中国绝经后2型糖尿病患者骨质疏松影响因素的Meta分析  

Associated Factors of Osteoporosis in Postmenopausal Women with Type 2 Diabetic Mellitus in China:a Meta-analysis

作　　者：嵇星辰 王明欣 陈少华[3] 高改 吴小婉[1] JI Xingchen;WANG Mingxin;CHEN Shaohua;GAO Gai;WU Xiaowan(School of Nursing,Guangzhou University of Chinese Medicine,Guangzhou 510006,China;Second Clinical Medical College,Guangzhou University of Chinese Medicine,Guangzhou 510405,China;No.1 Department of Orthopedics,Guangdong Provincial Hospital of Chinese Medicine,Guangzhou 510120,China)

机构地区：[1]广州中医药大学护理学院,广东省广州市510006 [2]广州中医药大学第二临床医学院,广东省广州市510405 [3]广东省中医院骨一科,广东省广州市510120

出　　处：《中国全科医学》2023年第4期504-511,共8页Chinese General Practice

基　　金：广东省研究生教育创新计划项目(2020SFKC021)。

摘　　要：背景糖尿病和骨质疏松均是中老年人的常见病,且糖尿病可导致多种急/慢性并发症,但糖尿病性骨骼改变常被忽略。女性绝经后患骨质疏松较为普遍,绝经后2型糖尿病患者更是具有多种合并骨质疏松的危险因素,因此早期识别这些因素并开展针对性干预十分必要。目的探讨我国绝经后2型糖尿病患者骨质疏松的影响因素。方法于2021年7月,计算机检索中国知网、维普网、万方数据知识服务平台、中国生物医学文献数据库、PubMed、EmBase、the Cochrane Library数据库,获取与我国绝经后2型糖尿病患者骨质疏松影响因素相关的文献,检索时间设定为从建库至2021年7月。由2名研究员独自进行文献筛选及数据提取,采用RevMan 5.4软件及Stata 15.0统计软件对数据结果进行Meta分析。结果最终纳入21篇研究,提取出11个影响因素。Meta分析结果显示:年龄〔MD(95%CI)=6.56(5.24,7.88)〕、绝经年限〔MD(95%CI)=5.93(4.23,7.62)〕、糖尿病病程〔MD(95%CI)=1.94(0.89,2.98)〕、体质指数〔MD(95%CI)=-1.99(-2.63,-1.36)〕、血清钙〔MD(95%CI)=0.03(0.01,0.06)〕、空腹血糖〔MD(95%CI)=0.49(0.09,0.90)〕、糖化血红蛋白〔MD(95%CI)=0.37(0.02,0.71)〕、空腹胰岛素〔MD(95%CI)=3.65(1.24,6.06)〕是我国绝经后2型糖尿病患者合并骨质疏松的影响因素(P<0.05);血肌酐〔MD(95%CI)=4.02(0.00,8.04)〕、血清磷〔MD(95%CI)=0.00(-0.05,0.05)〕、碱性磷酸酶〔MD(95%CI)=1.26(-0.06,2.57)〕对我国绝经后2型糖尿病患者合并骨质疏松的影响无统计学意义(P>0.05)。敏感性分析结果显示:除血肌酐外,其他因素的结果均较稳定。结论年龄、绝经年限、糖尿病病程、BMI、血清钙、空腹胰岛素、空腹血糖、糖化血红蛋白是我国2型糖尿病患者合并骨质疏松的影响因素,而血肌酐、血清磷、碱性磷酸酶对我国绝经后2型糖尿病患者合并骨质疏松的影响还需进一步论证。Background Diabetes and osteoporosis are common diseases in middle-aged and elderly people.Diabetes can lead to various acute and chronic complications,but its related bone changes are often neglected.Osteoporosis is more common in postmenopausal women,and those with type 2 diabetes mellitus(T2DM)have multiple risk factors for osteoporosis.Therefore,it is particularly important to early identify risk factors of osteoporosis in these women,and to provide them with targeted interventions.Objective To explore the associated factors of osteoporosis in Chinese postmenopausal women with T2DM through a meta-analysis.Methods In July 2021,databases of China National Knowledge Infrastructure,CQVIP,WanFang Data,SinoMed,PubMed,EmBase,and the Cochrane Library were searched for literature about factors associated with osteoporosis in Chinese postmenopausal women with T2DM from inception to July 2021.Two researchers independently screened literature and extracted data.RevMan 5.4 and Stata 15.0 were used to conduct a meta-analysis on the data.Results Twenty-one studies were finally included,from which 11 osteoporosis-related factors were extracted.The meta-analysis showed that age〔MD(95%CI)=6.56(5.24,7.88)〕,years of postmenopause〔MD(95%CI)=5.93(4.23,7.62)〕,duration of diabetes〔MD(95%CI)=1.94(0.89,2.98)〕,body mass index〔MD(95%CI)=-1.99(-2.63,-1.36)〕,serum calcium〔MD(95%CI)=0.03(0.01,0.06)〕,fasting blood glucose〔MD(95%CI)=0.49(0.09,0.90)〕,glycosylated hemoglobin〔MD(95%CI)=0.37(0.02,0.71)〕,and fasting insulin〔MD(95%CI)=3.65(1.24,6.06)〕were associated factors for osteoporosis in postmenopausal women with T2DM.But no significant association was found between osteoporosis and serum creatinine〔MD(95%CI)=4.02(0.00,8.04)〕,serum phosphorus〔MD(95%CI)=0.00(-0.05,0.05)〕,or serum alkaline phosphatase〔MD(95%CI)=1.26(-0.06,2.57)〕in these women.Sensitivity analysis revealed that the association of all the above-mentioned factors(except for serum creatinine)with osteoporosis was relatively robust.Conclu

关 键 词：糖尿病 2型 骨质疏松 绝经后 影响因素分析 META分析 

分 类 号：R587.1[医药卫生—内分泌] R681[医药卫生—内科学]