A meta-analysis of prevalence estimates and moderators of low bone mass in people with schizophrenia

作者：Stubbs B^*; De Hert M; Sepehry A A; Correll C U; Mitchell A J; Soundy A; Detraux J; Vancampfort D

来源：Acta Psychiatrica Scandinavica, 2014, 130(6): 470-486.

DOI：10.1111/acps.12313

• bone mineral density
• bone mass
• osteoporosis
• osteopenia
• schizophrenia
• physical health
• antipsychotics
• meta-analysis
• hyperprolactinemia
• screening

ObjectiveTo assess the prevalence and moderators of low bone mass, osteopenia and osteoporosis in schizophrenia patients. %26lt;br%26gt;MethodMajor 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. %26lt;br%26gt;ResultsNineteen studies were included (n=3038 with schizophrenia; 59.2% male; age 24.5-58.9years). 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, P%26lt;0.001, n=1872) and osteoporosis (OR=2.86, CI=1.27-6.42, P=0.01, n=1824), but not osteopenia (OR=1.33, CI=0.934-1.90, P=0.1, n=1862). In an exploratory regression analysis, older age (P=0.004) moderated low bone mass, while older age (P%26lt;0.0001) and male sex (P%26lt;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%). %26lt;br%26gt;ConclusionReduced bone mass (especially osteoporosis) is significantly more common in people with schizophrenia than controls.

• 出版日期2014-12