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Changes in bone mineral density in Down syndrome individuals: a systematic review and meta-analysis

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Abstract

Data evaluating changes in bone mineral density (BMD) in Down syndrome (DS) individuals remains controversial. Therefore, we conducted a systematic review and meta-analysis to better understand associations between BMD and DS. A systematic literature search of PubMed, EMBASE, Web of Science, and the Cochrane Library up until 1st January 2021 was conducted. We used the keywords “bone mineral density” and “Down Syndrome.” Fifteen studies were included. Overall, our results showed a significant decrease in BMD of total body (TB BMD) [MD =  − 0.18; 95% CI (− 0.23 and − 0.12), P < 0.00001, I2 = 89%], total hip (TH BMD) [MD =  − 0.12; 95% CI (− 0.15 and − 0.10), P < 0.00001, I2 = 0%], lumbar spine (LS BMD) [MD =  − 0.12; 95% CI (− 0.14 and − 0.09), P < 0.00001, I2 = 18%], and femoral neck (FN BMD) [MD =  − 0.08; 95% CI (− 0.10 and − 0.06), P < 0.00001, I2 = 0%] in DS individuals when compared with controls. Moreover, the volumetric BMD of lumbar spine (LS vBMD) [MD =  − 0.01; 95% CI (− 0.02 and − 0.01), P = 0.0004, I2 = 19%] also showed a decreasing tendency while the volumetric BMD of the femoral neck (FN vBMD) [MD = 0.01; 95% CI (0.00 and 0.02), P = 0.02, I2 = 0%] was elevated in DS individuals versus controls. These findings demonstrated that individuals with DS had a decreased total and regional (TH, LS, and FN) BMD when compared with the general population. Additionally, when BMD was adjusted for skeletal volume, LS vBMD was also lower, while FN vBMD was elevated in DS individuals versus controls.

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Article Open access 01 July 2023

Enisa Shevroja, Jean-Yves Reginster, … Nicholas C. Harvey

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Funding

This project was supported by grants from the National Natural Science Foundation of China [No. 31671066].

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Authors and Affiliations

  1. Department of Pediatric, Peking University People’s Hospital, Beijing, 100044, China

    Y. Zhang, S. Ye, S. Ren, X. Hou & J. Guo

  2. Department of Obstetrics and Gynecology, Peking University People’s Hospital, Beijing, 100044, China

    Z. Tian

  3. Department of Central Laboratory & Institute of Clinical Molecular Biology, Peking University People’s Hospital, Beijing, 100044, China

    Q. Mu, X. Wang & W. Yu

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  1. Y. Zhang
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Yang Zhang, Zhao Tian, and Shuai Ye contributed equally to this work

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Zhang, Y., Tian, Z., Ye, S. et al. Changes in bone mineral density in Down syndrome individuals: a systematic review and meta-analysis. Osteoporos Int 33, 27–37 (2022). https://doi.org/10.1007/s00198-021-06070-7

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