Lv Qing-Bo, Fu Xin, Jin Hai-Ming, Xu Hai-Chao, Huang Zhe-Yu, Xu Hua-Zi, Chi Yong-Long, Wu Ai-Min
Department of Orthopaedics, Second Affiliated Hospital of Wenzhou Medical University, Second Medical College of Wenzhou Medical University, Wenzhou, Zhejiang, China.
Department of Orthopaedics, Tianjin Hospital, Tianjin, China.
Sci Rep. 2015 Nov 2;5:16030. doi: 10.1038/srep16030.
The relationship between weight change and risk of hip fracture is still controversial. We searched PubMed and Embase for studies on weight change and risk of hip fracture. Eight prospective studies were included. The weight loss studies included 85592 participants with 1374 hip fractures, and the weight gain studies included 80768 participants with 732 hip fractures. Weight loss is more likely a risk factor of hip fracture, with an adjusted RR (Relative Risk) (95% CI) of 1.84 (1.45, 2.33). In contrast, weight gain can decrease the risk of hip fracture, with an adjusted RR (95% CI) of 0.73 (0.61, 0.89). Dose-response meta-analysis shows that the risk of hip fracture is an ascending curve, with an increase of weight loss above the line of RR = 1; this trend is consistent with the results of forest plots that examine weight loss and hip fracture. For weight gain and risk of hip fracture, the descending curve below the line of RR = 1; this trend is consistent with the results of forest plots that examine weight gain and hip fracture. Our meta-analysis suggests that weight loss may be a risk factor for hip fracture and that weight gain may be a protective factor for hip fracture.
体重变化与髋部骨折风险之间的关系仍存在争议。我们在PubMed和Embase数据库中检索了关于体重变化与髋部骨折风险的研究。共纳入8项前瞻性研究。体重减轻研究纳入了85592名参与者，其中发生1374例髋部骨折；体重增加研究纳入了80768名参与者，其中发生732例髋部骨折。体重减轻更有可能是髋部骨折的一个危险因素，调整后的相对危险度（RR）（95%可信区间）为1.84（1.45，2.33）。相比之下，体重增加可降低髋部骨折风险，调整后的RR（95%可信区间）为0.73（0.61，0.89）。剂量反应荟萃分析表明，髋部骨折风险呈上升曲线，体重减轻超过RR = 1线时风险增加；这一趋势与检查体重减轻与髋部骨折关系的森林图结果一致。对于体重增加与髋部骨折风险，RR = 1线以下呈下降曲线；这一趋势与检查体重增加与髋部骨折关系的森林图结果一致。我们的荟萃分析表明，体重减轻可能是髋部骨折的危险因素，而体重增加可能是髋部骨折的保护因素。
