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Association Between Smoking and Dupuytren's Contracture: A Systematic Review and Meta-Analysis
Brandon Chai, MD
1, Meghan He, BSc
1, Alexis E Mah, BHSc
2, Brendan K Tao, MD
3; David T Tang, MEd, MD, FRCSC
1(1)University of British Columbia, Vancouver, BC, Canada, (2)University of Ottawa, Ottawa, ON, Canada, (3)University of Toronto, Toronto, ON, Canada
Background: Smoking is a commonly cited risk factor for Dupuytren's disease; however, evidence on both the directionality and strength of its association has remained inconclusive. The current study aimed to quantify the association between smoking and the prevalence of Dupuytren's disease.
Methods: A systematic database search was conducted to identify comparative studies reporting Dupuytren's disease prevalence in smokers and non-smokers (CRD420251043113). Results were pooled using pairwise meta-analysis with a random-effects model.
Results: 22 studies were included in the analysis, encompassing 609,195 smokers and 906,297 non-smokers. The prevalence of Dupuytren's disease was 5.6% among smokers and 4.4% among non-smokers. Current active smokers were at increased odds of Dupuytren's disease compared to non-smokers (OR 1.45, 95% CI 1.06-1.98, IČ = 95.8%). To a lesser degree, this risk was also increased among former smokers (OR 1.39, 95% CI 1.14-1.7, IČ = 97.5%). Overall, any smoking history conferred a 1.5-fold increased odds for Dupuytren's disease (OR 1.50, 95% CI 1.20-1.88, IČ = 95.5%), which remained statistically significant on exclusion of studies with high risk of bias and leave-one-out sensitivity analysis.
Conclusions: This study found a statistically significant association of smoking with Dupuytren's disease. Smoking cessation should be encouraged in patients with Dupuytren's disease, although further research is needed to identify if smoking cessation could slow disease progression or prevent recurrence.
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