儿童癌症幸存者的骨矿物质密度:一个元分析
Lilly Velentza1, Panagiotis Filis2, Mari Wilhelmsson3,4
1Division of Pediatric Endocrinology, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
Pediatrics
|July 30, 2024
概括
儿童癌症幸存者 (CCS) 在治疗后显示骨矿物质密度 (BMD) 降低. 这凸显了在这个不断增长的人群中对骨损伤监测和预防策略的关键需求,以减轻骨折风险.
科学领域:
- 儿科瘤学 儿科瘤学
- 骨健康研究 骨健康研究
- 幸存率研究 幸存率研究
背景情况:
- 儿童癌症幸存者 (CCS) 面临治疗相关骨疾病的风险增加.
- 骨矿物质密度 (BMD) 降低是骨健康不佳的关键指标,与骨质疏松症和中枢神经系统骨折有关.
研究的目的:
- 在儿童癌症幸存者 (CCS) 治疗后系统地审查和元分析骨矿物质密度 (BMD).
- 评估BMD减少的程度及其对CCS患者长期骨健康的影响.
主要方法:
- 主要数据库 (Medline,Embase,Cochrane,Web of Science) 的综合文献搜索更新至2023年5月.
- 包括84项研究 (N=8106) 在治疗完成后在CCS中通过双能X射线吸收计测量的BMDZ-score.
- 联合分析BMDZ-score和对健康对照进行比较分析,按测量地点分层.
主要成果:
- 在所有测量地点,整体汇总的 BMD Z-score 平均值显著降低: -0.57 (全身), -0.84 (腰椎), -0.79 (大腿部) 和 -0.14 (全部).
- 与健康对照人相比,幸存者在所有分析的骨部位都表现出明显较低的BMD.
- 治疗结束时间差异很大 (2个月至24年),表明对骨健康的长期影响.
结论:
- 儿童癌症幸存者在骨矿物质密度 (BMD) Z-score 中显著降低.
- 观察到的骨质量减少,特别是低于-1 SD,强调需要进行常规的骨质量监测和预防CCS中的二次骨折.
- 这些发现强调了癌症治疗对幸存者的长期骨健康影响.
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