益生菌对绝经后妇女骨代谢影响的Meta分析

Effect of probiotics on bone metabolism in postmenopausal women:a meta-analysis

目的应用Meta分析方法系统评价益生菌对绝经后妇女骨代谢的影响。方法计算机检索PubMed、中国知网等国内外8个数据库中关于益生菌治疗对绝经后妇女骨代谢影响的随机对照试验,检索时限自建库至2021年10月28日。由2名研究者根据纳排标准独立筛选文献、资料提取及评价文献质量,用RevMan 5.3软件对纳入文献进行Meta分析。结果本研究共纳入8篇文献包含826例患者,其中益生菌组418例,安慰剂组408例。Meta分析结果显示:与安慰剂组相比,益生菌组股骨骨密度增加[MD=0.04,95%CI(0.00,0.08),P=0.04],血清I型胶原吡啶交联终肽(CTX)[MD=-0.12,95%CI(-0.13,-0.11),P<0.00001]和骨特异性碱性磷酸酶(BALP)[MD=-4.19,95%CI(-4.68,-3.70),P<0.00001]水平显著降低,两组患者的腰椎骨密度及不良反应发生率均无统计学差异(P>0.05)。结论益生菌可以改善绝经后妇女的股骨骨密度,降低血清CTX和BALP水平,并且不会增加不良反应的发生,对绝经后妇女的骨质疏松有一定的预防作用但尚需进一步开展多中心大样本的随机对照试验(RCT)加以佐证。

Objective:To systematically evaluate the effect of probiotics on bone metabolism in postmenopausal women through meta-analysis.Methods:The randomized controlled trials(RCTs)involved the effect of probiotic therapy on bone metabolism in postmenopausal women in 8 databases at home and abroad,including PubMed and CNKI,were searched by computer.The retrieval time limit was from the establishment of the database to October 28,2021.Two researchers independently screened the literature,extracted the data and evaluated the quality of the literature according to the inclusion and exclusion criteria.The included literature was meta analyzed with RevMan 5.3 software.Results:A total of 8 RCTs including 826 patients were included in this study,including 418 in the probiotic group and 408 in the placebo group.Meta-analysis showed that compared with the placebo group,femur bone mineral density significantly increased[MD=0.04,95%CI(0.00,0.08),P=0.04],serum levels of type Ⅰ collagen-pyridine crosslinked endopeptide(CTX)[MD=-0.12,95%CI(-0.13,-0.11),P<0.00001]and bone specific alkaline phosphatase(BALP)[MD=-4.19,95%CI(-4.68,-3.70),P<0.00001]significantly decreased in the probiotic group.There was no significant difference in lumbar bone mineral density and the incidence of adverse events between the patients of the two groups(P>0.05).Conclusions:Probiotics can improve the femur bone density,reduce the serum CTX and BALP levels,and do not increase the occurrence of adverse reactions in postmenopausal women,which has a certain preventive effect on postmenopausal women’s osteoporosis.However,it needs to be further verified by multi-center large sample randomized controlled trials.