唑来膦酸联合他汀类药物治疗糖尿病合并骨质疏松症的meta分析  

Meta Analysis of Zoledronic Acid Combined with Statins in the Treatment of Diabetes Mellitus Complicated with Osteoporosis

作　　者：胡慧萍 杨庆宇[2] 陈启超 HU Huiping;YANG Qingyu;CEHN Qichao(Affiliated Hospital of Anhui Health Vocational College;Department of Geriatrics,the First Affiliated Hospital of Bengbu Medical College;Department of Ophthalmology,Chizhou people's Hospital,Chizhou,Anhui 247100,China)

机构地区：[1]安徽卫生健康职业学院附属医院 [2]蚌埠医学院第一附属医院老年医学科 [3]池州市人民医院眼科,安徽池州247100

出　　处：《九江学院学报（自然科学版）》2022年第4期85-92,共8页Journal of Jiujiang University：Natural Science Edition

基　　金：安徽省高校自然科学研究项目(编号KJ2019A1282);安徽省高校优秀人才支持计划项目(编号gxyq2019209);安徽省精品课程项目(编号2021jpkc071)的研究成果之一。

摘　　要：目的系统评价唑来膦酸联合他汀类药物治疗糖尿病合并骨质疏松的临床疗效及安全性。方法检索中国知网、万方数据库、维普数据库、中国生物医学数据库、Pubmed、Embase、、the Cochrane library、web of science等数据库关于唑来膦酸联合他汀类药物治疗糖尿病合并骨质疏松症的相关文献,检索时间均为建库至2022年2月10日。制定检索策略、纳入和排除标准,然后根据标准确定最终纳入的随机对照研究。采用RevMan 5.3软件进行分析。结果该研究共纳入10个随机对照研究,包括1149个研究对象,其中观察组575例,对照组574例。Meta分析结果显示:唑来膦酸联合他汀类药物治疗糖尿病合并骨质疏松症与单用唑来膦酸比较,在骨密度相关指标中改变中,腰椎骨密度的MD为0.10(0.8,0.12)、股骨粗隆骨密度的MD为0.06(0.05,0.08)、股骨颈骨密度MD为004(0.02,0.06)、WARD三角区骨密度MD为0.05(0.03,0.06),均有统计学意义。在血液学相关指标中,血钙浓度的MD值为0.02(-0.04,0.07),但p=0.58>0.05,血P浓度MD值为0.03(-0.02,0.07),p=0.22>0.05,两组在血钙、血P浓度改变上差异无统计学意义;在骨钙素上,MD值为0.02(-0.04,0.07),p<0.05,差异有统计学意义;血清Ⅰ型胶原C末端肽上MD值为-1.02(-1.48,-0.57),p值<0.05,差异有统计学意义;在碱性磷酸酶(alkaline phosphatase,ALP)上,MD值为-0.67(-0.87,0.53),p<0.05,差异有统计学意义;在抗酒石酸酸性磷酸酶其MD为-1.02(-1.13,-0.91),p<0.05,差异有统计学意义。结论唑来膦酸联合他汀类药物治疗糖尿病合并骨质疏松在骨密度指标较单用唑来膦酸能改善骨代谢指标,在血液学相关骨代谢指标上优于单药组,但在血钙和血P上两组无明显差异。Objective to systematically evaluate the efficacy and safety of zoledronic acid combined with statins in the treatment of diabetes mellitus complicated with osteoporosis.Method Search china China Network(CNKI),Wanfang database,VP database(VP),China biomedical database(CBM),Pubmed,Embase,the Cochrane library,web of science database,etc.,about zoledronic acid combined statin treatment of diabetes mellitus osteoporosis associated literature,search time was from the creation of the database to February 10,2022.Formulate retrieval strategies,inclusion and exclusion criteria,and then determine the final randomized controlled study according to the criteria,then we used Revman 5.3 software for analysis.Result This study included 10 randomized controlled studies,including 1149 subjects,including 575 cases in the observation group and 574 cases in the control group.Zoledronic acid combined with statins in the treatment of diabetic osteoporosis combined with zoledronic acid alone,in bone mineral density related indicators(bone mineral density,BMD)changes,lumbar bone mineral density MD(Mean difference)was 0.10(0.8,0.12),femoral trochanter bone density MD was 0.06(0.05,0.08),femoral neck bone mineral density MD was 004(0.02,0.06).The MD of ward triangle was 0.05(0.03,0.06).In hematology related indicators,The MD value of blood calcium concentration was 0.02(-0.04,0.07),but p=0.58>0.05,the MD value of blood P concentration was 0.03(-0.02,0.07),p=0.22>0.05.There was no significant difference in the changes of blood calcium and blood pconcentration between the two groups;in osteocalcin,the MD value was 0.02(-0.04,0.07),p<0.05,the difference was statistically significant;the C-terminal peptide of serum type I collagen The MD value on serum type I collagen C-terminal peptide(s-ctx)was-1.02(-1.48,-0.57),p<0.05;In alkaline phosphatase(ALP),the MD value was-0.67(-0.87,0.53),p<0.05,the difference was statistically significant;in tartrate resistant acid phosphatase(tr-acp-5b),the MD value was-1.02(-1.13,-0.91),p<0.05,the difference wa

关 键 词：糖尿病 骨质疏松症 唑来膦酸 他汀类药物 META分析 

分 类 号：R587.1[医药卫生—内分泌]