饮酒对骨密度影响的Meta分析

Effects of alcohol drinking on bone density:a meta analysis

目的:探讨饮酒对骨密度的影响。方法:应用计算机检索中国知网、维普网、万方数据库、中国生物医学文献数据库、Pubmed、Embase、Web of Science、Cochrane library建库至2019年4月30日收录的有关饮酒对骨密度影响的观察性研究文献。由2位研究者独立筛选文献、提取资料,依据Newcastle-Ottawa量表进行文献质量评价后,采用RevMan5.3软件进行Meta分析。结果:最初共检索到5811篇文献,其中中文文献2586篇、英文文献3225篇。经筛选后共有8篇文献纳入本次分析,中文文献和英文文献各4篇。纳入的8篇文献质量均较高,Newcastle-Ottawa量表评分均≥6分。Meta分析结果显示,饮酒组骨密度降低的风险高于非饮酒组[OR=2.58,95%CI(1.62,4.10)]。按样本来源进行亚组分析,国内人群和国外人群中饮酒组骨密度降低的风险均高于非饮酒组,其中国内人群中饮酒组骨密度降低的风险更高[OR=5.01,95%CI(2.04,12.33);OR=1.61,95%CI(1.19,2.16)]。按性别进行亚组分析,男性人群中饮酒组骨密度降低的风险高于非饮酒组[OR=3.02,95%CI(1.69,5.39)],女性人群中饮酒组与非饮酒组骨密度降低风险的差异无统计学意义[OR=1.37,95%CI(0.68,2.74)]。剔除样本量最大的1篇文献后,Meta分析结果与未剔除文献前相比没有改变。漏斗图显示左下角出现空缺。结论:饮酒会增加骨密度降低的风险;饮酒引起国内人群骨密度降低的风险高于国外人群,饮酒引起男性骨密度降低的风险高于女性。

Objective:To explore the effects of alcohol drinking on bone density.Methods:All the observational research articles about the effects of alcohol drinking on bone density included from database establishing to April 30,2019 were retrieved from China national knowledge internet,VIP Database,WanFang Database,Chinese biomedical literature database,Pubmed,Embase,Web of Science and Cochrane library through computer.The articles were screened and the information was extracted independently by two searchers.The methodological quality of research in the articles was evaluated according to the Newcastle-Ottawa scale(NOS)and a Meta-analysis was conducted by using RevMan 5.3 software.Results:Five thousand eight hundred and eleven articles(2586 Chinese articles and 3225 English articles)were searched out in the initial stage.After screening,8 articles(4 Chinese articles and 4 English articles)were included in the final analysis.The NOS scores of the 8 articles were≥6 points,and it suggested that the quality of these articles was good.The results of Meta-analysis demonstrated that the risk of bone density loss was higher in drinking group compared to non-drinking group(OR=2.58,95%CI(1.62,4.10)).The subgroup analysis was performed according to the sample source,and the results demonstrated that the risk of bone density loss was higher in drinking group compared to non-drinking group,both in Chinese people and overseas people,and was more higher in drinking group compared to non-drinking group in Chinese people(OR=5.01,95%CI(2.04,12.33);OR=1.61,95%CI(1.19,2.16)).The subgroup analysis was performed according to gender,and the results demonstrated that the risk of bone density loss was higher in drinking group compared to non-drinking group in males(OR=3.02,95%CI(1.69,5.39)).There was no statistical difference in risk of bone density loss between drinking group and non-drinking group in females(OR=1.37,95%CI(0.68,2.74)).The meta-analysis results did not change after excluding one article which had the largest sample size.The funnel plot showed that there was vacancy in the lower-left corner.Conclusion:Alcohol drinking can increase the risk of bone density loss.The risk of bone density loss caused by alcohol drinking is higher in Chinese people compared to overseas people,and is higher in males compared to females.