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Abstract：
OBJECTIVE: The OPG/RANKL signal pathway was important regulation mechanism of bone remodeling cycle, but the effect of osteoprotegerin (OPG) and RANKL in osteoporosis was uncertain. We did a systematic review with meta-analysis to assess the association between serum OPG/RANKL and osteoporosis.
METHODS: The systematic search, data extraction, critical appraisal, and meta-analysis were performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Randomized controlled studies were searched in PubMed, OvidMedline, Embase (1946 to present). Standard mean difference (SMD), and associated credible interval (CI) were calculated using RevMan statistical software to assess the continuous data. Heterogeneity in studies was measured by I2 values. Subgroup analysis was performed based on different bone turnover.
RESULTS: A total of 5 randomized controlled studies met the inclusion criteria. Both OPG and RANKL had no significant differences between the osteoporosis and control group, and the statistical heterogeneity was high in meta-analysis. However, RANKL had significant differences between the osteoporosis group with low bone turnover and control group (SMD = - 1.17; 95% CI - 1.77 to 0.57; P value < 0.01) in subanalysis. Furthermore, the OPG/RANKL ratio was significant lower in the osteoporosis group than in the control group (SMD = - 0.29; 95% CI - 0.57 to - 0.02; P value < 0.05), and the statistical heterogeneity was very low (Chi2 = 0.20, P = 0.66, I2 = 0%).
CONCLUSIONS: Our meta-analysis study supported OPG and RANKL were important modulatory factors of bone formation and resorption in bone turnover, respectively. Although the serum level of both OPG and RANKL were not associated with osteoporosis, but the OPG/RANKL ratio was associated with osteoporosis. In future, standardizing the test method and unit was good to clinical application.
METHODS: The systematic search, data extraction, critical appraisal, and meta-analysis were performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Randomized controlled studies were searched in PubMed, OvidMedline, Embase (1946 to present). Standard mean difference (SMD), and associated credible interval (CI) were calculated using RevMan statistical software to assess the continuous data. Heterogeneity in studies was measured by I2 values. Subgroup analysis was performed based on different bone turnover.
RESULTS: A total of 5 randomized controlled studies met the inclusion criteria. Both OPG and RANKL had no significant differences between the osteoporosis and control group, and the statistical heterogeneity was high in meta-analysis. However, RANKL had significant differences between the osteoporosis group with low bone turnover and control group (SMD = - 1.17; 95% CI - 1.77 to 0.57; P value < 0.01) in subanalysis. Furthermore, the OPG/RANKL ratio was significant lower in the osteoporosis group than in the control group (SMD = - 0.29; 95% CI - 0.57 to - 0.02; P value < 0.05), and the statistical heterogeneity was very low (Chi2 = 0.20, P = 0.66, I2 = 0%).
CONCLUSIONS: Our meta-analysis study supported OPG and RANKL were important modulatory factors of bone formation and resorption in bone turnover, respectively. Although the serum level of both OPG and RANKL were not associated with osteoporosis, but the OPG/RANKL ratio was associated with osteoporosis. In future, standardizing the test method and unit was good to clinical application.
摘要：
目的：OPG/RANKL信号通路是骨重塑周期的重要调控机制,但骨保护素（OPG）和RANKL在骨质疏松症中的作用尚不确定。我们用荟萃分析进行了系统评价，以评估血清OPG/RANKL与骨质疏松症之间的关系。
方法：系统搜索，数据提取,批判性评估，根据系统评价和荟萃分析（PRISMA）声明的首选报告项目进行荟萃分析。在PubMed中搜索了随机对照研究，OvidMedline,Embase（1946年至今）。标准平均差(SMD)，使用RevMan统计软件计算相关可信区间(CI)以评估连续数据。研究中的异质性通过I2值测量。根据不同的骨转换进行亚组分析。
结果：共有5项随机对照研究符合纳入标准。OPG和RANKL在骨质疏松组与对照组之间均无显著性差异。荟萃分析的统计学异质性较高。然而,在亚组分析中，RANKL在低骨转换的骨质疏松组与对照组之间具有显着差异（SMD=-1.17；95％CI-1.77至0.57；P值<0.01）。此外，骨质疏松组OPG/RANKL比值显著低于对照组(SMD=-0.29;95%CI-0.57~-0.02;P值<0.05),统计学异质性很低(Chi2=0.20,P=0.66,I2=0%)。
结论：我们的荟萃分析研究支持OPG和RANKL是骨转换过程中骨形成和骨吸收的重要调节因素，分别。尽管OPG和RANKL的血清水平与骨质疏松症无关。但OPG/RANKL比值与骨质疏松相关.在未来,规范检验方法和单位,有利于临床应用。
方法：系统搜索，数据提取,批判性评估，根据系统评价和荟萃分析（PRISMA）声明的首选报告项目进行荟萃分析。在PubMed中搜索了随机对照研究，OvidMedline,Embase（1946年至今）。标准平均差(SMD)，使用RevMan统计软件计算相关可信区间(CI)以评估连续数据。研究中的异质性通过I2值测量。根据不同的骨转换进行亚组分析。
结果：共有5项随机对照研究符合纳入标准。OPG和RANKL在骨质疏松组与对照组之间均无显著性差异。荟萃分析的统计学异质性较高。然而,在亚组分析中，RANKL在低骨转换的骨质疏松组与对照组之间具有显着差异（SMD=-1.17；95％CI-1.77至0.57；P值<0.01）。此外，骨质疏松组OPG/RANKL比值显著低于对照组(SMD=-0.29;95%CI-0.57~-0.02;P值<0.05),统计学异质性很低(Chi2=0.20,P=0.66,I2=0%)。
结论：我们的荟萃分析研究支持OPG和RANKL是骨转换过程中骨形成和骨吸收的重要调节因素，分别。尽管OPG和RANKL的血清水平与骨质疏松症无关。但OPG/RANKL比值与骨质疏松相关.在未来,规范检验方法和单位,有利于临床应用。
