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<p>Patients with ankylosing spondylitis are at greater risk of fractures and osteoporosis. This meta-analysis reveals their fracture and osteoporosis prevalence exceeds 13%. Two clinical indices, BASDAI and mSASSS, significantly correlate with fracture risk. These findings support early screening and targeted management to prevent skeletal complications and improve patient outcomes.&#xa0;Patients with Ankylosing Spondylitis (AS) face an elevated risk of fractures and osteoporosis, which negatively impact quality of life and increase healthcare costs. This study systematically evaluates the prevalence of these conditions in AS patients and analyzes the associated risk factors.&#xa0;As of October 10, 2024, we conducted a systematic search of PubMed, Embase, the Cochrane Library, and Web of Science for epidemiological studies on the risk factors or prevalence of fractures and osteoporosis in AS. Effect sizes were pooled using fixed- or random-effects models, with subgroup and sensitivity analyses. Publication bias was evaluated using funnel plots and Begg's or Egger's test.&#xa0;A total of 28 studies were included in the final analysis. The overall fracture prevalence in AS patients was 13% (95% CI: 9%-17%), vertebral fracture prevalence was 14% (95% CI: 9%-19%), and osteoporosis prevalence was 14% (95% CI: 10%-19%). AS was significantly associated with vertebral fractures (OR = 2.26; 95% CI: 1.70–3.00) and non-vertebral fractures (OR = 1.24; 95% CI: 1.02–1.50). Among AS assessment indices, BASDAI (OR = 1.05; 95% CI: 1.02–1.08) and mSASSS (OR = 1.04; 95% CI: 1.01–1.06) were significantly associated with fracture risk, while BASFI and BASRI were not.&#xa0;AS significantly increases the risk of fractures and osteoporosis in patients.&#xa0;The BASDAI and mSASSS scoring systems can help predict fracture risk, enabling enhanced early identification and monitoring of complications in AS patients. This approach may ultimately improve long-term health outcomes and quality of life for&#xa0;affected&#xa0;individuals.</p>

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Prevalence and relative risk of fractures and osteoporosis in patients with ankylosing spondylitis: a systematic review and meta-analysis

  • 期刊论文

  • 发表日期：

    2026年1月23日

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  • Yining Liu,
  • Xiang Ma,
  • Tengfei Dai,
  • Jiaming Zhang,
  • Yingbo Liu,
  • Wang Ren,
  • Jinsong Bian

摘要

Patients with ankylosing spondylitis are at greater risk of fractures and osteoporosis. This meta-analysis reveals their fracture and osteoporosis prevalence exceeds 13%. Two clinical indices, BASDAI and mSASSS, significantly correlate with fracture risk. These findings support early screening and targeted management to prevent skeletal complications and improve patient outcomes. Patients with Ankylosing Spondylitis (AS) face an elevated risk of fractures and osteoporosis, which negatively impact quality of life and increase healthcare costs. This study systematically evaluates the prevalence of these conditions in AS patients and analyzes the associated risk factors. As of October 10, 2024, we conducted a systematic search of PubMed, Embase, the Cochrane Library, and Web of Science for epidemiological studies on the risk factors or prevalence of fractures and osteoporosis in AS. Effect sizes were pooled using fixed- or random-effects models, with subgroup and sensitivity analyses. Publication bias was evaluated using funnel plots and Begg's or Egger's test. A total of 28 studies were included in the final analysis. The overall fracture prevalence in AS patients was 13% (95% CI: 9%-17%), vertebral fracture prevalence was 14% (95% CI: 9%-19%), and osteoporosis prevalence was 14% (95% CI: 10%-19%). AS was significantly associated with vertebral fractures (OR = 2.26; 95% CI: 1.70–3.00) and non-vertebral fractures (OR = 1.24; 95% CI: 1.02–1.50). Among AS assessment indices, BASDAI (OR = 1.05; 95% CI: 1.02–1.08) and mSASSS (OR = 1.04; 95% CI: 1.01–1.06) were significantly associated with fracture risk, while BASFI and BASRI were not. AS significantly increases the risk of fractures and osteoporosis in patients. The BASDAI and mSASSS scoring systems can help predict fracture risk, enabling enhanced early identification and monitoring of complications in AS patients. This approach may ultimately improve long-term health outcomes and quality of life for affected individuals.