Skip to main content
Erschienen in: Osteoporosis International 2/2017

30.08.2016 | Original Article

A meta-analysis of breastfeeding and osteoporotic fracture risk in the females

verfasst von: X. Duan, J. Wang, X. Jiang

Erschienen in: Osteoporosis International | Ausgabe 2/2017

Einloggen, um Zugang zu erhalten

Abstract

Summary

Our meta-analysis included 12 studies from PubMed, Embase, and Web of Science. Finding indicated breastfeeding may well reduce the risk of osteoporotic fracture.

Introduction

Several epidemiologic studies have investigated that breastfeeding is associated with short-term bone loss in the women, but the long-term effect on osteoporotic fracture risk remains unclear. Thus, we conducted this meta-analysis to explore the potential association between breastfeeding and osteoporotic fracture risk in the females and possible dose-response relationship between them.

Methods

We searched PubMed, Embase, and Web of Science (ISI) up to April 2016 for relevant articles associated between breastfeeding and osteoporotic fracture. Pooled relative risks (RRs) with 95 % confidence intervals (CIs) were calculated with a random-effects model. Dose-response analysis was performed by restricted cubic spline.

Results

Twelve articles including 14,954 participants were identified. The pooled RRs of osteoporotic hip and forearm fracture for the highest vs lowest duration of breastfeeding were 0.84 (95 % CI 0.67–1.05), 0.72 (95 % CI 0.52–0.99), and 0.82 (95 % CI 0.56–1.19), respectively. In subgroup analysis, breastfeeding was associated with a decreased risk of osteoporotic fracture in case-control study (RR = 0.70, 95 % CI 0.49–0.99) and postmenopausal women (RR = 0.66, 95 % CI 0.47–0.93). In dose-response analysis, osteoporotic and hip fracture risk decreased by 0.9 and 1.2 % for each month increment of breastfeeding, respectively.

Conclusions

Our meta-analysis revealed that breastfeeding may well reduce the risk of osteoporotic fracture. More cohort studies with large sample sizes are needed to confirm the conclusion.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
3.
Zurück zum Zitat Gullberg B, Johnell O, Kanis JA (1997) World-wide projections for hip fracture. Osteoporos Int 7(5):407–413CrossRefPubMed Gullberg B, Johnell O, Kanis JA (1997) World-wide projections for hip fracture. Osteoporos Int 7(5):407–413CrossRefPubMed
4.
Zurück zum Zitat Kang HY, Kang DR, Jang YH, Park SE, Choi WJ, Moon SH, Yang KH (2008) Estimating the economic burden of osteoporotic vertebral fracture among elderly Korean women. Journal of preventive medicine and public health = Yebang Uihakhoe chi 41(5):287–294. doi:10.3961/jpmph.2008.41.5.287 CrossRefPubMed Kang HY, Kang DR, Jang YH, Park SE, Choi WJ, Moon SH, Yang KH (2008) Estimating the economic burden of osteoporotic vertebral fracture among elderly Korean women. Journal of preventive medicine and public health = Yebang Uihakhoe chi 41(5):287–294. doi:10.​3961/​jpmph.​2008.​41.​5.​287 CrossRefPubMed
5.
Zurück zum Zitat Singer A, Exuzides A, Spangler L, O'Malley C, Colby C, Johnston K, Agodoa I, Baker J, et al. (2015) Burden of illness for osteoporotic fractures compared with other serious diseases among postmenopausal women in the United States. Mayo Clin Proc 90(1):53–62. doi:10.1016/j.mayocp.2014.09.011 CrossRefPubMed Singer A, Exuzides A, Spangler L, O'Malley C, Colby C, Johnston K, Agodoa I, Baker J, et al. (2015) Burden of illness for osteoporotic fractures compared with other serious diseases among postmenopausal women in the United States. Mayo Clin Proc 90(1):53–62. doi:10.​1016/​j.​mayocp.​2014.​09.​011 CrossRefPubMed
6.
Zurück zum Zitat Johansson H, Kanis JA, Oden A, McCloskey E, Chapurlat RD, Christiansen C, Cummings SR, Diez-Perez A, et al. (2014) A meta-analysis of the association of fracture risk and body mass index in women. J Bone Miner Res 29(1):223–233. doi:10.1002/jbmr.2017 CrossRefPubMed Johansson H, Kanis JA, Oden A, McCloskey E, Chapurlat RD, Christiansen C, Cummings SR, Diez-Perez A, et al. (2014) A meta-analysis of the association of fracture risk and body mass index in women. J Bone Miner Res 29(1):223–233. doi:10.​1002/​jbmr.​2017 CrossRefPubMed
9.
Zurück zum Zitat Handel MN, Heitmann BL (2015) Nutrient and food intakes in early life and risk of childhood fractures: a systematic review and meta-analysis. 102(5):1182–1195. doi:10.3945/ajcn.115.108456 Handel MN, Heitmann BL (2015) Nutrient and food intakes in early life and risk of childhood fractures: a systematic review and meta-analysis. 102(5):1182–1195. doi:10.​3945/​ajcn.​115.​108456
10.
Zurück zum Zitat Wang Q, Huang Q, Zeng Y, Liang J, Liu Sy GX, Ja L (2016) Parity and osteoporotic fracture risk in postmenopausal women: a dose-response meta-analysis of prospective studies. Osteoporos Int 27(1):319–330. doi:10.1007/s00198-015-3351-3 CrossRefPubMed Wang Q, Huang Q, Zeng Y, Liang J, Liu Sy GX, Ja L (2016) Parity and osteoporotic fracture risk in postmenopausal women: a dose-response meta-analysis of prospective studies. Osteoporos Int 27(1):319–330. doi:10.​1007/​s00198-015-3351-3 CrossRefPubMed
12.
Zurück zum Zitat Zhou Y, Chen J, Li Q, Huang W, Lan H, Jiang H (2015) Association between breastfeeding and breast cancer risk: evidence from a meta-analysis. Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine 10(3):175–182. doi:10.1089/bfm.2014.0141 CrossRef Zhou Y, Chen J, Li Q, Huang W, Lan H, Jiang H (2015) Association between breastfeeding and breast cancer risk: evidence from a meta-analysis. Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine 10(3):175–182. doi:10.​1089/​bfm.​2014.​0141 CrossRef
15.
Zurück zum Zitat Kalkwarf HJ (1999) Hormonal and dietary regulation of changes in bone density during lactation and after weaning in women. J Mammary Gland Biol Neoplasia 4(3):319–329CrossRefPubMed Kalkwarf HJ (1999) Hormonal and dietary regulation of changes in bone density during lactation and after weaning in women. J Mammary Gland Biol Neoplasia 4(3):319–329CrossRefPubMed
16.
18.
Zurück zum Zitat Canal-Macias ML, Roncero-Martin R, Moran JM, Lavado-Garcia JM, Costa-Fernandez Mdel C, Pedrera-Zamorano JD (2013) Increased bone mineral density is associated with breastfeeding history in premenopausal Spanish women. Archives of medical science : AMS 9(4):703–708. doi:10.5114/aoms.2013.36903 CrossRefPubMedPubMedCentral Canal-Macias ML, Roncero-Martin R, Moran JM, Lavado-Garcia JM, Costa-Fernandez Mdel C, Pedrera-Zamorano JD (2013) Increased bone mineral density is associated with breastfeeding history in premenopausal Spanish women. Archives of medical science : AMS 9(4):703–708. doi:10.​5114/​aoms.​2013.​36903 CrossRefPubMedPubMedCentral
21.
Zurück zum Zitat Ahn SK, Kam S, Chun BY (2014) Incidence of and factors for self-reported fragility fractures among middle-aged and elderly women in rural Korea: an 11-year follow-up study. Journal of Preventive Medicine and Public Health 47(6):289–297PubMedPubMedCentral Ahn SK, Kam S, Chun BY (2014) Incidence of and factors for self-reported fragility fractures among middle-aged and elderly women in rural Korea: an 11-year follow-up study. Journal of Preventive Medicine and Public Health 47(6):289–297PubMedPubMedCentral
23.
Zurück zum Zitat Bjornerem A, Ahmed LA, Jorgensen L, Stormer J, Joakimsen RM (2011) Breastfeeding protects against hip fracture in postmenopausal women: the Tromso study. J Bone Miner Res 26(12):2843–2850. doi:10.1002/jbmr.496 CrossRefPubMed Bjornerem A, Ahmed LA, Jorgensen L, Stormer J, Joakimsen RM (2011) Breastfeeding protects against hip fracture in postmenopausal women: the Tromso study. J Bone Miner Res 26(12):2843–2850. doi:10.​1002/​jbmr.​496 CrossRefPubMed
25.
Zurück zum Zitat Naves M, Diaz-Lopez JB, Gomez C, Rodriguez-Rebollar A, Cannata-Andia JB (2005) Determinants of incidence of osteoporotic fractures in the female Spanish population older than 50. Osteoporos Int 16(12):2013–2017. doi:10.1007/s00198-005-1983-4 CrossRefPubMed Naves M, Diaz-Lopez JB, Gomez C, Rodriguez-Rebollar A, Cannata-Andia JB (2005) Determinants of incidence of osteoporotic fractures in the female Spanish population older than 50. Osteoporos Int 16(12):2013–2017. doi:10.​1007/​s00198-005-1983-4 CrossRefPubMed
26.
Zurück zum Zitat Alderman BW, Weiss NS, Daling JR, Ure CL, Ballard JH (1986) Reproductive history and postmenopausal risk of hip and forearm fracture. Am J Epidemiol 124(2):262–267CrossRefPubMed Alderman BW, Weiss NS, Daling JR, Ure CL, Ballard JH (1986) Reproductive history and postmenopausal risk of hip and forearm fracture. Am J Epidemiol 124(2):262–267CrossRefPubMed
27.
Zurück zum Zitat Stewart LA, Clarke M, Rovers M, Riley RD, Simmonds M, Stewart G, Tierney JF (2015) Preferred reporting items for systematic review and meta-analyses of individual participant data: the PRISMA-IPD statement. JAMA 313(16):1657–1665. doi:10.1001/jama.2015.3656 CrossRefPubMed Stewart LA, Clarke M, Rovers M, Riley RD, Simmonds M, Stewart G, Tierney JF (2015) Preferred reporting items for systematic review and meta-analyses of individual participant data: the PRISMA-IPD statement. JAMA 313(16):1657–1665. doi:10.​1001/​jama.​2015.​3656 CrossRefPubMed
28.
Zurück zum Zitat Johnell O, Gullberg B, Kanis JA, Allander E, Elffors L, Dequeker J, Dilsen G, Gennari C, et al. (1995) Risk factors for hip fracture in European women: the MEDOS study. Mediterranean Osteoporosis Study. J Bone Miner Res 10(11):1802–1815. doi:10.1002/jbmr.5650101125 CrossRefPubMed Johnell O, Gullberg B, Kanis JA, Allander E, Elffors L, Dequeker J, Dilsen G, Gennari C, et al. (1995) Risk factors for hip fracture in European women: the MEDOS study. Mediterranean Osteoporosis Study. J Bone Miner Res 10(11):1802–1815. doi:10.​1002/​jbmr.​5650101125 CrossRefPubMed
29.
Zurück zum Zitat Clark P, de la Pena F, Gomez Garcia F, Orozco JA, Tugwell P (1998) Risk factors for osteoporotic hip fractures in Mexicans. Arch Med Res 29(3):253–257PubMed Clark P, de la Pena F, Gomez Garcia F, Orozco JA, Tugwell P (1998) Risk factors for osteoporotic hip fractures in Mexicans. Arch Med Res 29(3):253–257PubMed
30.
Zurück zum Zitat Mallmin H, Ljunghall S, Persson I, Bergstrom R (1994) Risk factors for fractures of the distal forearm: a population-based case-control study. Osteoporos Int 4(6):298–304CrossRefPubMed Mallmin H, Ljunghall S, Persson I, Bergstrom R (1994) Risk factors for fractures of the distal forearm: a population-based case-control study. Osteoporos Int 4(6):298–304CrossRefPubMed
31.
Zurück zum Zitat Michaelsson K, Baron JA, Farahmand BY, Ljunghall S (2001) Influence of parity and lactation on hip fracture risk. Am J Epidemiol 153(12):1166–1172CrossRefPubMed Michaelsson K, Baron JA, Farahmand BY, Ljunghall S (2001) Influence of parity and lactation on hip fracture risk. Am J Epidemiol 153(12):1166–1172CrossRefPubMed
32.
Zurück zum Zitat Hoffman S, Grisso JA, Kelsey JL, Gammon MD, O'Brien LA (1993) Parity, lactation and hip fracture. Osteoporos Int 3(4):171–176CrossRefPubMed Hoffman S, Grisso JA, Kelsey JL, Gammon MD, O'Brien LA (1993) Parity, lactation and hip fracture. Osteoporos Int 3(4):171–176CrossRefPubMed
33.
Zurück zum Zitat Chan HH, Lau EM, Woo J, Lin F, Sham A, Leung PC (1996) Dietary calcium intake, physical activity and the risk of vertebral fracture in Chinese. Osteoporos Int 6(3):228–232CrossRefPubMed Chan HH, Lau EM, Woo J, Lin F, Sham A, Leung PC (1996) Dietary calcium intake, physical activity and the risk of vertebral fracture in Chinese. Osteoporos Int 6(3):228–232CrossRefPubMed
34.
Zurück zum Zitat Cumming RG, Klineberg RJ (1993) Breastfeeding and other reproductive factors and the risk of hip fractures in elderly women. Int J Epidemiol 22(4):684–691CrossRefPubMed Cumming RG, Klineberg RJ (1993) Breastfeeding and other reproductive factors and the risk of hip fractures in elderly women. Int J Epidemiol 22(4):684–691CrossRefPubMed
35.
Zurück zum Zitat Zhu Y, Goff JP, Reinhardt TA, Horst RL (1998) Pregnancy and lactation increase vitamin D-dependent intestinal membrane calcium adenosine triphosphatase and calcium binding protein messenger ribonucleic acid expression. Endocrinology 139(8):3520–3524. doi:10.1210/endo.139.8.6141 PubMed Zhu Y, Goff JP, Reinhardt TA, Horst RL (1998) Pregnancy and lactation increase vitamin D-dependent intestinal membrane calcium adenosine triphosphatase and calcium binding protein messenger ribonucleic acid expression. Endocrinology 139(8):3520–3524. doi:10.​1210/​endo.​139.​8.​6141 PubMed
36.
Zurück zum Zitat Cross NA, Hillman LS, Allen SH, Krause GF, Vieira NE (1995) Calcium homeostasis and bone metabolism during pregnancy, lactation, and postweaning: a longitudinal study. Am J Clin Nutr 61(3):514–523PubMed Cross NA, Hillman LS, Allen SH, Krause GF, Vieira NE (1995) Calcium homeostasis and bone metabolism during pregnancy, lactation, and postweaning: a longitudinal study. Am J Clin Nutr 61(3):514–523PubMed
37.
Zurück zum Zitat Sowers M, Eyre D, Hollis BW, Randolph JF, Shapiro B, Jannausch ML, Crutchfield M (1995) Biochemical markers of bone turnover in lactating and nonlactating postpartum women. J Clin Endocrinol Metab 80(7):2210–2216. doi:10.1210/jcem.80.7.7608281 PubMed Sowers M, Eyre D, Hollis BW, Randolph JF, Shapiro B, Jannausch ML, Crutchfield M (1995) Biochemical markers of bone turnover in lactating and nonlactating postpartum women. J Clin Endocrinol Metab 80(7):2210–2216. doi:10.​1210/​jcem.​80.​7.​7608281 PubMed
38.
Zurück zum Zitat Ardeshirpour L, Dann P, Adams DJ, Nelson T, VanHouten J, Horowitz MC, Wysolmerski JJ (2007) Weaning triggers a decrease in receptor activator of nuclear factor-kappaB ligand expression, widespread osteoclast apoptosis, and rapid recovery of bone mass after lactation in mice. Endocrinology 148(8):3875–3886. doi:10.1210/en.2006-1467 CrossRefPubMed Ardeshirpour L, Dann P, Adams DJ, Nelson T, VanHouten J, Horowitz MC, Wysolmerski JJ (2007) Weaning triggers a decrease in receptor activator of nuclear factor-kappaB ligand expression, widespread osteoclast apoptosis, and rapid recovery of bone mass after lactation in mice. Endocrinology 148(8):3875–3886. doi:10.​1210/​en.​2006-1467 CrossRefPubMed
39.
Zurück zum Zitat Kalkwarf HJ, Specker BL, Heubi JE, Vieira NE, Yergey AL (1996) Intestinal calcium absorption of women during lactation and after weaning. Am J Clin Nutr 63(4):526–531PubMed Kalkwarf HJ, Specker BL, Heubi JE, Vieira NE, Yergey AL (1996) Intestinal calcium absorption of women during lactation and after weaning. Am J Clin Nutr 63(4):526–531PubMed
Metadaten
Titel
A meta-analysis of breastfeeding and osteoporotic fracture risk in the females
verfasst von
X. Duan
J. Wang
X. Jiang
Publikationsdatum
30.08.2016
Verlag
Springer London
Erschienen in
Osteoporosis International / Ausgabe 2/2017
Print ISSN: 0937-941X
Elektronische ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-016-3753-x

Weitere Artikel der Ausgabe 2/2017

Osteoporosis International 2/2017 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Arthroskopie kann Knieprothese nicht hinauszögern

25.04.2024 Gonarthrose Nachrichten

Ein arthroskopischer Eingriff bei Kniearthrose macht im Hinblick darauf, ob und wann ein Gelenkersatz fällig wird, offenbar keinen Unterschied.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Ärztliche Empathie hilft gegen Rückenschmerzen

23.04.2024 Leitsymptom Rückenschmerzen Nachrichten

Personen mit chronischen Rückenschmerzen, die von einfühlsamen Ärzten und Ärztinnen betreut werden, berichten über weniger Beschwerden und eine bessere Lebensqualität.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.