摘要
目的评价FRAX评估工具在中国汉族和少数民族中的应用。方法通过CNKI、CBM、VIP、Wan Fang、PubMed、Embase、Cochrane图书馆进行系统检索,开展质量评估并借助软件Stata16.0、Metadisc1.4和MedCalc实施Meta分析,分析各研究之间统计学异质性。采用随机效应模型分析,并使用漏斗图以评估检测数据发表偏倚。结果纳入文献量共计11篇,涉及研究27个,总样本量27554例。(1)8篇文献报道了汉族MOF,最终合并敏感度0.75(95%CI:0.53~0.89);合并特异度为0.76(95%CI:0.56~0.88);SROC AUC为0.82(95%CI:0.78~0.85)。3篇文献报道了汉族HF(10年髋部骨折概率%),汇总敏感度为0.80(95%CI:0.56~0.93)和汇总特异度为0.72(95%CI:0.53~0.86);SROC AUC为0.83(95%CI:0.80~0.86)。(2)行汉族MOF亚组分析,结果提示性别、研究方法是引起异质性的潜在因素。(3)5篇文献报道了少数民族(藏族、蒙古族、高山族、壮族、维吾尔族)MOF,合并敏感度0.66(95%CI:0.43~0.84);合并特异度为0.76(95%CI:0.36~0.95);SROC AUC为0.75(95%CI:0.71~0.78)。行MOF亚组分析,结果提示性别是引起异质性的潜在因素。(4)各指标Deeks检验均不存在偏倚。(5)文献分析结果支持将中国人群MOF的干预阈值设定为6%。结论民族差异和性别会影响对骨折风险的预测;建议将中国人群MOF的干预阈值设定为6%。
Objective To systematically reviewof the application of the FRAX assessment tool in China’s Han and ethnic minorities,clarifying that ethnic differences may affect fracture risk prediction,and proposethe intervention threshold for the MOF(10-year probability of fracture in major parts)for Chinese population.Methods Systematic retrieval was conducted through CNKI,CBM,VIP,WanFang,PubMed,Embase,Cochrane libraries,quality evaluation was carried out,and Meta analysis was carried out with the help of software Stata16.0,Metadisc1.4 and MedCalc to analyze the statistical heterogeneity between the studies.Random effects model analysis was used,and a funnel chart was used to assess the publication bias of the test data.Results Total 11 articles were included,including 27 studies,with a total sample size of 27554 cases.(1)8 articles reported on the Han MOF with combined sensitivity of 0.75(95%CI:0.53-0.89);combined specificity of 0.76(95%CI:0.56-0.88);SROC AUC of 0.82(95%CI:0.78-0.85).Three literatures reported on HF(probability of hip fracture in 10 years%),with aggregated sensitivity of0.80(95%CI:0.56-0.93)and aggregated specificity of 0.72(95%CI:0.53-0.86);SROC AUC is 0.75(95%CI:0.71-0.78).(2)A MOF subgroup analysis was conducted,the result suggested that ethnicity,gender,and research method were the potential factors that cause heterogeneity.(3)5 articles reported on the MOF of ethnic minorities(Tibetan,Mongolian,Gaoshan,Zhuang,Uygur),the combined sensitivity is 0.66(95%CI:0.43-0.84);the combined specificity is 0.76(95%CI:0.36-0.95);SROC AUCis 0.75(95%CI:0.71-0.78).A MOF subgroup analysis isperformed,and the result suggest that gender was a potential factor causing heterogeneity.(4)There was no bias in the Deeks test for all indicators.(5)The literature analysis result supported the setting of the intervention threshold of MOF for the Chinese population at 6%.Conclusion National differences and gender that affect fracture risk prediction;the intervention threshold of MOF for the Chinese population is set to 6%.
作者
孙兢
杨明霞
张智海
SUN Jing;YANG Mingxia;ZHANG Zhihai(Renmin University Hospital of China,Beijing 100872;Guang’anmen Hospital,Chinese Academy of Traditional Chinese Medicine,Beijing 100053)
出处
《中国骨质疏松杂志》
CAS
CSCD
北大核心
2021年第8期1147-1153,共7页
Chinese Journal of Osteoporosis
