摘要
目的通过Meta分析针对绝经后骨质疏松症(postmenopausal osteoporosis,PMOP)患者发生骨质疏松性脊柱压缩骨折(osteoporotic vertebral compression fracture,OVCF)与骨密度(bone mineral density,BMD)、骨代谢指标的相关性进行系统评价。方法检索中英文数据库,搜索有关发生OVCF的PMOP患者骨密度、骨代谢指标相关病例对照研究和队列研究,设定文献发表时间为各数据库建库至2021年05月。应用Revman 5.3软件进行Meta分析。结果共纳入7篇研究,Meta分析显示:OVCF患者腰椎BMD显著低于非OVCF患者[MD=-0.18,95%CI(-0.24,-0.13),P=0.003],根据研究对象是否含有腰椎压缩性骨折进行亚组分析:无腰椎压缩性骨折的OVCF患者腰椎BMD显著低于非OVCF患者[MD=-0.15,95%CI(-0.18,-0.12),P<0.00001];含腰椎压缩性骨折的OVCF患者腰椎BMD低于非OVCF患者,但差异无统计学意义[MD=-0.03,95%CI(-0.06,0.00),P=0.09]。OVCF患者股骨颈BMD低于非OVCF患者,但差异无统计学意义[MD=-0.01,95%CI(-0.01,0.00),P=0.17];OVCF患者CTX水平显著高于非OVCF患者[MD=0.17,95%CI(0.16,0.19),P<0.00001];OVCF患者PINP水平显著高于非OVCF患者[MD=21.45,95%CI(17.56,25.33),P<0.00001];OVCF患者BALP显著高于非OVCF患者[MD=2.24,95%CI(1.57,2.91),P<0.00001];OVCF患者1,25(OH)2D3水平显著低于非OVCF患者[MD=-5.78,95%CI(-7.05,-4.51),P<0.00001]。结论BMD的变化与发生OVCF的风险尚不明确,但CTX、PINP、BALP水平与发生OVCF的风险呈正相关;1,25(OH)2D3水平则相反,其与发生OVCF的风险呈负相关。临床上可密切观察PMOP患者骨代谢指标变化,早期干预,尽量较少OVCF发生的风险。
Objective To explore the association between bone mineral density,bone metabolism and osteoporotic vertebral compression fracture in postmenopausal osteoporosis with systematical evaluation.Methods The Chinese and English databases were retrieved for the case control studies and the array studies on the association between bone mineral density,bone metabolism and osteoporotic vertebral compression fracture in postmenopausal osteoporosis,including CNKI,CBM,Chinese Science and Technique Journals Database,Wanfang database,the Cochrane Library,PubMed,Web of Science and EMBASE during the time from the establishment of database to 31 May 2021.Meta-analysis was made via RevMan 5.3.Results A total of 7 studies were included,and Meta-analysis showed that the lumbar BMD of OVCF patients was significantly lower than that of non OVCF patients[MD=-0.18,95%CI(-0.24,-0.13),P=0.003].Subgroup analysis was conducted based on whether the study subjects had lumbar compression fractures:OVCF patients without lumbar compression fractures had significantly lower lumbar BMD than non OVCF patients[MD=-0.15,95%CI(-0.18,-0.12),P<0.00001];OVCF patients with lumbar compression fractures had lower lumbar BMD than non OVCF patients,but the difference was not statistically significant[MD=-0.03,95%CI(-0.06,0.00),P=0.09].The BMD of the femoral neck in OVCF patients was lower than that in non OVCF patients,but the difference was not statistically significant[MD=-0.01,95%CI(-0.01,0.00),P=0.17];the CTX levels in OVCF patients were significantly higher than those in non OVCF patients[MD=0.17,95%CI(0.16,0.19),P<0.0001];the PINP level in OVCF patients was significantly higher than that in non OVCF patients[MD=21.45,95%CI(17.56,25.33),P<0.0001];the BALP of OVCF patients was significantly higher than that of non OVCF patients[MD=2.24,95%CI(1.57,2.91),P<0.0001];the 1,25(OH)2D3 levels in OVCF patients were significantly lower than those in non OVCF patients[MD=-5.78,95%CI(-7.05,-4.51),P<0.0001].Conclusion The change of BMD is still unclear to the risk of O
作者
张兵
吕朝晖
董云鹏
邱剑鸣
李伟举
ZHANG Bing;LYU Zhao-hui;DONG Yun-peng;QIU Jian-ming;LI Wei-jv(Guangdong Second Traditional Chinese Medicine Hospital,Guangzhou 510095,China)
出处
《颈腰痛杂志》
2023年第6期958-962,共5页
The Journal of Cervicodynia and Lumbodynia
基金
广东省中医药局科研项目(编号:20202013)。
关键词
绝经后骨质疏松
椎体压缩性骨折
骨密度
骨代谢指标
META分析
postmenopausal osteoporosis
osteoporotic vertebral compression fracture
bone mineral density
bone metabolism
Meta analysis
