背景:多发性硬化症(PwMS)患者在几个解剖区域表现出降低的骨矿物质密度(BMD)。研究表明,由于BMD降低以及骨质减少和骨质疏松症的患病率增加,PwMS的骨折风险增加。本研究旨在调查骨量减少的患病率和风险。骨质疏松,和PwMS之间的骨折。
方法:通过数据库的全面搜索确定了相关研究(PubMed/MEDLINE,Scopus,Embase,和WebofScience)从2000年1月1日至2024年1月21日。R软件版本4.4.0和随机效应模型用于估计合并患病率,比值比(OR),和骨质减少的风险比(RR),骨质疏松,和PwMS之间的骨折,以及他们各自的95%置信区间(CI)。
结果:在总共2039篇文章中,51项研究1,503,785PwMS符合我们的纳入标准。骨量减少的合并患病率,骨质疏松,PwMS中的整体骨折为41.41%(95%CI:36.14%至46.69%,I2=97%),14.21%(95%CI:10.75%至17.68%,I2=99%),和12.84%(95%CI:8.49%至17.19%,I2=100%),分别。骨质减少的可能性(OR=2.02,95%CI:1.46至2.8,p值<0.01,I2=17%)和骨质疏松症(OR=1.71,95%CI:1.27至2.31,p值<0.01,I2=74%),PwMS的总体骨折概率(RR=1.86,95%CI:1.61~2.14,p值<0.01,I2=74%)显著高于健康对照组(HC)。
结论:PwMS发生骨质减少的风险显著增加(2倍),骨质疏松症(1.7倍),和整体骨折(1.9倍)。需要精心设计的研究来进一步探索这些关联。
BACKGROUND: People with multiple sclerosis (PwMS) exhibit reduced bone mineral density (BMD) across several anatomical regions. Studies have indicated that PwMS are at a heightened risk of fractures due to decreased BMD and increased prevalence of
osteopenia and osteoporosis. This study aimed to investigate the prevalence and risk of
osteopenia, osteoporosis, and fracture among PwMS.
METHODS: Relevant studies were identified through comprehensive searches of databases (PubMed/MEDLINE, Scopus, Embase, and Web of Science) from January 1, 2000, to January 21, 2024. R software version 4.4.0 and random-effects models were employed to estimate the pooled prevalence, odds ratio (OR), and risk ratio (RR) of osteopenia, osteoporosis, and fracture among PwMS, along with their respective 95 % confidence intervals (CIs).
RESULTS: From a total of 2039 articles, 51 studies with 1,503,785 PwMS met our inclusion criteria. The pooled prevalence of
osteopenia, osteoporosis, and overall fracture among PwMS was 41.41 % (95 % CI: 36.14% to 46.69 %, I2=97 %), 14.21 % (95 % CI: 10.75 % to 17.68 %, I2=99 %), and 12.84 % (95 % CI: 8.49 % to 17.19 %, I2 = 100 %), respectively. The likelihood of
osteopenia (OR=2.02, 95 % CI: 1.46 to 2.8, p-value<0.01, I2=17 %) and osteoporosis (OR=1.71, 95 % CI: 1.27 to 2.31, p-value<0.01, I2=74 %), as well as the probability of overall fracture (RR=1.86, 95 % CI: 1.61 to 2.14, p-value<0.01, I2=74 %) were significantly higher in PwMS than healthy controls (HCs).
CONCLUSIONS: PwMS were at a substantially increased risk of developing
osteopenia (2-fold), osteoporosis (1.7-fold), and overall fractures (1.9-fold). Well-designed studies are needed to explore these associations further.