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Smoking and fracture risk in men: a meta-analysis of cohort studies, using both frequentist and Bayesian approaches

Xu, Yingke and Bao, Yueyang and Wang, Megan and Wu, Qing (2022) Smoking and fracture risk in men: a meta-analysis of cohort studies, using both frequentist and Bayesian approaches. Scientific Reports, 12 . Art. No. 9270. ISSN 2045-2322. PMCID PMC9166727. doi:10.1038/s41598-022-13356-1.

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Past studies indicate that men are more likely to smoke and be at higher risk of smoking-related conditions than women. Our research aimed, through meta-analysis, to assess the association between smoking and fracture risk in men. The following databases were searched, including MEDLINE, EMBASE, Scopus, PsycINFO, ISI Web of Science, Google Scholar, WorldCat, and Open Grey, for identifying related studies. A random-effects model was used to pool the confounder-adjusted relative risk (R.R.). Frequentist and Bayesian hierarchical random-effects models were used for the analysis. The heterogeneity and publication bias were evaluated in this study. Twenty-seven studies met the inclusion criteria. Overall, smoking is associated with a significantly increased risk of fracture in both the frequentist approach (R.R., 1.37; 95% confidence interval: 1.22, 1.53) and the Bayesian approach (R.R., 1.36; 95% credible interval: 1.22, 1.54). Significant heterogeneity was observed in the meta-analysis (Higgin's I2 = 83%) and Cochran's Q statistic (p < 0.01). A significant association was also observed in multiple pre-specified sensitivity and subgroup analyses. Similar results were observed in the group containing a large sample size (≥ 10,000 participants), and the group has a small sample size (< 10,000 participants); the pooled R.R was 1.23 (95% confidence interval, 1.07–1.41) and 1.56 (95% confidence interval, 1.37–1.78), respectively. With the Bayesian method, the effect size was 1.23 (95% credible interval, 1.05, 1.45) for the large sample size group and 1.57 (95% credible interval, 1.35, 1.82) for the small sample size group. Smoking is associated with a significant increase in fracture risk for men. Thus, smoking cessation would also greatly reduce fracture risk in all smokers, particularly in men.

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Wang, Megan0000-0001-8845-4936
Additional Information:© The Author(s) 2022. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit Received 08 June 2021. Accepted 16 May 2022. Published 03 June 2022. Contributions: Conceptualization, Q.W.; methodology, Y.X. and Q.W.; software, Y.X.; validation, Y.X., Y.B. and Q.W.; formal analysis, Y.X., Y.B., and M.W.; investigation, Y.X.; resources, Q.W.; data curation, Y.X.; writing—original draft preparation, Y.X.; writing—review and editing, Y.X. and Q.W.; visualization, Y.X.; supervision, Q.W.; project administration, Y.X. and Q.W.; All authors have read and agreed to the published version of the manuscript. The authors declare no competing interests.
PubMed Central ID:PMC9166727
Record Number:CaltechAUTHORS:20220606-736007000
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Official Citation:Xu, Y., Bao, Y., Wang, M. et al. Smoking and fracture risk in men: a meta-analysis of cohort studies, using both frequentist and Bayesian approaches. Sci Rep 12, 9270 (2022).
Usage Policy:No commercial reproduction, distribution, display or performance rights in this work are provided.
ID Code:115028
Deposited By: George Porter
Deposited On:07 Jun 2022 16:50
Last Modified:07 Jun 2022 16:50

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