肝硬化与骨折发生风险相关性的Meta分析

赵健; 李伟; 梁才全; 姚定康

doi:10.3969/j.issn.1001-5256.2017.06.019

肝硬化与骨折发生风险相关性的Meta分析

DOI: 10.3969/j.issn.1001-5256.2017.06.019

第二军医大学附属长征医院内科学教研室

详细信息

中图分类号: R575.2;R683
计量
- 文章访问数: 2507
- HTML全文浏览量: 71
- PDF下载量: 449
- 被引次数: 0
出版历程
- 出版日期: 2017-06-20

Liver cirrhosis and the risk of fracture: a Meta-analysis

摘要

摘要: 目的从循证医学角度探讨肝硬化与骨折发生风险的相关性。方法通过计算机全面检索PubMed、Web of Science、Embase、CNKI、万方、中国生物医学文献、维普等数据库已发表的肝硬化与骨折发生风险相关的观察性研究,对文献质量进行评价,采用Rev Man5.3软件对骨折风险进行Meta分析,计算比值比(OR)和95%可信区间(95%CI)。结果最终纳入3个队列研究,2个横断面研究,肝硬化组28 820例,对照组214 313例。肝硬化组与对照组比较,总体骨折发生风险增加(合并研究:OR=2.07,95%CI:1.52~2.83,P<0.000 01;队列研究:OR=2.00,95%CI:1.93~2.07,P<0.000 01);按骨折类型进行分组分析,相比对照组,肝硬化组椎体骨折和非椎体骨折(上肢)发生风险均增加,(OR=2.10,95%CI:1.30~3.40,P=0.003;OR=1.61,95%CI:1.53~1.69,P<0.000 01)。结论肝硬化可增加骨折的发生风险,但由于所纳入的各研究间存在异质性,上述结论尚需更细致的研究来进一步证实。
- 肝硬化 /
- 骨折 /
- Meta分析
Abstract: Objective To investigate the association between liver cirrhosis and the risk of fracture from the perspective of evidence-based medicine. Methods Pub Med, Web of Science, Embase, CNKI, Wanfang Data, Sino Med, and VIP were searched to collect published observational studies on the association between liver cirrhosis and fracture. The quality of each study was assessed and Rev Man5. 3 software was used to perform a meta-analysis of the risk of fracture, and the odds ratio (OR) and 95% confidence interval (CI) were calculated.Results Three cohort studies and two cross-sectional studies were included with 28 820 patients in liver cirrhosis group and 214 313 cases in control group. The analysis showed that compared with the control group, the liver cirrhosis group had a significant increase in the overall risk of fracture (all studies: OR = 2. 07, 95% CI: 1. 52-2. 83, P < 0. 000 01; cohort studies: OR = 2. 00, 95% CI: 1. 93-2. 07, P <0. 000 01) . When the patients were divided according to the type of fracture, compared with the control group, the liver cirrhosis group had significant increases in the risks of vertebral fracture and non-vertebral fracture (upper extremities) (OR = 2. 10, 95% CI: 1. 30-3. 40, P = 0. 003; OR = 1. 61, 95% CI: 1. 53-1. 69, P < 0. 000 01) . Conclusion Liver cirrhosis may increase the risk of fracture. However, due to the heterogeneity of these studies, the above results need to be further verified by more detailed studies.
- liver cirrhosis /
- fractures, bone /
- Meta-analysis

HTML全文

参考文献(20)

[1]HANDZLIK-ORLIK G, HOLECKI M, WILCZYNSKI K, et al.Osteoporosis in liver disease:pathogenesis and management[J].Ther Adv Endocrinol Metab, 2016, 7 (3) :128-135.

[2]SUZUKI H.Bone complications in chronic liver disease (hepatic osteodystrophy) [J].Clin Calcium, 2015, 25 (11) :1619-1624.

[3]LIU W, YANG LH, KONG XC, et al.Meta-analysis of osteoporosis:fracture risks, medication and treatment[J].Minerva Med, 2015, 106 (4) :203-214.

[4]STANG A.Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses[J].Eur J Epidemiol, 2010, 25 (9) :603-605.

[5]BANG UC, BENFIELD T, BENDTSEN F, et al.The risk of fractures among patients with cirrhosis or chronic pancreatitis[J].Clin Gastroenterol Hepatol, 2014, 12 (2) :320-326.

[6]TSAI CF, LIU CJ, CHEN TJ, et al.Increased incidence of orthopedic fractures in cirrhotic patients:a nationwide population-based study[J].J Hepatol, 2013, 58 (4) :706-714.

[7]ZHANG Q, CHENG J, ZHAO CS, et al.Epidemiologic study of osteoporotic vertebral compression fractures in patients with chronic hepatitis B[J].J Cervicodynia Lumbodynia, 2013, 34 (6) :441-444. (in Chinese) 张强, 成军, 赵昌松, 等.慢性乙型肝炎肝病患者骨质疏松性椎体压缩骨折的调查研究[J].颈腰痛杂志, 2013, 34 (6) :441-444.

[8]SOLAYMANI-DODARAN M, CARD TR, AITHAL GP, et al.Fracture risk in people with primary biliary cirrhosis:a population-based cohort study[J].Gastroenterology, 2006, 131 (6) :1752-1757.

[9]DIAMOND T, STIEL D, LUNZER M, et al.Osteoporosis and skeletal fractures in chronic liver disease[J].Gut, 1990, 31 (1) :82-87.

[10]YAKAR S, ROSEN CJ, BEAMER WG, et al.Circulating levels of IGF-1 directly regulate bone growth and density[J].J Clin Invest, 2002, 110 (6) :771-781.

[11]KAWELKE N, BENTMANN A, HACKL N, et al.Isoform of fibronectin mediates bone loss in patients with primary biliary cirrhosis by suppressing bone formation[J].J Bone Miner Res, 2008, 23 (8) :1278-1286.

[12]BENTMANN A, KAWELKE N, MOSS D, et al.Circulating fibronectin affects bone matrix, whereas osteoblast fibronectin modulates osteoblast function[J].J Bone Miner Res, 2010, 25 (4) :706-715.

[13]MOSCHEN AR, KASER A, STADLMANN S, et al.The RANKL/OPG system and bone mineral density in patients with chronic liver disease[J].J Hepatol, 2005, 43 (6) :973-983.

[14]SHAHIN AA, SHAKER OG, KAMAL N, et al.Circulating interleukin-6, soluble interleukin-2 receptors, tumor necrosis factor alpha, and interleukin-10 levels in juvenile chronic arthritis:correlations with soft tissue vascularity assessed by power doppler sonography[J].Rheumatol Int, 2002, 22 (2) :84-88.

[15]CHEN CH, LIN CL, KAO CH.Association between chronic hepatitis B virus infection and risk of osteoporosis:a nationwide population-based study[J].Medicine (Baltimore) , 2015, 94 (50) :e2276.

[16]CHEN CH, LIN CL, KAO CH.Relation between hepatitis C virus exposure and risk of osteoporosis:a nationwide population-based study[J].Medicine (Baltimore) , 2015, 94 (47) :e2086.

[17]LOPEZ-LARRAMONA G, LUCENDO AJ, GONZALEZ-DELGADO L.Alcoholic liver disease and changes in bone mineral density[J].Rev Esp Enferm Dig, 2013, 105 (10) :609-621.

[18]GLASS LM, SU GL.Metabolic bone disease in primary biliary cirrhosis[J].Gastroenterol Clin North Am, 2016, 45 (2) :333-343.

[19]LIAO CC, CHEN TL.Risk and adverse outcomes of fractures in patients with liver cirrhosis:two nationwide studies[J].Hepatol Int, 2016, 10 (1) :s86-s87.

[20]SAEED NUS, GUL MA, SALIM A, et al.Frequency assessment of osteoporosis in patients of liver cirrhosis[J].Pak J Med Health Sci, 2015, 9 (1) :364-366.

施引文献

资源附件(0)

访问统计