维生素K2防治绝经后骨质疏松症作用的荟萃分析  

A Meta-analysis of the role of vitamin K2 in the prevention and treatment of osteoporosis in postmenopausal women

作　　者：胥小琴 张丹[2] 陶新城[1] 张宏秀[1] XU Xiaoqin;ZHANG Dan;TAO Xincheng;ZHANG Hongxiu(Department of Obstetrics and Gynecology,The First Affiliated Hospital of Nanjing Medical University,Nanjing 210029;Department of Obstetrics and Gynecology,Dian Shan Lake People's Hospital of Kunshan city,Kunshan 215345)

机构地区：[1]南京医科大学第一附属医院妇产科,江苏南京210029 [2]江苏省昆山市淀山湖人民医院妇产科,江苏昆山215345

出　　处：《中国骨质疏松杂志》2021年第12期1780-1787,共8页Chinese Journal of Osteoporosis

基　　金：江苏省自然科学基金(BK20181494)。

摘　　要：目的为了确定维生素K2对绝经后骨质疏松症(postmenopausal osteoporosis, PMOP)患者的预防和治疗作用,对22项随机对照试验进行了荟萃分析。方法在PubMed、Cochrane Library、Embase数据库和三个中文数据库(CBM、CNKI和万方)检索了2020年6月1日之前发布的相关随机对照试验(RCT),以维生素K2与安慰剂或其他抗骨质疏松药物预防和治疗PMOP进行比较。使用固定效应或随机效应模型计算合并风险比(RR)、平均值(MD)和95%置信区间(CI)。结果包括7 154名绝经女性参与的22项随机对照试验符合纳入标准。补充维生素K2 12个月后改善绝经后女性腰椎骨密度优于对照组(P=0.03),PMOP亚组腰椎骨密度改善较对照组差异有统计学意义(P=0.03)。补充维生素K2预防绝经后女性椎体骨折发生率优于对照组(RR=0.52, 95%CI:0.36~0.74,P=0.003),PMOP亚组椎体骨折发生率低于对照组(P=0.006)。补充维生素K2显著降低了低羧化骨钙素(ucOC)(P<0.01)。补充维生素K2药物不良反应略高于对照组(RR=1.29, 95%CI:1.03~1.63,P=0.03)。结论补充维生素K2 12个月后有效改善绝经后女性腰椎骨密度,预防椎体骨折,降低ucOC,PMOP患者获益更大。口服维生素K2被认为是安全的。Objective To investigate the preventive and therapeutic effects of vitamin K2 in women with postmenopausal osteoporosis(PMOP), we conducted a meta-analysis of 22 randomized controlled trials. Methods PubMed, Cochrane Library, Embase and three Chinese literature databases(CNKI, CBM and Wanfang) were searched for relevant randomized controlled trials(RCTs) published before June 1, 2020, comparing Vitamin K2 with placebo or other anti-osteoporotic drugs in treating osteoporosis. The pooled risk ratio(RR) or mean difference(MD) and 95% confidence interval(CI) were calculated using fixed-effects or random-effects meta-analysis. Results Twenty-two RCTs(7 154 postmenopausal women) were included. Pooled analyses showed that supplementation with Vitamin K2 was more effective than placebo in improving lumbar bone mineral density(BMD)(P=0.03) and more beneficial in preventing vertebral fractures for PMOP patients(RR=0.51, 95% CI: 0.35-0.75, P=0.000 6). Supplementation with vitamin K2 significantly decreased undercarboxylated osteocalcin(ucOC)(P<0.01). Furthermore, compared with placebo, Vitamin K2 significantly increased the incidence of adverse drug reactions(RR=1.29, 95% CI: 1.03-1.63, P=0.03). Conclusion Vitamin K2 supplementation can effectively improve postmenopausal women’s lumbar spine bone mineral density, prevent osteoporotic fractures, and decreases ucOC in postmenopausal women. vitamin K2 is a safe choice for the treatment of PMOP.

关 键 词：维生素K2 骨密度 绝经 骨质疏松症 荟萃分析 

分 类 号：R173[医药卫生—妇幼卫生保健]