类风湿性关节炎患者骨质疏松症的危险因素:一个元分析
Tianyu Fu1, Renhao Zhang1, Liang Yue2
1First Clinical Academy, Shandong University of Traditional Chinese Medicine, No. 16369 Jingshi Road, Jinan City, 250000, Shandong Province, China.
概括
类风湿性关节炎患者的骨质疏松风险在女性,老年人以及先前骨折或疾病持续时间较长的人群中较高. 较高的BMI和维生素D水平是风湿性关节炎中骨质疏松症的保护因素.
科学领域:
- 类风湿病学 类风湿病学
- 骨质疏松症研究 骨质疏松症研究
- 超分析方法论 方法论
背景情况:
- 类风湿性关节炎 (RA) 与骨质疏松症 (OP) 的风险增加有关.
- 确定RA患者OP的特定风险因素对于有效的预防和管理至关重要.
- 之前的研究已经产生了不一致的结论,关于OP风险因素在RA.
研究的目的:
- 进行全面的文献审查和元分析,以确定类风湿性关节炎患者骨质疏松症的风险因素.
- 系统地识别和量化各种人口,临床和实验室因素对RA患者OP发展的影响.
主要方法:
- 在多个数据库 (PubMed,Embase,Cochrane,Web of Science等) 中进行系统搜索. 在2024年12月31日之前进行.
- 使用纽卡斯尔-太华量表来评估研究质量,并使用STATA 18分析数据以计算95%置信区间 (CI) 的几率比率 (OR).
- 出版偏差是使用漏斗图和埃格尔测试来评估的.
主要成果:
- 在元分析中包含了57篇文章.
- 关键风险因素包括女性性别 (OR=2.10),年龄 (OR=1.11),先前的骨折 (OR=2.83),更长的疾病持续时间 (OR=1.16) 和绝经后的状态 (OR=3.96).
- 升高的CTX,更高的DAS28得分,增加的ESR,更高的Sharp得分,RF标位和葡萄糖皮质激素治疗也与增加的OP风险有关. 较高的BMI (OR=0.86),足够的25-OH-D水平 (OR=0.88),以及/维生素D补充剂 (OR=0.49) 是具有保护性的.
结论:
- 女性性别,晚年,绝经后状态,先前骨折和葡萄糖皮质激素治疗是类风湿性关节炎患者骨质疏松的主要危险因素.
- 较高的体重指数 (BMI) 和足够的维生素D水平被确定为保护因素.
- 这些发现可以为患有类风湿性关节炎的个体提供骨质疏松症的个性化预防策略.
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