绝经后女性骨密度与冠状动脉粥样硬化关系的 Meta分析

摘要

Objective To study the relationship between bone mineral density and coronary atherosclerosis in postmenopausal women from the perspective of evidence-based medicine, in order to provide theoretical basis for early prevention and treatment of coronary heart disease.Methods By making searching strategy, the related literatures published in recent 10 years were retrieved from PubMed, EMbase, Ovid, EBSCO, CNKI, SinoMed, VIP, and Wanfang Data etc.All the relevant case-control studies that met the requirements were evaluated.The data were analyzed using the software Review Manager 5.2.Results Eight case-control studies were enrolled, including 986 patients from the low bone mineral density group ( low bone mass and osteoporosis) and 926 patients from the control group.Meta analysis showed that the heterogeneity of the test results were I2 =0%, χ2 =6.52, and P=0.48.The heterogeneity of the studies was subtle by adopting the fixed effects model and merging effect quantity:OR=2.81, 95%of CI=2.26 -3.50.The difference of incidences of coronary atherosclerosis between low bone mineral density group and the normal bone mass group was statistically significant.Conclusion The declination of bone mineral density in postmenopausal women is significantly correlated with the occurrence of coronary atherosclerosis.Osteopenia and osteoporosis may be the risk factors for coronary atherosclerosis.%目的：从循证医学角度探讨绝经后女性骨密度与冠状动脉粥样硬化的关系，为冠心病早期防治提供理论依据。方法通过制定检索策略，在PubMed、EMbase、Ovid、EBSCO、CNKI、中国生物医学文献、维普中文科技期刊等数据库中检索近10年发表的相关文献，对所有符合要求的相关病例对照研究文献进行评价，应用Review Manager 5.2分析软件对数据进行分析。结果最终共纳入8个病例对照研究，包括骨密度降低组（低骨量和骨质疏松）986例患者，对照组926例患者。 Meta分析结果显示：各研究数据异质性检验结果I2＝0％，χ2＝6.52，P＝0.48，各研究间异质性小，采用固定效应模型，合并效应量OR＝2.81，95％CI为2.26－3.50，低骨密度组与骨量正常组冠状动脉粥样硬化的发病率差异有统计学意义。结论绝经后女性骨密度的降低与冠状动脉粥样硬化的发生有显著相关性，骨量减少和骨质疏松可能是冠状动脉粥样硬化的危险因素。