Bone fracture risk in patients with rheumatoid arthritis
Bone fracture risk in patients with rheumatoid arthritis
复制标题
类风湿性关节炎患者的骨折风险
作者：
Ao Xue;Su;Lei Jiang;Aimei Feng;Haifeng Guo;Pu Zhao
背景：类风湿关节炎（RA）患者易发生类风湿性骨折。本研究旨在确定类风湿性关节炎（RA）和骨折风险之间的关系，以及与性别和部位特异性骨折的关系。研究方法：从PubMed、EMBASE和奥维德等数据库中检索了从开始到2016年4月期间与RA患者骨折相关的研究。研究质量采用Newcastle-Ottawa量表进行评价。采用Stata13.1软件进行Meta分析。使用随机效应模型，基于风险比（RR）和95%置信区间（95% CI）报告结果。结果：13篇文献的Meta分析显示，RA患者骨折的危险性显著高于非RA患者（RR = 2.25，95% CI [1.76-2.87]）。 亚组分析显示，与非RA的女性和男性患者相比，女性和男性RA患者的骨折风险增加（女性：RR = 1.99，95% CI [1.58-2.50];男性：RR = 1.87，95% CI [1.48-2.37]）。 另一项部位特异性骨折的亚组分析也显示，RA与椎骨骨折（RR = 2.93，95% CI [2.25-3.83]）或髋部骨折（RR = 2.41，95% CI [1.83-3.17]）的发生率呈正相关。 结论：RA是男性和女性骨折的危险因素，在椎骨和髋部骨折的风险相当。
Background: Patients with rheumatoid arthritis (RA) are predisposed to osteoporotic fracture. The present study aims to determine the association between rheumatoid arthritis (RA) and bone fracture risk, and in relation to gender and site-specific fractures. Methods: Studies related to bone fracture in patients with RA were searched from databases including PubMed, EMBASE, and OVID from inception through April 2016. The quality of the studies was evaluated using the Newcastle-Ottawa Scale. Meta-analysis was performed with Stata13.1 software. The results were reported based on risk ratio (RR) and 95% confidence interval (95% CI) using a random effects model. Results: The meta-analysis of 13 studies showed a significant higher risk of bone fracture in patients with RA than in patients without RA (RR = 2.25, 95% CI [1.76–2.87]). Subgroup analyses showed that both female and male patients with RA had increased risk of fracture when compared with female and male patients without RA (female: RR = 1.99, 95% CI [1.58–2.50]; male: RR = 1.87, 95% CI [1.48–2.37]). Another subgroup analysis of site-specific fracture also showed that RA is positively correlated with the incidence of vertebral fracture (RR = 2.93, 95% CI [2.25–3.83]) or hip fracture (RR = 2.41, 95% CI [1.83–3.17]). Conclusion: RA is a risk factor for bone fracture in both men and women, with comparable risks of fractures at the vertebral and hip.