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Association between depression and the risk for fracture: a meta-analysis and systematic review

机译：抑郁与骨折风险之间的关联：荟萃分析和系统评价

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Several studies have suggested that depression is associated with an increased risk for fracture; however, the results are conflicting. This study aimed to conduct a meta-analysis of cohort studies assessing the association between depression and the risk for fracture. Relevant studies were identified by a search of Web of Science, PubMed, Embase, China National Knowledge Infrastructure and WanFang database to Feb 2018. Cohort studies on the relationship between depression and the risk for fracture in the general population were included in the meta-analysis. Data collection was in accordance with the Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines, and the quality of the included studies was assessed using the Newcastle–Ottawa scale. Two independent investigators screened the abstracts and full texts of the studies, extracted data, and assessed the quality of the study. Either a fixed-effect or random-effects model was used to compute the pooled risk estimates when appropriate. In total, 16 cohort studies with 25 independent reports that included 414,686 participants during a follow-up duration of 3–14?years were included in the analysis. The pooled hazard ratio (HR) for total fracture was 1.24 (95% confidence interval [CI]: 1.14–1.35; P??0.001 for heterogeneity; random-effects model). In the subgroup analyses conducted in terms of study region, the pooled HR for the studies conducted in Europe was higher (HR: 1.76; 95% CI: 1.44–2.17; P?=?0.792 for heterogeneity) than that in America and Asia, with a significant difference between the groups (P?=?0.036). The results of our meta-analysis suggest that depression is prospectively associated with a significantly increased risk for fracture, which may have substantial implications, both clinical and preventive.
机译：多项研究表明，抑郁症与骨折风险增加有关。但是，结果是矛盾的。本研究旨在对队列研究进行荟萃分析，以评估抑郁与骨折风险之间的关系。通过搜索Web of Science，PubMed，Embase，中国国家知识基础设施和皖方数据库（截至2018年2月）确定了相关研究。荟萃分析包括了有关一般人群中抑郁与骨折风险之间关系的同类研究。 。数据收集符合流行病学观察性研究（MOOSE）指南的荟萃分析，并使用纽卡斯尔-渥太华量表对纳入研究的质量进行了评估。两名独立研究人员筛选了研究的摘要和全文，提取了数据并评估了研究的质量。适当时，可以使用固定效应模型或随机效应模型来计算汇总风险估计。分析共纳入了16项队列研究，其中25项独立报告，包括414,686名参与者，随访时间为3-14年。总骨折的危险比（HR）为1.24（95％置信区间[CI]：1.14-1.35;异质性P 0.001;随机效应模型）。在按研究区域进行的亚组分析中，欧洲进行的研究的合并HR高于美洲和亚洲（HR：1.76; 95％CI：1.44-2.17; P <= 0.792）;两组之间有显着差异（P≥0.036）。我们的荟萃分析结果表明，抑郁症可能与骨折风险显着增加相关，这可能对临床和预防都有重大影响。

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