■本系统综述和荟萃分析旨在调查循环irisin水平与女性骨质疏松症之间的关系,探讨irisin在骨质疏松症病理生理和治疗中的潜在作用。
■我们搜索了PubMed,Embase,WebofScience,科克伦图书馆,CNKI,万方,和截至2023年1月的VIP数据库。纳入标准是观察性研究,报告女性循环irisin水平。在随机效应模型下,使用具有95%置信区间(CI)的标准化平均差(SMD)和相关系数作为主要效应指标。使用CochraneQ统计量和I2统计量评估异质性。进行亚组分析和单变量荟萃回归分析以确定异质性的来源。纳入研究的质量通过纽卡斯尔-渥太华评分进行评估。使用GRADE系统评估证据质量。使用Begg和Egger测试评估出版偏倚,和修剪和填充方法。进行灵敏度分析以评估结果的稳定性。
■15项研究共2856名参与者符合标准。分析显示,与非骨质疏松对照组相比,绝经后骨质疏松妇女的irisin水平显着降低(SMD=-1.66,95%CI:-2.43至-0.89,P<0.0001;I2=98%,P<0.00001),绝经后骨质疏松性骨折的个体比非骨折对照组(SMD=-1.25,95%CI:-2.15至-0.34,P=0.007;I2=97%,P<0.00001)。相关分析显示,irisin水平与腰椎骨密度呈正相关(r=0.37,95%CI:0.18~0.54),股骨骨密度(r=0.30,95%CI:0.18至0.42),女性股骨颈骨密度(r=0.31,95%CI:0.14~0.47)。尽管存在显著的异质性,使用随机效应模型和敏感性分析支持结果的稳健性。
■目前的证据表明,较低的irisin水平与绝经后妇女的骨质疏松和骨折显著相关,提示其作为早期发现骨质疏松症和治疗靶点的潜在生物标志物的实用性。然而,需要进一步开展控制混杂因素的高质量前瞻性研究,以阐明irisin水平与骨质疏松结局之间的关系.
■https://www.crd.约克。AC.英国/PROSPERO,标识符CRD42023410264。
UNASSIGNED: This systematic
review and meta-analysis aimed to investigate the association between circulating irisin levels and osteoporosis in women, exploring irisin\'s potential role in the pathophysiology and management of osteoporosis.
UNASSIGNED: We searched PubMed, Embase, Web of Science, Cochrane Library, CNKI, WanFang, and VIP databases up to January 2023. The inclusion criteria were observational studies reporting on circulating irisin levels in women. The standardized mean difference (SMD) and correlation coefficients with a 95% confidence interval (CI) were used as the main effect measures under a random-effects model. Heterogeneity was evaluated using the Cochrane Q statistic and the I2 statistics. Subgroup analysis and univariate meta-regression analysis were performed to identify the sources of heterogeneity. The quality of the included study was assessed by the Newcastle-Ottawa Score. The quality of evidence was evaluated using the GRADE system. Publication bias was assessed using Begg\'s and Egger\'s test, and the trim-and-fill method. Sensitivity analysis was performed to assess the stability of the results.
UNASSIGNED: Fifteen studies with a total of 2856 participants met the criteria. The analysis showed significantly lower irisin levels in postmenopausal osteoporotic women compared to non-osteoporotic controls (SMD = -1.66, 95% CI: -2.43 to -0.89, P < 0.0001; I2 = 98%, P < 0.00001) and in postmenopausal individuals with osteoporotic fractures than in non-fractures controls (SMD = -1.25, 95% CI: -2.15 to -0.34, P = 0.007; I2 = 97%, P < 0.00001). Correlation analysis revealed that irisin levels positively correlated with lumbar spine BMD (r = 0.37, 95% CI: 0.18 to 0.54), femoral BMD (r = 0.30, 95% CI: 0.18 to 0.42), and femoral neck BMD (r = 0.31, 95% CI: 0.14 to 0.47) in women. Despite significant heterogeneity, the robustness of the results was supported by using the random effects model and sensitivity analysis.
UNASSIGNED: The current evidence suggests that lower irisin levels are significantly associated with osteoporosis and fracture in postmenopausal women, suggesting its utility as a potential biomarker for early detection of osteoporosis and therapeutic target. However, further high-quality prospective research controlling for confounding factors is needed to clarify the relationship between irisin levels and osteoporotic outcomes.
UNASSIGNED: https://www.crd.york.ac.uk/PROSPERO, identifier CRD42023410264.