A meta‐analysis of prevalence estimates and moderators of low bone mass in people with schizophrenia. (10th July 2014)

• Record Type: Journal Article
• Authors: Stubbs, B.; De Hert, M.; Sepehry, A. A.; Correll, C. U.; Mitchell, A. J.; Soundy, A.; Detraux, J.; Vancampfort, D.
• Is Part Of: Acta psychiatrica Scandinavica. Volume 130:Number 6(2014:Dec.)
• Page Start: 470
• Page End: 486
• Publication Date: 2014-07-10
• Subjects: Psychiatry -- Periodicals; 616.89
• DOI: 10.1111/acps.12313
• Languages: English
• ISSNs: 0001-690X

Abstract

<abstract abstract-type="main" id="acps12313-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="acps12313-sec-0001" sec-type="section"> <title>Objective</title> <p>To assess the prevalence and moderators of low bone mass, osteopenia and osteoporosis in schizophrenia patients.</p> </sec> <sec id="acps12313-sec-0002" sec-type="section"> <title>Method</title> <p>Major electronic databases were searched from inception till December 2013 for studies reporting the prevalence of low bone mass (osteopenia + osteoporosis = primary outcome), osteopenia or osteoporosis in schizophrenia patients. Two independent authors completed methodological appraisal and extracted data. A random effects meta‐analysis was utilized.</p> </sec> <sec id="acps12313-sec-0003" sec-type="section"> <title>Results</title> <p>Nineteen studies were included (<italic>n</italic> = 3038 with schizophrenia; 59.2% male; age 24.5–58.9 years). The overall prevalence of low bone mass was 51.7% (95% CI = 43.1–60.3%); 40.0% (CI = 34.7–45.4%) had osteopenia and 13.2% (CI = 7.8–21.6%) had osteoporosis. Compared with controls, schizophrenia patients had significantly increased risk of low bone mass (OR = 1.9, CI = 1.30–2.77, <italic>P</italic> < 0.001, <italic>n</italic> = 1872) and osteoporosis (OR = 2.86, CI = 1.27–6.42, <italic>P</italic> = 0.01, <italic>n</italic> = 1824), but not osteopenia (OR = 1.33, CI = 0.934–1.90, <italic>P</italic> = 0.1, <italic>n</italic> = 1862). In an exploratory regression analysis, older age (<italic>P</italic> = 0.004) moderated low bone mass, while older age (<italic>P</italic> < 0.0001) and male sex (<italic>P</italic> < 0.0001) moderated osteoporosis. The subgroup analyses demonstrated high heterogeneity, but low bone mass was less prevalent in North America (35.5%, CI = 26.6–45.2%) than Europe (53.6%, CI = 38.0–68.5%) and Asia (58.4%, CI = 48.4–67.7%), and in mixed in‐/out‐patients (32.9%, CI = 49.6–70.1%) vs. in‐patients (60.3%, CI = 49.6–70.1%).</p> </sec> <sec id="acps12313-sec-0004" sec-type="section"> <title>Conclusion</title> <p>Reduced bone mass (especially osteoporosis) is significantly more common in people with schizophrenia than controls.</p> </sec> </abstract>