腹主动脉钙化与骨折风险的Meta分析

A Meta-analysis on the relationship between abdominal aortic calcification and fracture

目的腹主动脉钙化(AAC)是否是骨折发生的危险因素尚不明确。本研究通过Meta分析观察两者之间的关系。方法检索Pub Med、EMbase、CNKI等数据库,筛选并纳入相关文献。提取文献特征,采用STATA 12.0软件计算总的危险比(RR)及95%可信区间(95%CI),并评价研究间的异质性、有无发表偏倚。结果共纳入7篇前瞻性队列研究。总的Meta分析结果显示严重AAC是骨折发生的独立危险因素(RR=1.52,95%CI:1.30~1.78,P=0.000;I2=30.1%)。亚组分析显示,AAC与髋骨骨折的发生呈显著正相关(RR=1.62,95%CI:1.25~2.11,P=0.000,I2=17.0%,n=5),而与椎体(RR=1.45,95%CI:0.81~2.58,P=0.213,I2=69.0%,n=3)及非椎体骨折(RR=1.35,95%CI:0.96~1.88,P=0.081,I2=75.9%,n=3)的发生无显著相关性。发表偏倚检验结果未发现存在发表偏倚证据(Begg:P=0.266;Egger:P=0.139)。结论本项Meta分析结果提示严重AAC可能是预测骨折发生风险的因素之一。

Objective Uncertainties remain about the relationship between abdominal aortic calcification(AAC) and the risk of fracture. This Meta-analysis was performed to explore the association between them. Methods Multiple databases were searched to identify studies on the association between AAC and the risk of fracture. Relevant information for analysis was extracted. The pooled risk estimate and its 95% confidence interval(CI) was calculated by software STATA 12.0. Heterogeneity across studies and publication bias were tested. Results 7 prospective cohort studies were included. The pooled relative risk(RR) for the risk of fracture comparing severe AAC with no or mild AAC was 1.52(1.30-1.78, P=0.000; I2=30.1%). Subgroup analysis by fracture type showed that a significant relationship only existed in hip fracture(RR=1.62, 95% CI: 1.25-2.11, P=0.000, I2=17.0%, n=5), but not in vertebral(RR=1.45, 95% CI: 0.81-2.58, P=0.213, I2=69. 0%, n=3)or non-verterbral fracture(RR=1.35, 95% CI: 0.96-1.88, P=0.081, I2=75.9%, n=3). No evidence of publication bias was observed(Begg: P=0.266; Egger: P=0.139). Conclusion Our results showed that severe AAC may be one of the predictors for bone fractures.