成人血清骨钙素水平与非酒精性脂肪性肝病发生风险的Meta分析  

Association between Serum Osteocalcin Level and Non-alcoholic Fatty Liver Disease in Adults:a Meta-analysis

作　　者：张娜文 黄少敏 田利民[2] ZHANG Nawen;HUANG Shaomin;TIAN Limin(The First Clinical Medical College of Gansu University of Traditional Chinese Medicine,Lanzhou 730000,China;Department of Endocrinology,Gansu Provincial Hospital,Lanzhou 730000,China)

机构地区：[1]甘肃中医药大学第一临床医学院,甘肃省兰州市730000 [2]甘肃省人民医院内分泌科,甘肃省兰州市730000

出　　处：《中国全科医学》2024年第12期1519-1524,1532,共7页Chinese General Practice

基　　金：甘肃省卫生健康行业计划项目(GSWSKY2020-08)。

摘　　要：背景非酒精性脂肪性肝病(NAFLD)的发病率逐年上升,已成为重大公共卫生问题之一。血清骨钙素(OCN)是骨形成的标志,可能增加NAFLD的风险。目的本研究进行Meta分析,以定量评估影像学或活检证实的NAFLD与OCN水平之间的关系。方法计算机检索Medline、Embase、Web of Science、Cochrane Library、PROSPERO以及中国知网(CNKI)、万方数据知识服务平台和中维普网(VIP)中有关血清OCN与NAFLD的病例对照研究、横断面研究和队列研究。由2名研究人员筛选文献、提取数据并进行质量评价。采用Stata 16.0软件进行Meta分析。结果共纳入13篇文献,包含11772例参与者。Meta分析结果显示,NAFLD患者血清OCN水平低于非NAFLD者(SMD=-0.73,95%CI=-1.20~-0.27,P<0.05);血清OCN最低四分位数NFALD发生率高于OCN最高四分位数(OR=2.19,95%CI=1.15~4.17,P<0.05)。亚组分析结果显示,是否合并基础疾病、研究质量、研究设计不是异质性的来源。敏感性分析结果表明,删除1项研究后Meta荟萃分析的结果没有显著变化,表明结果稳定可靠。Egger's检验未发现统计学发表偏倚(P=0.519)。结论研究结果表明,血清OCN水平与NAFLD发生风险增加呈负相关。Background The incidence of non-alcoholic fatty liver disease(NAFLD)is increasing by years and has become a major public health problem.Serum osteocalcin(OCN),as a marker of bone formation,may increase the risk of NAFLD.Objective To conduct a Meta-analysis to quantitatively evaluate the association between imaging or biopsy-confirmed NAFLD and serum OCN levels.Methods English databases including Medline,Embase,Web of Science,Cochrane,and PROSPERO,as well as Chinese databases including CNKI,Wanfang Data,and VIP were searched for case-control studies,cross-sectional studies,and cohort studies on serum OCN and NAFLD.Two investigators screened the literature,extracted data and performed quality evaluation.Meta-analysis was performed using Stata 16.0 software.Results A total of 13 papers involving 11772 participants were included.Meta-analysis showed that serum OCN levels were lower in patients with NAFLD than in those without NAFLD(SMD=-0.73,95%CI=-1.20 to-0.27,P<0.05);The incidence of NFALD in the lowest quartile of serum OCN was higher than that in the highest quartile of OCN(OR=2.19,95%CI=1.15 to 4.17,P<0.05).The results of subgroup analysis showed that the presence of comorbid underlying diseases,study quality,and study design were not sources of heterogeneity.The results of the sensitivity analysis showed that the results of Meta-analysis were not significantly affected by the deletion of 1 study,indicating stable and reliable results.Statistical publication bias was not revealed by Egger's test(P=0.519).Conclusion Our results suggest that serum OCN levels are negatively associated with an increased risk of NAFLD.

关 键 词：非酒精性脂肪性肝病 骨钙素 观察性研究 META分析 

分 类 号：R575.5[医药卫生—消化系统]