Evidence map›Paper›PMID 38816361›Full record

SynthesisTranslational psychiatry2024

The neglected association between schizophrenia and bone fragility: a systematic review and meta-analyses.

Behnaz Azimi Manavi, Kayla B Corney, Mohammadreza Mohebbi, Shae E Quirk, Amanda L Stuart, Julie A Pasco, Jason M Hodge, Michael Berk, Lana J Williams

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Translational psychiatry, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Review
  2. Article
  3. Review
  4. Review
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Behnaz Azimi ManaviDeakin University, Institute for Mental and Physical Health and Clinical Translation-IMPACT, Geelong, VIC, Australia. bazimimanavi@deakin.edu.au.ORCID 0000-0001-7450-1877
Kayla B CorneyDeakin University, Institute for Mental and Physical Health and Clinical Translation-IMPACT, Geelong, VIC, Australia.
Mohammadreza MohebbiDeakin University, Institute for Mental and Physical Health and Clinical Translation-IMPACT, Geelong, VIC, Australia.
Shae E QuirkDeakin University, Institute for Mental and Physical Health and Clinical Translation-IMPACT, Geelong, VIC, Australia.
Amanda L StuartDeakin University, Institute for Mental and Physical Health and Clinical Translation-IMPACT, Geelong, VIC, Australia.
Julie A PascoDeakin University, Institute for Mental and Physical Health and Clinical Translation-IMPACT, Geelong, VIC, Australia.ORCID 0000-0002-8968-4714
Jason M HodgeDeakin University, Institute for Mental and Physical Health and Clinical Translation-IMPACT, Geelong, VIC, Australia.
Michael BerkDeakin University, Institute for Mental and Physical Health and Clinical Translation-IMPACT, Geelong, VIC, Australia.
Lana J WilliamsDeakin University, Institute for Mental and Physical Health and Clinical Translation-IMPACT, Geelong, VIC, Australia.

Funding

Wellcome Trust
6 · The paper itself

Abstract

Schizophrenia is associated with increased risk of medical comorbidity, possibly including osteoporosis, which is a public health concern due to its significant social and health consequences. In this systematic review and meta-analysis, we aimed to determine whether schizophrenia is associated with bone fragility. The protocol for this review has been registered with PROSPERO (CRD42020171959). The research question and inclusion/exclusion criteria were developed and presented according to the PECO (Population, Exposure, Comparison, Outcome) framework. Schizophrenia was identified from medical records, DSM-IV/5 or the ICD. The outcomes for this review were bone fragility [i.e., bone mineral density (BMD), fracture, bone turnover markers, bone quality]. A search strategy was developed and implemented for the electronic databases. A narrative synthesis was undertaken for all included studies; the results from eligible studies reporting on BMD and fracture were pooled using a random effects model to complete a meta-analysis. The conduct of the review and reporting of results adhered to PRISMA guidelines. Our search yielded 3103 studies, of which 29 met the predetermined eligibility criteria. Thirty-seven reports from 29 studies constituted 17 studies investigating BMD, eight investigating fracture, three investigating bone quality and nine investigating bone turnover markers. The meta-analyses revealed that people with schizophrenia had lower BMD at the lumbar spine [standardised mean difference (SMD) -0.74, 95% CI -1.27, -0.20; Z = -2.71, p = 0.01] and at the femoral neck (SMD -0.78, 95% CI -1.03, -0.53; Z = -6.18, p ≤ 0.001). Also observed was a higher risk of fracture (OR 1.43, 95% CI 1.27, 1.61; Z = 5.88, p ≤ 0.001). Following adjustment for publication bias, the association between schizophrenia and femoral neck BMD (SMD -0.63, 95% CI -0.97, -0.29) and fracture (OR 1.32, 95% CI 1.28, 1.35) remained. Significantly increased risk of bone fragility was observed in people with schizophrenia. This association was independent of sex, participant number, methodological quality and year of publication.

Indexed as

Bone DensityOsteoporosisSchizophreniaFractures, BoneHumans

Identifiers

PMID38816361
PMCPMC11139985

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.