A meta-analysis of fracture risk and bone mineral density in patients with systemic sclerosis
A meta-analysis of fracture risk and bone mineral density in patients with systemic sclerosis
复制标题
系统性硬化症患者骨折风险和骨密度的荟萃分析
DOI：
10.1007/s10067-019-04847-0
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发表时间：
2020-04-01
影响因子：
3.4
通讯作者：
Zhao, Cheng
中科院分区：
文献类型：
--
作者：
Chen, Juan;Lei, Ling;Zhao, Cheng
骨质疏松症和骨折是重要的公共卫生问题，给患者带来严重的负担。系统性硬化症（SSc）患者的骨密度（BMD）较低，骨折风险增加。我们的目的是探讨SSc和BMD和骨折risk.MethodsFor this meta analysis之间的关联，我们分析的数据从文章报道的平均差异，在SSc患者和对照组之间的BMD或骨折风险。我们对PubMed、Web of Science和科克伦图书馆数据库进行了系统的文献检索。合并加权平均差（WMD）用于估计SSc患者和对照组之间BMD的平均差。合并优势比（OR;与95%置信区间[95%CI]）被用来评估SSc和骨折risk.ResultsAnalysis的结果从18项研究表明，SSc患者的BMD显着低于对照组在以下类别：全身（WMD − 0.07，95% CI − 0.1至− 0.04，p <0.00001）、腰椎（WMD − 0.08，95% CI − 0.11至− 0.05，p <0.00001）、股骨颈（WMD：−0.28，95% CI：−0.46至− 0.10，p =0.002）、全髋关节（WMD − 0.10，95%CI − 0.14至− 0.06，p <0.00001）和股骨转子（WMD − 0.06，95%CI − 0.09至− 0.03，p <0.0001）。此外，SSc患者发生椎体骨折的风险增加（OR 10.38，95%CI 1.19 ~ 90.58，p = 0.03）。SSc患者与对照组相比，发生椎体骨折的危险性无显著性差异（OR = 2.24，95%CI 0.58 ~ 8.59，p = 0.24）。结论SSc患者骨量明显减少，椎体骨折的危险性增加。建议对SSc患者进行早期BMD监测，以预防骨质疏松和骨折。要点·SSc患者BMD明显偏低·SSc患者发生椎体骨折的风险也增加
IntroductionOsteoporosis and fractures are important public health issues that impose serious burdens on patients. Patients with systemic sclerosis (SSc) have low bone mineral density (BMD) and increased risk for fracture. We aimed to explore the association between SSc and BMD and fracture risk.MethodsFor this meta-analysis, we analyzed data from articles that reported mean differences in BMD or fracture risk between patients with SSc and controls. We undertook a systematic literature search of the PubMed, Web of Science, and Cochrane Library databases. The pooled weighted mean difference (WMD) was used to estimate the mean difference in BMD between patients with SSc and controls. Pooled odds ratios (ORs; with 95% confidence intervals [95% CIs]) were used to assess the association between SSc and fracture risk.ResultsAnalysis of the results from 18 studies showed that patients with SSc had significantly lower BMD than controls in the following categories: whole body (WMD − 0.07, 95% CI − 0.1 to − 0.04,p <0.00001), lumbar spine (WMD − 0.08, 95% CI − 0.11 to − 0.05,p <0.00001), femoral neck (WMD: −0.28, 95% CI: −0.46 to −0.10,p=0.002), total hip (WMD − 0.10, 95% CI − 0.14 to − 0.06,p <0.00001), and femoral trochanter (WMD − 0.06, 95% CI − 0.09 to − 0.03,p <0.0001). Moreover, patients with SSc had an increased risk of vertebral fracture (OR 10.38, 95% CI 1.19 to 90.58,p= 0.03). We did not find a significant difference in the risk of osteoporotic fracture between patients with SSc and controls (OR = 2.24, 95% CI 0.58 to 8.59,p= 0.24).ConclusionPatients with SSc have a significant reduction in bone mass, and these patients have an increased risk of vertebral fracture. The early monitoring of BMD in patients with SSc is recommended for the prevention of osteoporosis and fracture.Key points•SSc patients have a significant low BMD•SSc patients also have an increased risk of vertebral fracture