目的:卒中幸存者经常遇到身体并发症。这项研究旨在评估中风对骨矿物质密度(BMD)的影响,并评估中风后骨质疏松症或骨质疏松性骨折的风险。
方法:系统评价和荟萃分析。
方法:我们系统地搜索了Medline,Embase,和Cochrane系统评价数据库,以确定报告中风对BMD影响的纵向研究,骨质疏松,骨质疏松性骨折.利用随机效应模型进行汇集分析。
结果:本研究包括21项研究,1,029,742名参与者。随访和初始测量之间的浅裂股骨颈BMD的平均差异为-0.07g/cm2(95%CI,-0.09至-0.04),和-0.03g/cm2(95%CI,-0.05至-0.01)在非麻痹性股骨颈中。与六个月以下的随访相比,超过六个月的随访时间与更明显的减少相关(MD,-0.08;95%CI,-0.11至-0.05vsMD,-0.04;95%CI,-0.06至-0.02;P=0.03)。卒中后未检测到腰椎BMD的显着变化(MD,-0.00;95%CI,-0.03至0.02),在非麻痹性桡骨远端也没有观察到显著变化,肱骨近端,胫骨,转子,和全髋关节。卒中与骨质疏松或骨质疏松性骨折的风险增加无关(HR,1.43;95%CI,0.95-2.13)。
结论:卒中幸存者瘫痪肢体BMD明显下降,尤其是股骨颈.然而,腰椎的BMD在中风后没有显着降低。卒中后骨质疏松或骨质疏松性骨折的风险应谨慎解释,需要进一步调查。
OBJECTIVE: Stroke survivors frequently encounter physical complications. This study aimed to evaluate the impact of stroke on bone mineral density (BMD) and assess the risk of post-stroke osteoporosis or osteoporotic fractures.
METHODS: Systematic
review and meta-analysis.
METHODS: We systematically searched Medline, Embase, and the Cochrane Database of Systematic Reviews to identify longitudinal studies reporting the influence of stroke on BMD, osteoporosis, and osteoporotic fractures. Pooled analyses were performed utilizing random-effects models.
RESULTS: This study included 21 studies with 1,029,742 participants. The mean difference of BMD in the paretic femoral neck between follow-up and initial measurements was -0.07 g/cm2 (95% CI, -0.09 to -0.04), and -0.03 g/cm2 (95% CI, -0.05 to -0.01) in the non-paretic femoral neck. A follow-up length exceeding six months was associated with a more pronounced decrease compared to a follow-up of under six months (MD, -0.08; 95% CI, -0.11 to -0.05 vs MD, -0.04; 95% CI, -0.06 to -0.02; P = 0.03). No significant change in lumbar spine BMD was detected post-stroke (MD, -0.00; 95% CI, -0.03 to 0.02), nor was significant change observed in the non-paretic distal radius, proximal humerus, tibia, trochanter, and total hip. Stroke was not associated with an increased risk of osteoporosis or osteoporotic fractures (HR, 1.43; 95% CI, 0.95-2.13).
CONCLUSIONS: Stroke survivors undergo significant BMD loss in paralyzed limbs, most notably in the femoral neck. However, BMD in the lumbar spine does not exhibit a significant decrease post-stroke. The risk of post-stroke osteoporosis or osteoporotic fractures should be interpreted with caution and needs further investigation.