幽门螺杆菌感染与骨质疏松症相关性Meta分析  

Relationship between helicobacter pylori infection and osteoporosis:A meta-analysis

作　　者：张玲[1] 游颜杰 包树臻 张雪[1] 虎金朋 马梅娟 杨珍 白飞虎[2,4] ZHANG Ling;YOU Yanjie;BAO Shuzhen;ZHANG Xue;HU Jinpeng;MA Meijuan;YANG Zhen;BAI Feihu(Department of Digestion, the First Clinical College of Northwest University for Nationalities, Yinchuan 750004;Department of Digestion, People’s Hospital of Ningxia Hui Autonomous Region, Yinchuan 750004;Department of Anesthesiology, the First Clinical College of Northwest University for Nationalities, Yinchuan 750004;Department of Digestion, the Second Affiliated Hospital of Hainan Medical University, Haikou 570000, China)

机构地区：[1]西北民族大学第一临床学院消化内科,宁夏银川750004 [2]宁夏回族自治区人民医院消化内科,宁夏银川750004 [3]西北民族大学第一临床学院麻醉科,宁夏银川750004 [4]海南医学院第二附属医院消化内科,海南海口570000

出　　处：《中国骨质疏松杂志》2021年第5期655-661,667,共8页Chinese Journal of Osteoporosis

基　　金：国家自然科学基金项目(81760440);宁夏回族自治区重点研发计划项目(2019BEG03005);宁夏消化疾病临床医学研究中心(2018CXPT0075)。

摘　　要：目的探讨幽门螺杆菌感染与骨质疏松症的相关性。方法计算机检索从数据库建库至2020年7月收录于PubMed、Springer Link、Web of Science、中国知网、万方数据库中关于幽门螺杆菌与骨质疏松症及血清钙、碱性磷酸酶、维生素D关系的相关文献。由两位评审员提取数据,采用Stata15.0软件进行Meta分析,Q检验和I2检验评估异质性,当存在异质性的情况下,通过亚组分析寻找异质性来源并采用随机效应模型计算RR值和95%CI,否则采用固定效应模型。结果共纳入文献23篇,Meta分析结果显示,幽门螺杆菌感染可以增加骨质疏松症发生率并有显著性差异(RR:1.45,95%CI:1.22~1.72)。亚组分析显示,在老人及女性中有显著性差异,而在男性及总人群中无显著性差异。幽门螺杆菌感染可以降低骨密度水平并有统计学差异(SMD:-2.16,95%CI:-3.96~-0.36)。幽门螺杆菌感染能影响维生素D水平并有显著性差异(SMD:-0.70,95%CI:-1.13~-0.27)。但在血清钙、碱性磷酸酶中无显著性差异。结论幽门螺杆菌感染可能促进骨质疏松症的发生,降低骨密度和维生素D的水平,对于骨质疏松患者应予以重视幽门螺杆菌的治疗。Objective To explore the relationship between helicobacter pylori(Hp)infection and osteoporosis.Methods The related literatures about the relationship between Hp and osteoporosis,serum calcium,alkaline phosphatase,and vitamin D were searched in PubMed,Springer Link,Web of Science,China knowledge Network,and Wanfang database from the establishment of the database to July 2020.The data were extracted by two reviewers.meta-analysis,Q test,and I2 test were used to evaluate the heterogeneity with a Stata15.0 software.When there was heterogeneity,subgroup analysis was used to find the source of heterogeneity.The random effect model was used to calculate RR and 95%CI.The fixed effect model was used otherwise.ResultsA total of 23 articles were included.Meta-analysis showed that Hp infection increased the incidence of osteoporosis and there was significant difference(RR:1.45,95%CI:1.22,1.72).Subgroup analysis showed that there was significant difference between the elderly and females,but there was no significant difference between males and general population.Hp infection reduced the level of bone mineral density and there was a statistical difference(SMD:-2.16,95%CI:-3.96,-0.36).Hp infection affected the level of vitamin D and there was a significant difference(SMD:-0.70,95%CI:-1.13,-0.27).However,there was no significant difference in serum calcium and alkaline phosphatase.Conclusion Hp infection may promote the occurrence of osteoporosis and decrease the levels of bone mineral density and vitamin D.More attention should be paid to the treatment of Hp in patients with osteoporosis.

关 键 词：幽门螺杆菌 骨质疏松 骨密度 血清钙 碱性磷酸酶 维生素D META分析 

分 类 号：R589.5[医药卫生—内分泌] R573.6[医药卫生—内科学]