Prevalence of osteoporosis in chronic diseases: an umbrella review of 283 observational studies from 13 systematic reviews.

INTRODUCTION

Osteoporosis is a disease characterized by decreased bone mineral density and deterioration of bone microarchitecture, which increases fracture risk. In the context of various chronic pathologies, this condition may present an even higher prevalence, impacting morbidity, mortality, and healthcare burden.

OBJECTIVE

To synthesize and compare available evidence from systematic reviews on the prevalence of osteoporosis across different chronic diseases.

METHODOLOGY

An umbrella review following PRISMA guidelines was conducted, focusing on systematic reviews (with or without meta-analysis) reporting prevalence data of osteoporosis in adults with at least one chronic disease. Databases, including PubMed/MEDLINE, Scopus, Web of Science, and EMBASE, were searched, covering publications between 2009 and 2023, without language restrictions. Two independent reviewers performed study selection and data extraction, resolving discrepancies through consensus. A risk of bias assessment was conducted using the ROBIS tool. Prevalence estimates reported in each review were analyzed, classifying diseases according to the magnitude of the percentages found.

RESULTS

Thirteen systematic reviews were evaluated (twelve included meta-analyses). The highest prevalence of osteoporosis was observed in patients with Chronic Obstructive Pulmonary Disease (up to 36.8%) and diabetes mellitus (approximately 27.7%). Other conditions, such as rheumatoid arthritis, multiple sclerosis, liver cirrhosis, and celiac disease, showed variable prevalence but were equally relevant in clinical terms. Methodological heterogeneity, both in diagnostic criteria and populations, was a notable factor.

CONCLUSIONS

The results highlight the need for systematic assessment of bone health in patients with chronic diseases, particularly those with a higher prevalence of osteoporosis. These findings underscore the importance of timely screening strategies and multidisciplinary approaches to prevent fractures and optimize comprehensive care.

CLINICAL TRIAL NUMBER

Not applicable.