Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2020 Jun 25:26:e925707.
doi: 10.12659/MSM.925707.

The Analysis for Anemia Increasing Fracture Risk

Yirong Teng  1 , Zhaowei Teng  1 , Shuanglan Xu  2 , Xiguang Zhang  1 , Jie Liu  2 , Qiaoning Yue  1 , Yun Zhu  1 , Yong Zeng  1
Affiliations
Meta-Analysis

The Analysis for Anemia Increasing Fracture Risk

Yirong Teng et al. Med Sci Monit. .

Abstract

BACKGROUND Fractures are a major public health problem for elderly people throughout the world. Anemia is also a common, important health problem among elderly populations. The aim of this article was to estimate the association between anemia and fracture incidence via a systematic review and meta-analysis. MATERIAL AND METHODS The participant, intervention, observation, and study design (PICOS) reporting guidelines were followed, and databases were searched from their inception to May 2020 to identify relevant studies. When heterogeneity was significant, and a random-effects model was used. Subgroup analysis was conducted to explore the source of heterogeneity based on sex, study design, and region. RESULTS We found that anemia significantly increased fracture risk [relative risk (RR)=1.26, 95% confidence interval (CI)=1.14-1.39, P<0.001], specifically, hip fracture (RR=1.44, 95% CI=1.29-1.61), spine fracture (RR=1.15, 95% CI=1.08-1.23), and nonspine fracture (RR=1.42, 95% CI=1.33-1.52). Males with anemia had a 1.51-fold higher fracture risk, females had a 1.09-fold higher fracture risk. And the association was stronger in Asian (RR=1.22, 95% CI=1.07-1.40), but not in American and European study populations. CONCLUSIONS In conclusion, a significantly increased fracture risk was observed, and anemia can be a predictor of fracture risk.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest

None.

Figures

Figure 1
Figure 1
Flow chart of the meta-analysis.
Figure 2
Figure 2
Forest plot. (A). Forest plot of the of anemia association with fracture risk. (B) Forest plot of anemia association with hip fracture risk. (C) Forest plot of anemia association with spine fracture risk. (D) Forest plot of anemia association with nonspine fracture risk. (CI – confidence interval).
Figure 3
Figure 3
Sensitivity analysis. The analysis was performed via recalculation of the pooled results of the primary analysis after exclusion of one study per iteration.
See this image and copyright information in PMC

References

    1. Nguyen TV. Toward the era of precision fracture risk assessment. J Clin Endocrinol Metab. 2020;105(7) dgaa222. - PubMed
    1. Leslie WD, Morin SN. New developments in fracture risk assessment for current osteoporosis reports. Curr Osteoporos Rep. 2020;18(3):115–29. - PubMed
    1. Brauer CA, Coca-Perraillon M, Cutler DM, et al. Incidence and mortality of hip fractures in the United States. JAMA. 2009;302(14):1573–79. - PMC - PubMed
    1. Trajanoska K, Schoufour JD, De Jonge EAL, et al. Fracture incidence and secular trends between 1989 and 2013 in a population-based cohort: The Rotterdam Study. Bone. 2018;114:116–24. - PubMed
    1. Sheehan KJ, Williamson L, Alexander J, et al. Prognostic factors of functional outcome after hip fracture surgery: A systematic review. Age Ageing. 2018;47(5):661–70. - PubMed