原发性骨质疏松症患者与对照人群血清骨钙素水平比较的Meta分析

Comparison of serum osteocalcin levels between patients with primary osteoporosis and healthy controls: A Meta-analysis of case-control studies

目的比较原发性骨质疏松症(osteoporosis,OP)患者与对照人群血清骨钙素(serum osteocalcin,s OC)水平。方法荟萃分析。检索CENTRAL、Pub Med和CNKI等国内外大型数据库,筛选关于骨质疏松症患者与对照人群s OC水平比较的病例对照研究,对纳入研究进行Meta分析,比较在不同性别及检测不同s OC分子片段的情况下原发性骨质疏松症患者与对照人群体内的s OC水平,以获得相关临床证据。结果共纳入22项女性研究(包括2906人)以及13项男性研究(包括1338人)。绝经后骨质疏松(postmenopausal osteoporosis,PMO)组与对照组相比s OC水平明显升高[95%置信区间(confidence interval,CI)为(1.59,5.84),P=0.0006],与PMO的高骨转换率相符。而男性原发性OP发病机制不同于PMO,OP组与对照组相比s OC水平无统计学差异[95%CI(-2.31,3.98),P=0.60],此结果可能与男性原发性OP骨代谢状态较为复杂且存在异质性有关。结论 PMO患者s OC水平升高,结果对于PMO具有较高的辅助诊断价值。男性原发性OP患者s OC水平变化情况仍有争议,综合分析结果与对照组无差异。s OC检测尚缺乏统一标准,本研究结论尚需高质量临床研究进一步验证。

Objective To compare the level of serum osteocalcin（ sOC） between patients with primary osteoporosis（ OP） and age and sex matched healthy controls. Methods We searched the large-scale databases of CENTRAL,PubMed and CNKI for relevant case-control studies. A meta-analysis was performed to compare the sOC level between OP patients and controls. Subgroup analyses according to different target segments of sOC molecule were also performed for comprehensive evidence. Results 22 studies with 2906 postmenopausal females and 13 studies with 1338 adult males were included in this research. In females,sOC increased significantly in postmenopausal osteoporosis（ PMO） patients compared with controls（ 95% CI 1. 59, 5. 84,P = 0. 0006）.However,we found no significant difference of the pooled sOC level between male osteoporotic patients and controls（ 95% CI-2. 31,3. 98,P = 0. 60）. Conclusion In PMO cases,sOC increased significantly,consistent with the high bone turnover status characterized in PMO. However,no consistent change of sOC was found in male osteoporotic individuals compared to controls,indicating the complexity and heterogeneity of bone turnover in primary male osteoporosis. Future well-designed trials with standardized method ologies are awaited to confirm and update the findings of this analysis.