Title : Modifiable lifestyle and occupational risk factors associated with dupuytrens disease: A systematic review and meta analysis
Abstract:
Background: Dupuytren’s Disease (DD) is a chronic fibroproliferative disorder of the palmar fascia that leads to progressive flexion contractures of the fingers. While its genetic basis is well recognised, the role of modifiable lifestyle and occupational risk factors remains unclear. This systematic review and meta-analysis aimed to evaluate the association between modifiable lifestyle and occupational exposures and the risk of developing DD.
Methods: Following a pre-registered PROSPERO protocol (CRD420251105387), comprehensive searches were conducted across six databases up to July 2025. Eligible observational and randomised studies examining modifiable risk factors were included. The risk of bias was assessed using the Newcastle–Ottawa Scale, Joanna Briggs Institute checklist, and AMSTAR-2 tool, while the certainty of evidence was graded using the GRADE framework.
Results: Fifty studies encompassing approximately 4.62 million participants from 20 countries were included. Smoking (OR = 1.23), alcohol consumption (OR = 1.89), diabetes (OR = 1.42), manual labour (OR = 2.81), hand–arm vibration exposure (OR = 2.06–2.65), and previous hand trauma (OR = 1.81) were all positively associated with DD. However, substantial heterogeneity was observed across studies. Most evidence was of moderate certainty, with methodological limitations primarily due to exposure assessment and confounder control.
Conclusion: Modifiable lifestyle and occupational factors are associated with an increased risk of Dupuytren’s disease, with manual labour and hand–arm vibration showing the strongest associations. Despite these findings, evidence heterogeneity limits causal inference. Future high-quality longitudinal studies are needed to clarify these relationships and inform preventive strategies.
