title: Multiple sclerosis increases fracture risk: a meta-analysis.
abstract: OBJECTIVE
  The association between multiple sclerosis (MS) and fracture risk has been reported, but results of previous studies remain controversial and ambiguous. To assess the association between MS and fracture risk, a meta-analysis was performed.
  
  
  METHODS
  Based on comprehensive searches of the PubMed, Embase, and Web of Science, we identified outcome data from all articles estimating the association between MS and fracture risk. The pooled risk ratios (RRs) with 95% confidence intervals (CIs) were calculated.
  
  
  RESULTS
  A significant association between MS and fracture risk was found. This result remained statistically significant when the adjusted RRs were combined. Subgroup analysis stratified by the site of fracture suggested significant associations between MS and tibia fracture risk, femur fracture risk, hip fracture risk, pelvis fracture risk, vertebrae fracture risk, and humerus fracture risk. In the subgroup analysis by gender, female MS patients had increased fracture risk. When stratified by history of drug use, use of antidepressants, hypnotics/anxiolytics, anticonvulsants, and glucocorticoids increased the risk of fracture risk in MS patients.
  
  
  CONCLUSIONS
  This meta-analysis demonstrated that MS was significantly associated with fracture risk.
authors.affiliation: Department of Orthopedics, Harrison International Peace Hospital, Hengshui, Hebei 053000, China.
authors.forename: Guixian
authors.initials: G
authors.lastname: Dong
authors.affiliation: Department of Orthopedics, Harrison International Peace Hospital, Hengshui, Hebei 053000, China.
authors.forename: Ning
authors.initials: N
authors.lastname: Zhang
authors.affiliation: Department of Orthopedics, Harrison International Peace Hospital, Hengshui, Hebei 053000, China.
authors.forename: Zhanpo
authors.initials: Z
authors.lastname: Wu
authors.affiliation: Department of Orthopedics, Harrison International Peace Hospital, Hengshui, Hebei 053000, China.
authors.forename: Yumin
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Orthopedics, Harrison International Peace Hospital, Hengshui, Hebei 053000, China.
authors.forename: Litao
authors.initials: L
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D015984:Causality; D015897:Comorbidity; D005260:Female; D050723:Fractures, Bone / Q000175:diagnosis* / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000175:diagnosis* / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors