血清鸢尾素水平与绝经后骨质疏松相关性的Meta分析

Meta Analysis of the Correlation Between Serum Irisin Level and Postmenopausal Osteoporosis

目的 系统评价血清鸢尾素(Irisin)水平与绝经后骨质疏松症(postmenopausal osteoporosis, PMOP)的相关性。方法 计算机系统检索PubMed、Embase、Web of science、中国知网等中英文数据库中关于血清Irisin水平与PMOP相关性的文献,检索时间为从建库至2022-01月。通过纽卡斯尔-渥太华量表(Newcastle-Ottawa scale, NOS)评分对纳入研究的文献质量进行评价,并在数据提取后采用Revman 5.3和Stata 14.0进行统计分析。结果 共纳入研究14项,其中PMOP组人数1257例,对照组人数1243例。Meta分析结果显示,PMOP组的血清Irisin水平显著低于对照组,差异具有统计学意义(SMD=-1.65,95%CI:-2.17~-1.14,P<0.001)。亚组分析结果显示,糖尿病和体质量指数(body mass index, BMI)的亚组组间差异具有统计学意义(P均<0.05),其中患有糖尿病和BMI<25 kg/m^(2)亚组的PMOP患者血清Irisin水平下降程度更大。相关性结果显示,血清Irisin水平与股骨颈、腰椎和全髋部骨密度呈正相关(r值分别为0.22、0.31、0.41,P均<0.05)。结论 PMOP患者较正常绝经后女性血清Irisin水平更低,且受BMI和糖尿病的影响。另外,血清Irisin水平与股骨颈、腰椎和全髋部骨密度呈正相关。以上结果进一步提示血清Irisin水平可能是临床诊疗PMOP的潜在生化标志物。

Objective To systematically evaluate the correlation between serum Irisin level and postmenopausal osteoporosis(PMOP).Methods PubMed, Embase, Web of science, China National knowledge Infrastructure and other Chinese and English databases were searched by computer system for literature on the correlation between serum Irisin level and PMOP from the establishment of the database to January 2022. The literature quality of the included studies was evaluated by Newcastle-Ottawa scale(NOS) score, and Revman 5.3 and Stata 14.0 were used for statistical analysis after data extraction.Results A total of 14 studies were included, including 1257 cases in the PMOP group and 1243 cases in the control group. The results of Meta analysis showed that serum Irisin level in the PMOP group was significantly lower than that in the control group and the difference was statistically significant(SMD=-1.65, 95% CI:-2.17 to-1.14, P<0.001). The results of subgroup analysis showed that the differences of diabetes and body mass index(BMI) between subgroups were statistically significant(all P<0.05), and the serum Irisin level of PMOP patients with diabetes and BMI25 kg/m^(2) subgroup decreased more. The correlation results showed that the serum Irisin level was positively correlated with the bone mineral density of the femoral neck, lumbar spine and total hip(r=0.22, 0.31 and 0.41 respectively, all P<0.05).Conclusion Serum Irisin level in PMOP patients is lower than that in normal postmenopausal women, which is affected by BMI and diabetes. In addition, serum Irisin level was positively correlated with bone mineral density of the femoral neck, lumbar spine and total hip. The above results further suggest that serum Irisin level may be a potential biochemical marker for clinical diagnosis and treatment of PMOP.