中国绝经女性骨质疏松症患病率的Meta分析

Prevalence of osteoporosis in Chinese postmenopausal females:a meta-analysis

目的系统评价中国绝经女性骨质疏松症(osteoporosis,OP)的患病情况。方法计算机检索CNKI、VIP、CBM、WanFang Data、PubMed、EMbase和The Cochrane Library数据库,搜集有关中国绝经女性OP患病率的横断面研究,检索时限均从建库至2022年3月17日。由2名研究者独立筛选文献,提取资料并评价纳入研究的偏倚风险后,采用Stata 14.0软件进行Meta分析。结果共纳入54个研究,包括绝经后女性96391例,其中41651人患有OP。Meta分析结果显示,我国绝经女性OP患病率为38.8%[95%CI(34.1%,43.5%)]。亚组分析结果显示,以绝经年限分组,绝经时间≤4年的女性OP患病率为31.7%[95%CI(16.6%,48.6%)],5~9年为47.4%[95%CI(32.2%,62.5%)],10~14年为52.7%[95%CI(37.1%,68.3%)],15~19年为77.5%[95%CI(69.5%,85.4%)],≥20年为78.3%[95%CI(56.3%,100.0%)]。以年龄段分组,<50岁OP的患病率为16.2%[95%CI(28.8%,37.2%)],50~59岁为28.8%[95%CI(34.4%,47.9%)],60~69岁为41.1%[95%CI(34.4%,47.9%)],70~79岁为55.3%[95%CI(45.8%,64.8%)],≥80岁为82.0%[95%CI(76.1%,87.9%)]。以地区分组,东北地区为31.0%[95%CI(24.6%,37.4%)],华东地区为40.0%[95%CI(30.5%,49.4%)],华北地区为35.9%[95%CI(22.3%,49.5%)],华中地区为36.8%[95%CI(34.0%,39.5%)],华南地区为41.2%[95%CI(28.1%,54.4%)],西南地区为36.2%[95%CI(21.6%,50.7%)],西北地区为43.5%[95%CI(22.3%,64.7%)]。以发表时间分组,1997—2009年为43.9%[95%CI(15.7%,72.0%)],2010—2021年为38.2%[95%CI(33.8%,42.5%)]。以生育次数分组,<2次为24.9%[95%CI(20.5%,29.3%)],≥2次为45.0%[95%CI(37.0%,53.0%)]。结论现有证据显示,我国绝经女性OP患病率较高。受纳入研究数量和质量的限制,上述结论尚需更多高质量研究予以验证。

Objective To systematically review the prevalence of osteoporosis(OP)in Chinese postmenopausal females.Methods The CNKI,VIP,CBM,WanFang Data,PubMed,EMbase and The Cochrane Library databases were electronically searched to collect studies on the prevalence of OP in Chinese postmenopausal females from inception to March 17,2022.Two reviewers independently screened the literature,extracted data and evaluated the risk of bias of the included studies.Meta-analysis was then performed using Stata 14.0 software.Results A total of 54 studies involving 96391 cases and 41651 confirmed OP patients were included.The meta-analysis results showed that the prevalence of OP in Chinese postmenopausal females was 38.8%(95%CI 34.1%to 43.5%).Subgroup analysis showed that the prevalence of OP was 31.7%(95%CI 16.6%to 48.6%)in females who had been menopausal for less than 5 years,47.4%(95%CI 32.2%to 62.5%)for 5-9 years,52.7%(95%CI 37.1%to 68.3%)for 10-14 years,77.5%(95%CI 69.5%to 85.4%)for 15-19 years,and78.3%(95%CI 56.3%to 100.0%)for more than 20 years.The rate was 16.2%(95%CI 28.8%to 37.2%)in under 50 years age group,28.8%(95%CI 34.4%to 47.9%)for 50-years group,41.1%(95%CI 34.4%to 47.9%)for 60-years group,55.3%(95%CI 45.8%to 64.8%)for 70-years group,82.0%(95%CI 76.1%to 87.9%)for 80-years group.The prevalence in different regions was between 31.0%and 43.5%,which was lowest in the northeast(31.0%,95%CI 26.3%to 51.4%)and highest in the northwest(43.5%,95%CI 22.3%to 64.7%).According to the year of publication,the rate was 43.9%(95%CI 15.7%to 72.0%)from 1997 to 2009 and 38.2%(95%CI 33.8%to 42.5%)from 2010 to 2021.The prevalence of OP was 24.9%(95%CI 20.5%to 29.3%)in postmenopausal females with no birth or 1 birth,and 45.0%(95%CI 37.0%to 53.0%)in females with 2 or more births.Conclusion The prevalence of OP in Chinese postmenopausal females is relatively high.Due to the limited quantity and quality of the included studies,more high-quality studies are needed to verify the above conclusion.