男性骨密度与冠状动脉粥样硬化关系的Meta分析  

The relationship between bone mineral density and coronary atherosclerosis in men: a meta-analysis

作　　者：孙哲[1] 刘正[1] 王其飞[1] 张光武[1] SUN Zhe LIU Zheng WANG Qifei ZHANG Guangwu(Department of Orthopaedics, Peking University Shougang Hospital, Beijing 100144, China)

机构地区：[1]北京大学首钢医院骨科,北京100144

出　　处：《中国骨质疏松杂志》2017年第8期1022-1025,1074,共5页Chinese Journal of Osteoporosis

摘　　要：目的从循证医学的角度探究男性骨密度改变与冠状动脉粥样硬化之间的关系。方法首先根据研究的目的制定检索策略,利用Pubmed、Embase、Cochrane图书馆、中国生物医学文献数据库(CBM)、维普信息资源系统、中国期刊全文数据库(CNKI)、万方数据库等检索截至目前已发表的相关文献,对符合纳入标准的文献进行数据的提取,利用Review Manager 5.3Meta分析软件对提取的数据进行分析。结果本研究最终纳入5篇文献,包含骨密度降低组(骨量减少和骨质疏松)325名患者,对照组259名患者。Meta分析显示5项研究之间的异质性检验结果为I^2=62%,Chi^2=10.56,P=0.03,说明各研究之间存有异质性,因此采用随机效应模型进行分析,合并后的效应量为OR=1.79,95%CI为(0.79,4.03),P=0.16;经灵敏度分析剔除1篇样本量较小的研究后,异质性检验结果显示I^2=35%,Chi^2=4.64,P=0.20,表明各研究之间的异质性较小并且可以接受,因此采用固定效应模型进行分析,合并后的效应量为OR=1.22,95%CI为(0.76,1.96),P=0.41,最后所得的合并效应量与样本量较小的研究删除之前的合并效应量相比,结果基本一致,说明此次Meta分析的结果比较稳定。结论男性骨密度的降低与冠状动脉粥样硬化之间没有显著的相关性。Objective To evaluate the relationship between bone mineral density and coronary atherosclerosis in men. Methods First we established the searching strategy,then we searched related publications in Pubmed,EMbase,Cochrane Library,CBM,VIP,CNKI,Wanfang Data,etc. Data were extracted from the literatures that met the requirement and were analyzed using ReviewManager 5. 3. Results Five studies that met the inclusion criteria were included,including 325 patients from the lowbone mineral density group（ lowbone mass or osteoporosis） and 259 patients from the control group. Meta-analysis indicated that the heterogeneity of the outcomes were I^2= 62%,Chi^2= 10. 56,and P = 0. 03. We therefore adopted the random effects model because the heterogeneity of the studies was significant and got the merged effect quantity ： OR = 1. 79,95% CI = 0. 79-4. 03. After sensitivity analysis a small sample-size study were excluded,and the heterogeneity of theresult were I^2= 35%,Chi^2= 4. 64,P =0. 20. The heterogeneity of the studies was small,so we adopted the fixed effects model and got the merged effect quantity of OR =1. 22,95% CI = 0. 76-1. 96,P = 0. 27. Compared to the first P value,the secondresult was basically consistent,indicating theresult of the Meta-analysis was stable. Conclusion The reduction of bone mineral density in men is not significantly related to coronary atherosclerosis.

关 键 词：骨密度 冠状动脉粥样硬化 META分析 

分 类 号：R589.9[医药卫生—内分泌]