Department of Internal Medicine, Bassett Medical Center, Cooperstown, NY, USA.
Department of Biochemistry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
J Evid Based Med. 2018 Feb;11(1):20-25. doi: 10.1111/jebm.12286. Epub 2018 Jan 11.
BACKGROUND/OBJECTIVES: Hepatitis C virus (HCV) infection is one of the most common causes of chronic liver disease. Several epidemiologic studies have suggested that patients with HCV infection might have a higher risk of osteoporotic fracture. However, the data are inconclusive. This systematic review and meta-analysis was conducted with the aims to summarize all available evidence.
A literature search was performed using MEDLINE and EMBASE database from inception to June 2016. Studies that reported relative risks, odd ratios, or hazard ratios comparing the risk of osteoporotic fracture among HCV-infected patients versus subjects without HCV infection were included. Pooled risk ratio (RR) and 95% confidence interval (CI) were calculated using a random-effect, generic inverse variance method.
Three studies with 362,285 participants met our eligibility criteria and were included in analysis. We found a significantly higher risk of osteoporotic fracture among patients with HCV infection with RR of 1.53 (95% CI 1.09 to 2.14).
Our study demonstrated an increased risk of osteoporotic fracture among HCV-infected patients. Further studies are required to clarify how this risk should be addressed in clinical practice.
背景/目的：丙型肝炎病毒（HCV）感染是慢性肝病最常见的原因之一。一些流行病学研究表明，HCV 感染患者可能有更高的骨质疏松性骨折风险。然而，数据尚无定论。本系统评价和荟萃分析旨在总结所有现有证据。
使用 MEDLINE 和 EMBASE 数据库从建库至 2016 年 6 月进行文献检索。纳入报告相对风险、比值比或风险比的研究，比较 HCV 感染患者与无 HCV 感染患者骨质疏松性骨折风险。采用随机效应、通用倒数方差法计算合并风险比（RR）和 95%置信区间（CI）。
符合纳入标准并纳入分析的有 3 项研究，共 362,285 名参与者。我们发现，HCV 感染患者的骨质疏松性骨折风险显著升高，RR 为 1.53（95% CI 1.09 至 2.14）。
本研究表明 HCV 感染患者骨质疏松性骨折风险增加。需要进一步研究以明确在临床实践中应如何处理这一风险。
