Research Papers:

Carotenoids and risk of fracture: a meta-analysis of observational studies

Jiuhong Xu, Chunli Song, Xiaochao Song, Xi Zhang and Xinli Li _

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Oncotarget. 2017; 8:2391-2399. https://doi.org/10.18632/oncotarget.13678

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Jiuhong Xu1,*, Chunli Song2,*, Xiaochao Song2, Xi Zhang3, Xinli Li2,4

1Department of Radiotherapy, The First Affiliated Hospital of Soochow University, Suzhou Jiangsu, PR China, 215006

2School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, PR China, 215123

3Clinical Research Unit, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, PR China, 200092

4Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, PR China, 215123

*These authors contributed equally to this work

Correspondence to:

Xinli Li, email: [email protected]

Keywords: carotenoids, carotene, lycopene, β-cryptoxanthin, lutein/zeaxanthin

Received: July 02, 2016     Accepted: November 22, 2016     Published: November 29, 2016


To quantify the association between dietary and circulating carotenoids and fracture risk, a meta-analysis was conducted by searching MEDLINE and EMBASE databases for eligible articles published before May 2016. Five prospective and 2 case-control studies with 140,265 participants and 4,324 cases were identified in our meta-analysis. Among which 5 studies assessed the association between dietary carotenoids levels and hip fracture risk, 2 studies focused on the association between circulating carotenoids levels and any fracture risk. A random-effects model was employed to summarize the risk estimations and their 95% confidence intervals (CIs). Hip fracture risk among participants with high dietary total carotenoids intake was 28% lower than that in participants with low dietary total carotenoids (OR: 0.72; 95% CI: 0.51, 1.01). A similar risk of hip fracture was found for β-carotene based on 5 studies, the summarized OR for high vs. low dietary β-carotene was 0.72 (95% CI: 0.54, 0.95). However, a significant between-study heterogeneity was found (total carotene: I2 = 59.4%, P = 0.06; β-carotene: I2 = 74.4%, P = 0.04). Other individual carotenoids did not show significant associations with hip fracture risk. Circulating carotene levels had no significant association with any fracture risk, the pooled OR (95% CI) was 0.83 (0.59, 1.17). Based on the evidence from observational studies, our meta-analysis supported the hypothesis that higher dietary total carotenoids or β-carotene intake might be potentially associated with a low risk of hip fracture, however, future well-designed prospective cohort studies and randomized controlled trials are warranted to specify the associations between carotenoids and fracture.

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