Prevalence and risk factors of bone fragility in duchenne muscular dystrophy: A systematic review and meta-analysis.

What was studied

This was a review and pooled analysis of bone weakness in Duchenne muscular dystrophy (DMD). Many patients have weak bones because of muscle loss, low movement and steroid use. The team asked how common low bone density and fractures are. They also looked at risk factors. They searched PubMed, Embase, the Cochrane library and Web of Science. 43 studies with 4940 patients were reviewed.

What they found

Low bone density had a pooled prevalence of 0.62, and fractures 0.38. Fractures peaked at 0.47 in North America and Oceania. They were lowest in Asia, at 0.17. Fracture prevalence was 0.39 with glucocorticoid (GCs) use and 0.23 without it. It rose with longer GCs use. The figure was 0.59 at 6 years or more.

What it means for patients

The authors said low bone density and fractures are very common worldwide in DMD. They said risk factors go beyond GCs and loss of walking. Others are age, vitamin D deficiency, more body fat and hormone imbalance. They said the results may inform trials of bone-protective therapies.

Why it is not certain yet

Prevalence varied widely across studies, from 0.16 to 0.93 for low bone density. Fracture prevalence ran from 0.07 to 0.87. Studies differed by region, GCs use and walking stage. Pooled figures from different studies can hide differences between groups.

Source

Prevalence and risk factors of bone fragility in duchenne muscular dystrophy: A systematic review and meta-analysis.

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