背景:肠道菌群通过多种机制参与儿童的骨骼发育,但对肠道菌群的干预是否能促进儿童骨骼发育尚不清楚。
方法:六个数据库(PubMed,WebofScience,Embase,科克伦图书馆,护理和相关健康的累积指数,和中国国家知识基础设施)搜索了截至2021年8月发表的所有英文和中文研究。Stata版本16.0(StataCorp,学院站,TX,美国)被使用。骨密度和与骨代谢相关的生化标志物被报道为主要结果。次要结果是人体测量参数,如身高,身高Z分年龄,和高度速度。通过标准化平均差异(SMD)和95%置信区间(CI)确定组间差异。
结果:共有来自20项RCT的3245名参与者和来自8项交叉试验的370名参与者被纳入研究。发现骨密度(SMD0.47;95%CI,0.28至0.66;p<0.001;I2=0.00%)和血清总钙(SMD1.07;95%CI,0.39至1.74;p<0.001;I2=61.9%)存在显着差异,以及年龄的身高Z评分(SMD=0.11;95%CI,0.00至0.22;P=0.044;I2=0%)。证据的总体质量从中等到非常低。
结论:本系统综述和荟萃分析提示肠道菌群干预是提高骨密度的有效方法。血清钙,和婴儿的身高,孩子们,和青少年。未来的研究需要更大的样本量和更长的干预期。本系统评价的方案在PROSPERO注册,注册编号为CRD42021282606。
BACKGROUND: The intestinal flora is involved in the bone development of children through a variety of mechanisms, but it remains unclear whether intervention of the intestinal flora can enhance children\'s bone development.
METHODS: Six databases (PubMed, Web of Science, Embase, Cochrane Library, Cumulative Index to Nursing and Allied Health, and China National Knowledge Infrastructure) were searched for all English and Chinese studies published up to August 2021. Stata version 16.0 (StataCorp, College Station, TX, USA) was used. Bone mass density and biochemical markers related to bone metabolism were reported as the primary outcome, and the secondary outcomes were anthropometric parameters such as height, height Z score for age, and height velocity. Intergroup differences were determined by standardized mean differences (SMDs) and 95% confidence intervals (CIs).
RESULTS: A total of 3245 participants from 20 RCTs and 370 participants from 8 crossover trials were included in the study. Significant differences were found in bone mineral density (SMD 0.47; 95% CI, 0.28 to 0.66; p < 0.001; I2 = 0.00%) and total serum calcium (SMD 1.07; 95% CI, 0.39 to 1.74; p < 0.001; I2 = 61.9%), as well as in height Z score for age (SMD = 0.11; 95% CI, 0.00 to 0.22; P = 0.044; I2 = 0%). The overall quality of evidence ranged from moderate to very low.
CONCLUSIONS: This systematic
review and meta-analysis suggested that intestinal flora intervention was an effective method of improving bone mineral density, serum calcium, and height in infants, children, and adolescents. Future studies with a larger sample size and longer intervention period are needed. The protocol of this systematic
review was registered in PROSPERO and the registered number was CRD42021282606.