Prevalence and risk factors of bone fragility in duchenne muscular dystrophy: A systematic review and meta-analysis
Authors' conclusion
Low BMD and fractures are highly prevalent globally in DMD, with bone fragility driven by multifactorial mechanisms.
Study context
- Population
- Patients with Duchenne muscular dystrophy (DMD)
- Participants
- 4,940 patients43 studies
- Outcome
- Pooled prevalence of low BMD and fractures
Methodological detailsrandom-effects meta-analysis, subgroup analyses by region, GC use, fracture location and ambulatory stage, PubMed, Embase, Cochrane library and Web of Science searched
- Random-effects meta-analysis
- Subgroup analyses by region, GC use, fracture location and ambulatory stage
- PubMed, Embase, Cochrane library and Web of Science searched
Pooled result
As reported in the abstract
Low bone mineral density (BMD), overall prevalence (95% CI, 0.45-0.79); range 0.16 to 0.93
0.62
Fracture, pooled prevalence (95% CI, 0.32-0.43); range 0.07 to 0.87
0.38
Further pooled results
Fracture prevalence by region
- North America
- 0.47 (95% CI, 0.39-0.56)
- Oceania
- 0.47 (95% CI, 0.40-0.54)
- Europe
- 0.30 (95% CI, 0.24-0.37)
- Asia
- 0.17 (95% CI, 0.07-0.27)
Fracture prevalence by GC use
- GC-treated
- 0.39
- Non-GC
- 0.23
Fracture prevalence by GC duration
- 3 years
- 0.23 (95% CI, 0.11-0.35)
- 3-6 years
- 0.33 (95% CI, 0.24-0.43)
- ≥ 6 years
- 0.59 (95% CI, 0.42-0.75)
Risk factors for bone fragility
- Multifactorial: beyond GC use and loss of ambulation, older age, vitamin D deficiency, fat mass accumulation and hormonal imbalances
Original publication
Prevalence and risk factors of bone fragility in duchenne muscular dystrophy: A systematic review and meta-analysis. Osteoporos Int. Published 11 August 2026. doi:10.
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