运动对骨质疏松老年人骨密度影响的Meta分析

Meta Analysis of the effect of exercise on Bone Mineral density in the elderly with Osteoporosis

目的:采用Meta分析的方法,评定运动干预对骨质疏松老年人骨密度(BMD)的改善效果。方法:检索PubMed、Embase、Web of Science、Cochrane Library和中国知网(CNKI)、万方数据,搜集自建库至2023年7月发表的有关运动干预治疗60岁以上老年人骨质疏松症的随机对照试验(RCTS),根据纳入标准和排除标准对文献进行筛选,提取干预特征和结局指标,对所纳入文献的结局指标进行分析,采用漏斗图进行发表偏倚的影响分析,Cochrane偏倚风险评估工具进行文献质量评价。结果:纳入9篇文献(21项研究)共1011例患者。结果显示:(1)运动干预后整体上的BMD明显提高。(2)腰椎和股骨近端BMD明显提高;髋骨、股骨总体、股骨颈BMD差异不明显。(3)有氧运动或组合运动后腰椎BMD显著提高;组合运动后髋骨BMD显著提高。(4)6个月以上的运动干预、每周3次以上的运动干预、每次30分钟以上的运动干预后腰椎BMD显著提高。结论:(1)运动干预能够有效改善老年人整体的BMD,提升腰椎和股骨近端BMD。(2)有氧运动和组合运动对提升腰椎BMD具有显著意义,组合运动对提升髋骨BMD具有显著意义。(3)6个月以上的运动干预、频率>3次/周的运动干预、时间>30min/次的运动干预都能显著提升腰椎BMD。

Objective:To comprehensively evaluate the improvement effect of exercise intervention on bone mineral density(BMD)in the elderly by using the method of Meta-analysis.Methods:Comprehensively searched PubMed,Embase,Web of Science,Cochrane lbrary,China National Knowledge Network(CNKI),Wanfang data and other Chinese databases.Randomized controlled trials(RCTS)on exercise intervention in the treatment of osteoporosis in elderly people over 60 years old published in the self-built database from July 2023 were collected.According to the inclusion criteria and exclusion criteria,the literatures were screened,the intervention characteristics and outcome indicators were extracted,the outcome indicators of the included literatures were analyzed,the influence of publication bias was analyzed by funnel diagram,and the quality of literatures was evaluated by Cochrane bias risk assessment tool.Results:A total of 1011 patients were included in 9 literatures(21 studies).The results of meta-analysis showed that:(1)Overall BMD was significantly improved after exercise intervention.(2)BMD of lumbar spine and proximal femur was significantly improved after exercise intervention;There was no significant difference in BMD of hip bone,overall femur and neck of femur.(3)Lumbar BMD was significantly increased after aerobic exercise or combined exercise;Hip BMD significantly improved after combined exercise(4)Lumbar BMD significantly improved after exercise intervention for more than 6 months,exercise intervention for more than 3 times a week,and exercise intervention for more than 30 minutes each time.Conclusion:(1)Exercise intervention can effectively improve the overall BMD of the elderly,and can effectively improve the BMD of the lumbar spine and the proximal femur.(2)Aerobic exercise and combination exercise have significant significance in improving lumbar BMD,and combination exercise has significant significance in improving hip BMD.(3)Exercise intervention over 6 months,exercise intervention with frequency>3 times/week,and exercise intervention with time>30 min/time can significantly improve lumbar BMD.