopus were systematically searched from their inception to September 2020 to identify relevant studies. Relative risk, hazard ratio, or odds ratio (OR), with their corresponding 95% confidence intervals (95% CI) were calculated and pooled using a random-effects model. RESULTS: A total of 12 different studies, with a total of 199,389,296 participants, were included. Overall, no significant relationship was observed between psoriasis/PsA and the risk of osteoporosis (psoriasis: OR=1.28, 95%CI=0.86-1.90; PsA: OR=1.32, 95%CI=0.79-2.19) and osteopenia (psoriasis: OR=1.50, 95%CI=0.75-3.02; PsA: OR=1.61, 95%CI=0.67-3.85). However, in the subgroup analysis, psoriasis was significantly associated with an increased risk of osteoporosis in males (OR=1.27, 95%CI=1.02-1.59) and studies with cohort design (OR=1.04, 95%CI=1.003-1.09). Psoriasis was also related to the risk of osteopenia in studies on a combination of both genders (OR=2.86, 95%CI=2.70-3.02). The pooled analysis demonstrated a significantly higher risk of fractures among patients with psoriasis (OR=1.29, 95%CI=1.02-1.63) and PsA (OR=2.88, 95%CI=1.51-5.48), compared with participants without psoriasis/PsA. CONCLUSIONS:Psoriasis/PsA patients have an increased risk of fractures. There is little evidence supporting the relation of psoriasis to osteoporosis/osteopenia. This article is protected by copyright. All rights reserved.