Parkinson's disease (PD) is a neurodegenerative disorder that is common in older individuals. PD patients have an increased risk of fractures compared to the general population, perhaps due to multiple falls. However, the fracture risk has not been fully assessed. To assess the impact of PD on the risk of hip and non-vertebral fractures, we conducted a systematic review and meta-analysis. Comprehensive searches of three key bibliographic databases were conducted to identify reviews and primary studies relating to the risk of fractures in patients with PD. Search terms included all relevant terms for Parkinson's disease and for fractures. We selected observational studies with data on the risk of fractures in adults with PD compared to controls without the diagnosis. Study quality was assessed using the Newcastle Ottawa Scale. The random-effects model was used to pool the results. Eighteen studies were included in the review. Seventeen independent studies (14 cohort and 3 case-control studies) were included in the hip fracture analysis. Nine studies (all cohorts, no case-control studies) were included in the non-vertebral fracture analysis. Study quality was judged to be moderate to good. Overall, PD patients had an increased risk for both hip fractures (2.40, 95% CI 2.04 to 2.82) and non-vertebral fractures (1.80, 95% CI 1.60 to 2.01) compared to controls. The relative risk for hip fractures was higher in men (2.93, 95% CI 2.05 to 4.18) than in women (1.81, 95% CI 1.61 to 2.04). There were no effects of the study design, geographical region, or criteria for diagnosing Parkinson's disease on these estimates of fracture risk. There is an increase in the risk of hip and non-vertebral fractures in patients with Parkinson's disease and we recommend a re-evaluation of the clinical guidelines on bone health in patients with PD to address this.

中文翻译：

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帕金森病和帕金森综合征患者髋部和非椎骨骨折的风险：系统评价和荟萃分析

帕金森病 (PD) 是一种神经退行性疾病，常见于老年人。与一般人群相比，PD 患者骨折的风险更高，这可能是由于多次跌倒所致。然而，骨折风险尚未得到充分评估。为了评估 PD 对髋部和非椎体骨折风险的影响，我们进行了系统回顾和荟萃分析。对三个关键书目数据库进行了全面检索，以确定与 PD 患者骨折风险相关的评论和初步研究。搜索术语包括帕金森病和骨折的所有相关术语。我们选择了观察性研究，其中包含与未诊断的对照组相比，患有 PD 的成人骨折风险的数据。使用纽卡斯尔渥太华量表评估研究质量。使用随机效应模型来汇总结果。审查中纳入了十八项研究。髋部骨折分析中纳入了 17 项独立研究（14 项队列研究和 3 项病例对照研究）。非椎体骨折分析中纳入了九项研究（所有队列，无病例对照研究）。研究质量被评为中等至良好。总体而言，与对照组相比，PD 患者髋部骨折（2.40，95% CI 2.04 至 2.82）和非椎骨骨折（1.80，95% CI 1.60 至 2.01）的风险均增加。男性髋部骨折的相对风险（2.93，95% CI 2.05 至 4.18）高于女性（1.81，95% CI 1.61 至 2.04）。研究设计、地理区域或帕金森病诊断标准对骨折风险的估计没有影响。帕金森病患者发生髋部和非椎骨骨折的风险增加，我们建议重新评估帕金森病患者骨骼健康临床指南以解决这一问题。