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Musculoskeletal conditions may increase the risk of chronic disease: A systematic review and meta-analysis of cohort studies

Abstract:
Background Chronic diseases and musculoskeletal conditions have a significant global burden and frequently co-occur. Musculoskeletal conditions may contribute to the development of chronic disease; however, this has not been systematically synthesised. We aimed to investigate whether the most common musculoskeletal conditions, neck or back pain or osteoarthritis of the knee or hip contribute to the development of chronic disease. Methods We searched CINAHL, Embase, Medline, Medline in Process, PsycINFO, Scopus and Web of Science to February 08, 2018, for cohort studies reporting adjusted estimates of the association between baseline musculoskeletal conditions (neck or back pain or osteoarthritis of the knee or hip) and subsequent diagnosis of a chronic disease (cardiovascular disease, cancer, diabetes, chronic respiratory disease or obesity). Two independent reviewers performed data extraction and assessed study quality. Adjusted hazard ratios were pooled using the generic inverse variance method in random effect models, regardless of the type of musculoskeletal condition or chronic disease. PROSPERO: CRD42016039519. Results There were 13 cohort studies following 3,086,612 people. In the primary meta-analysis of adjusted estimates osteoarthritis was the exposure in eight studies and back pain in two studies and cardiovascular disease was the outcome in eight studies, cancer in one study, and diabetes in one study. Pooled adjusted estimates from these ten studies showed that people with a musculoskeletal condition have a 17% increase in the rate of developing a chronic disease compared to people without a musculoskeletal condition (hazard ratio 1.17, 95% confidence interval 1.13 to 1.22; I2 52%, total n=2,686,113). Conclusions This meta-analysis found musculoskeletal conditions may increase the risk of chronic disease. In particular, osteoarthritis appears to increase the risk of developing cardiovascular disease. Prevention and early treatment of musculoskeletal conditions and targeting associated chronic disease risk factors in people with long standing musculoskeletal conditions may play a role in preventing other chronic diseases. However, greater understanding about why musculoskeletal conditions may increase the risk of chronic disease is needed.
Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1186/s12916-018-1151-2

Authors

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Institution:
University of Oxford
Division:
Medical Sciences Division
Department:
NDORMS
Sub department:
Botnar Research Centre
Department:
Unknown
Role:
Author
ORCID:
0000-0001-5692-0314


Publisher:
BioMed Central
Journal:
BMC Musculoskeletal Disorders More from this journal
Volume:
167
Issue:
16
Publication date:
2018-09-25
Acceptance date:
2018-08-15
DOI:
EISSN:
1471-2474


Keywords:
Pubs id:
pubs:911755
UUID:
uuid:1571dd16-856c-4dea-8cbd-9d6838bbde4a
Local pid:
pubs:911755
Source identifiers:
911755
Deposit date:
2018-09-03
ARK identifier:

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