{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T05:35:08Z","timestamp":1785648908184,"version":"3.56.0"},"reference-count":50,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,3,26]],"date-time":"2025-03-26T00:00:00Z","timestamp":1742947200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>The correlation between bone mineral density (BMD) and stroke remains inconsistent. This study aims to determine whether a reduction in BMD is associated with an increased risk of stroke.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We systematically searched Medline, Embase, and the Cochrane Database of Systematic Reviews through January 2025 to identify cohort studies with follow-up that reported the influence of a reduction in BMD or low BMD status on the risk of any type of stroke. Pooled analyses were performed using random-effects models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>This study included 13 studies with 146,758 individuals. A 1 SD reduction in BMD was associated with an increased risk of stroke (eight studies; RR, 1.24; 95% CI, 1.09\u20131.40; <jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.001; I<jats:sup>2<\/jats:sup>\u202f=\u202f87%). Subgroup analysis showed that a per SD reduction in BMD was associated with incident stroke in female persons (eight studies; RR, 1.28; 95% CI, 1.09\u20131.51; <jats:italic>p<\/jats:italic>\u202f=\u202f0.002; I<jats:sup>2<\/jats:sup>\u202f=\u202f87%), but not in male persons (four studies; RR, 1.04; 95% CI, 0.99\u20131.10; <jats:italic>p<\/jats:italic>\u202f=\u202f0.15; I<jats:sup>2<\/jats:sup>\u202f=\u202f0%). People with osteoporosis or osteopenia had an increased risk of incident stroke (six studies; RR, 1.59; 95% CI, 1.22\u20132.08; <jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.001; I<jats:sup>2<\/jats:sup>\u202f=\u202f92%), as well as male persons (two studies; RR, 3.16; 95% CI, 1.96\u20135.12; <jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.001; I<jats:sup>2<\/jats:sup>\u202f=\u202f35%). Sensitivity analysis showed that the results were stable.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Reduction in BMD is associated with a significantly increased risk of stroke. Female individuals have a higher risk than male persons.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2025.1561559","type":"journal-article","created":{"date-parts":[[2025,3,26]],"date-time":"2025-03-26T05:26:10Z","timestamp":1742966770000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Association between bone mineral density and stroke: a meta-analysis"],"prefix":"10.3389","volume":"16","author":[{"given":"Peng","family":"Zhao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huaxia","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,3,26]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"2429","DOI":"10.1056\/NEJMoa1804492","article-title":"Global, regional, and country-specific lifetime risks of stroke, 1990 and 2016","volume":"379","author":"Feigin","year":"2018","journal-title":"N Engl J Med"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"208","DOI":"10.1055\/s-0038-1649503","article-title":"Global burden of stroke","volume":"38","author":"Katan","year":"2018","journal-title":"Semin Neurol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"e897","DOI":"10.1016\/S2468-2667(21)00228-0","article-title":"Temporal trend and attributable risk factors of stroke burden in China, 1990-2019: an analysis for the global burden of disease study 2019","volume":"6","author":"Ma","year":"2021","journal-title":"Lancet Public Health"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"e254","DOI":"10.1161\/CIR.0000000000000950","article-title":"Heart disease and stroke statistics-2021 update: a report from the american heart association","volume":"143","author":"Virani","year":"2021","journal-title":"Circulation"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"119","DOI":"10.14740\/jocmr6070","article-title":"Clinical characteristics and bone mineral density score in Post-stroke neuromuscular deficit","volume":"17","author":"Saleh","year":"2025","journal-title":"J Clin Med Res"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"591","DOI":"10.1007\/s00198-015-3307-7","article-title":"Chronic effects of stroke on hip bone density and tibial morphology: a longitudinal study","volume":"27","author":"Lam","year":"2016","journal-title":"Osteoporos Int"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1161\/STROKEAHA.113.002999","article-title":"Bone mineral density and incidence of stroke: european prospective investigation into cancer-Norfolk population-based study, systematic review, and meta-analysis","volume":"45","author":"Myint","year":"2014","journal-title":"Stroke"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1169","DOI":"10.1007\/s10654-021-00803-y","article-title":"Bone mineral density and risk of cardiovascular disease in men and women: the hunt study","volume":"36","author":"Bhatta","year":"2021","journal-title":"Eur J Epidemiol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1016\/j.ijcard.2011.10.114","article-title":"Bone mineral density and all-cause, cardiovascular and stroke mortality: a meta-analysis of prospective cohort studies","volume":"166","author":"Qu","year":"2013","journal-title":"Int J Cardiol"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"368","DOI":"10.1007\/BF01622200","article-title":"Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: synopsis of a WHO report","volume":"4","author":"Kanis","year":"1994","journal-title":"Osteoporos Int"},{"key":"ref11","year":"2021"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1186\/1745-6215-8-16","article-title":"Practical methods for incorporating summary time-to-event data into meta-analysis","volume":"8","author":"Tierney","year":"2007","journal-title":"Trials"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"d4002","DOI":"10.1136\/bmj.d4002","article-title":"Recommendations for examining and interpreting funnel plot asymmetry in meta-analyses of randomised controlled trials","volume":"343","author":"Sterne","year":"2011","journal-title":"BMJ"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"228","DOI":"10.1093\/qjmed\/hcaa339","article-title":"Total bone mineral density is inversely associated with stroke: a family osteoporosis cohort study in rural China","volume":"115","author":"Zhu","year":"2022","journal-title":"QJM"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"940","DOI":"10.1161\/01.str.24.7.940","article-title":"Association between low bone density and stroke in elderly women. 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