Abstract：
OBJECTIVE: Vasomotor symptoms (VMS) adversely affect postmenopausal quality of life. However, their association with bone health has not been elucidated. This study aimed to systematically review and meta-analyze the evidence regarding the association of VMS with fracture risk and bone mineral density (BMD) in peri- and postmenopausal women.
METHODS: A literature search was conducted in PubMed, Scopus and Cochrane databases until 31 August 2023. Fracture, low BMD (osteoporosis/osteopenia) and mean change in lumbar spine (LS) and femoral neck (FN) BMD were assessed. The results are presented as odds ratio (OR) and mean difference (MD), respectively, with a 95% confidence interval (95% CI). The I2 index quantified heterogeneity.
RESULTS: Twenty studies were included in the qualitative and 12 in the quantitative analysis (n=49,659). No difference in fractures between women with and without VMS was found (n=5, OR 1.04, 95% CI 0.93-1.16, I2 16%). However, VMS were associated with low BMD (n=5, OR 1.54, 95% CI 1.42-1.67, I2 0%). This difference was evident for LS (MD -0.019 g/cm2, 95% CI -0.03 to -0.008, I2 85.2%), but not for FN BMD (MD -0.010 g/cm2, 95% CI -0.021 to 0.001, I2 78.2%). These results were independent of VMS severity, age and study design. When the analysis was confined to studies that excluded menopausal hormone therapy use, the association with BMD remained significant.
CONCLUSIONS: The presence of VMS is associated with low BMD in postmenopausal women, although it does not seem to increase fracture risk.
METHODS: A literature search was conducted in PubMed, Scopus and Cochrane databases until 31 August 2023. Fracture, low BMD (osteoporosis/osteopenia) and mean change in lumbar spine (LS) and femoral neck (FN) BMD were assessed. The results are presented as odds ratio (OR) and mean difference (MD), respectively, with a 95% confidence interval (95% CI). The I2 index quantified heterogeneity.
RESULTS: Twenty studies were included in the qualitative and 12 in the quantitative analysis (n=49,659). No difference in fractures between women with and without VMS was found (n=5, OR 1.04, 95% CI 0.93-1.16, I2 16%). However, VMS were associated with low BMD (n=5, OR 1.54, 95% CI 1.42-1.67, I2 0%). This difference was evident for LS (MD -0.019 g/cm2, 95% CI -0.03 to -0.008, I2 85.2%), but not for FN BMD (MD -0.010 g/cm2, 95% CI -0.021 to 0.001, I2 78.2%). These results were independent of VMS severity, age and study design. When the analysis was confined to studies that excluded menopausal hormone therapy use, the association with BMD remained significant.
CONCLUSIONS: The presence of VMS is associated with low BMD in postmenopausal women, although it does not seem to increase fracture risk.
摘要：
目的：血管舒缩症状（VMS）对绝经后生活质量有不利影响。然而,它们与骨骼健康的关系尚未阐明。本研究旨在系统回顾和荟萃分析绝经前后女性VMS与骨折风险和骨密度（BMD）相关的证据。
方法：在PubMed，Scopus和Cochrane数据库，直到2023年8月31日。骨折,评估了低BMD（骨质疏松症/骨质减少）以及腰椎（LS）和股骨颈（FN）BMD的平均变化。结果以比值比(OR)和平均差(MD)表示，分别,95%置信区间(95%CI)。I2指数量化了异质性。
结果：20项研究纳入定性分析，12项纳入定量分析（n=49,659）。有和没有VMS的女性之间的骨折没有差异（n=5，OR1.04，95％CI0.93-1.16，I216％）。然而,VMS与低骨密度相关（n=5，OR1.54，95％CI1.42-1.67，I20％）。对于LS（MD-0.019g/cm2，95％CI-0.03至-0.008，I285.2％），但不适用于FNBMD（MD-0.010g/cm2，95％CI-0.021至0.001，I278.2％）。这些结果与VMS严重程度无关，年龄和学习设计。当分析仅限于排除更年期激素治疗使用的研究时，与BMD的相关性仍然显著.
结论：VMS的存在与绝经后妇女的低骨密度有关，虽然它似乎不会增加骨折风险。
方法：在PubMed，Scopus和Cochrane数据库，直到2023年8月31日。骨折,评估了低BMD（骨质疏松症/骨质减少）以及腰椎（LS）和股骨颈（FN）BMD的平均变化。结果以比值比(OR)和平均差(MD)表示，分别,95%置信区间(95%CI)。I2指数量化了异质性。
结果：20项研究纳入定性分析，12项纳入定量分析（n=49,659）。有和没有VMS的女性之间的骨折没有差异（n=5，OR1.04，95％CI0.93-1.16，I216％）。然而,VMS与低骨密度相关（n=5，OR1.54，95％CI1.42-1.67，I20％）。对于LS（MD-0.019g/cm2，95％CI-0.03至-0.008，I285.2％），但不适用于FNBMD（MD-0.010g/cm2，95％CI-0.021至0.001，I278.2％）。这些结果与VMS严重程度无关，年龄和学习设计。当分析仅限于排除更年期激素治疗使用的研究时，与BMD的相关性仍然显著.
结论：VMS的存在与绝经后妇女的低骨密度有关，虽然它似乎不会增加骨折风险。
