Qu Xinhua, Zhang Xiaoyu, Zhai Zanjing, Li Haowei, Liu Xuqiang, Li Huiwu, Liu Guangwang, Zhu Zhenan, Hao Yongqiang, Dai Kerong
Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedics, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
J Bone Miner Res. 2014 Jan;29(1):202-11. doi: 10.1002/jbmr.2019.
Prospective studies that have examined the association between physical activity and fracture risks have reported conflicting findings. We performed a meta-analysis to evaluate this association. We searched MEDLINE (1966 to February 1, 2013), EMBASE (1980 to February 1, 2013), and OVID (1950 to February 1, 2013) for prospective cohort studies with no restrictions. Categorical, heterogeneity, publication bias, and subgroup analyses were performed. There were 22 cohort studies with 1,235,768 participants and 14,843 fractures, including 8874 hip, 690 wrist, and 927 vertebral fractures. The pooled relative risk (RR) of total fractures for the highest versus lowest category of physical activity was 0.71 (95% confidence interval [CI], 0.63-0.80). The analysis of fracture subtypes showed a statistically significant inverse relationship between a higher category of physical activity and risk of hip and wrist fracture. The risk of hip or wrist fracture was 39% and 28% lower, respectively, among individuals with the highest category of physical activity than among those with the lowest category (95% CI, 0.54-0.69 and 0.49-0.96, respectively). The association between physical activity and vertebral fracture risk was not statistically related (RR, 0.87; 95% CI, 0.72-1.03). There was no evidence of publication bias. There was a statistically significant inverse association between physical activity and total fracture risk, especially for hip and wrist fractures. Additional subject-level meta-analyses are required for a more reliable assessment of subgroups and types of physical activity.
探讨身体活动与骨折风险之间关联的前瞻性研究报告了相互矛盾的结果。我们进行了一项荟萃分析来评估这种关联。我们在MEDLINE（1966年至2013年2月1日）、EMBASE（1980年至2013年2月1日）和OVID（1950年至2013年2月1日）中检索了无限制的前瞻性队列研究。进行了分类、异质性、发表偏倚和亚组分析。有22项队列研究，共1235768名参与者和14843例骨折，包括8874例髋部骨折、690例腕部骨折和927例椎体骨折。身体活动最高类别与最低类别相比，总骨折的合并相对风险（RR）为0.71（95%置信区间[CI]，0.63 - 0.80）。骨折亚型分析显示，较高类别的身体活动与髋部和腕部骨折风险之间存在统计学上显著的负相关。身体活动最高类别的个体中，髋部或腕部骨折风险分别比最低类别的个体低39%和28%（95%CI分别为0.54 - 0.69和0.49 - 0.96）。身体活动与椎体骨折风险之间的关联无统计学意义（RR，0.87；95%CI，0.72 - 1.03）。没有发表偏倚的证据。身体活动与总骨折风险之间存在统计学上显著的负相关，尤其是对于髋部和腕部骨折。需要进行更多基于个体水平的荟萃分析，以更可靠地评估身体活动的亚组和类型。
