Atopic dermatitis and the risk of osteoporosis and fractures: a meta-analysis of cohort studies.
Hongfei Liu, Huilin Ru, Peng Yu et al.
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In 30 seconds
This systematic review and random-effects meta-analysis synthesized cohort studies examining osteoporosis and fracture risk in people with atopic dermatitis (AD). Across ten studies, AD was associated with higher odds of osteoporosis (OR = 1.56, 95% CI: 1.14-2.13) and all-cause fractures (OR = 1.08, 95% CI: 1.05-1.10). Fracture risk increased progressively with AD severity; vertebral and lower limb fractures also showed elevated odds. These observational findings indicate an association, not proof that AD causes skeletal outcomes.
Key findings
- Osteoporosis odds were higher in AD patients (OR = 1.56, 95% CI: 1.14-2.13; I² = 99.9%).
- All-cause fracture odds were higher in AD patients (OR = 1.08, 95% CI: 1.05-1.10; I² = 82.1%).
- Fracture risk increased with AD severity; vertebral fracture odds were OR = 1.14, 95% CI: 1.08-1.20.
- Lower limb fracture odds were OR = 1.11, 95% CI: 1.08-1.13.
Why it matters
The pooled findings suggest that skeletal health may be relevant when assessing people with AD, particularly when disease is more severe. Recognising the reported association can support clinical awareness of osteoporosis and fracture outcomes, while the substantial heterogeneity and observational design mean the estimates should not be interpreted as evidence that AD itself causes these outcomes.
What to keep in mind
The evidence comes from cohort studies, so it cannot establish causation. Heterogeneity was substantial for osteoporosis and all-cause fracture estimates (I² = 99.9% and 82.1%, respectively).