PDF(Pubmed)
Abstract：
BACKGROUND: Patients undergoing intestinal urinary diversion (IUD) may have a higher risk of osteoporosis and risk of fractures due to metabolic acidosis and decrease of intestinal absorption surface.
OBJECTIVE: We performed a systematic review of the available literature on the impact of IUD on bone demineralization.
METHODS: We systematically searched PubMed®, for original articles published before April 2020. Primary end points were the risk of fracture and loss of bone density. Secondary outcomes were the metabolic changes in biochemical and urine parameters related to calcium metabolism and histological changes.
RESULTS: Our electronic search identified a total of 2417 articles. After a detailed review, we selected 11 studies that addressed the impact of IUD on bone health in 10369 patients. The risk of bone fracture was studied in 3 articles, showing a higher risk in the IUD population. Of the 9 articles evaluating the relation between intestinal urinary diversion and bone density, 5 did find a positive association. One article evaluated the bone metabolism at a cellular level after IUD showing a decrease in bone turnover in this population. Three of the eight studies reporting data on serum parameters related to calcium and phosphate metabolism showed differences. Finally, a correlation between concentration of pyridolines in urine and loss of bone density was found in two of the three studies.
CONCLUSIONS: Although published data on BMD are contradictory, patients undergoing IUD seem to be at higher risk of bone fractures. Our finding support the need to implement accessible strategies on osteoporosis screening and prevention in IUD patients.
OBJECTIVE: We performed a systematic review of the available literature on the impact of IUD on bone demineralization.
METHODS: We systematically searched PubMed®, for original articles published before April 2020. Primary end points were the risk of fracture and loss of bone density. Secondary outcomes were the metabolic changes in biochemical and urine parameters related to calcium metabolism and histological changes.
RESULTS: Our electronic search identified a total of 2417 articles. After a detailed review, we selected 11 studies that addressed the impact of IUD on bone health in 10369 patients. The risk of bone fracture was studied in 3 articles, showing a higher risk in the IUD population. Of the 9 articles evaluating the relation between intestinal urinary diversion and bone density, 5 did find a positive association. One article evaluated the bone metabolism at a cellular level after IUD showing a decrease in bone turnover in this population. Three of the eight studies reporting data on serum parameters related to calcium and phosphate metabolism showed differences. Finally, a correlation between concentration of pyridolines in urine and loss of bone density was found in two of the three studies.
CONCLUSIONS: Although published data on BMD are contradictory, patients undergoing IUD seem to be at higher risk of bone fractures. Our finding support the need to implement accessible strategies on osteoporosis screening and prevention in IUD patients.
摘要：
背景：接受肠道尿流改道（IUD）的患者可能由于代谢性酸中毒和肠吸收表面减少而具有更高的骨质疏松症和骨折风险。
目的：我们对IUD对骨脱矿影响的现有文献进行了系统综述。
方法：我们系统地搜索了PubMed®，对于2020年4月之前发表的原创文章。主要终点是骨折和骨密度丢失的风险。次要结果是与钙代谢和组织学变化相关的生化和尿液参数的代谢变化。
结果：我们的电子搜索共识别了2417篇文章。经过详细的审查,我们选择了11项研究,在10369例患者中探讨了宫内节育器对骨骼健康的影响.在3篇文章中研究了骨折的风险，在宫内节育器人群中显示出更高的风险。在评价肠尿流改道与骨密度关系的9篇文章中，5确实发现了正相关。一篇文章评估了IUD后细胞水平的骨代谢，表明该人群的骨转换减少。报告与钙和磷酸盐代谢相关的血清参数数据的八项研究中的三项显示出差异。最后,在三项研究中的两项研究中发现，尿液中吡啶甲酸的浓度与骨密度丢失之间存在相关性。
结论：尽管已发表的BMD数据相互矛盾，接受宫内节育器的患者似乎有较高的骨折风险.我们的发现支持了在宫内节育器患者中实施骨质疏松症筛查和预防可访问策略的必要性。
目的：我们对IUD对骨脱矿影响的现有文献进行了系统综述。
方法：我们系统地搜索了PubMed®，对于2020年4月之前发表的原创文章。主要终点是骨折和骨密度丢失的风险。次要结果是与钙代谢和组织学变化相关的生化和尿液参数的代谢变化。
结果：我们的电子搜索共识别了2417篇文章。经过详细的审查,我们选择了11项研究,在10369例患者中探讨了宫内节育器对骨骼健康的影响.在3篇文章中研究了骨折的风险，在宫内节育器人群中显示出更高的风险。在评价肠尿流改道与骨密度关系的9篇文章中，5确实发现了正相关。一篇文章评估了IUD后细胞水平的骨代谢，表明该人群的骨转换减少。报告与钙和磷酸盐代谢相关的血清参数数据的八项研究中的三项显示出差异。最后,在三项研究中的两项研究中发现，尿液中吡啶甲酸的浓度与骨密度丢失之间存在相关性。
结论：尽管已发表的BMD数据相互矛盾，接受宫内节育器的患者似乎有较高的骨折风险.我们的发现支持了在宫内节育器患者中实施骨质疏松症筛查和预防可访问策略的必要性。
