Zhang Min, Li Xiao-Mei, Wang Guo-Sheng, Tao Jin-Hui, Chen Zhu, Ma Yan, Li Xiang-Pei
Department of Rheumatology and Immunology, Anhui Provincial Hospital, Anhui Medical University, Hefei, PR China.
Medicine (Baltimore). 2017 Dec;96(50):e8458. doi: 10.1097/MD.0000000000008458.
Ankylosing spondylitis (AS) is an inflammatory rheumatic disease and strongly associated with an increased risk of fractures. A great proportion of patients with AS are suffering from sustaining fractures and the aim of this study is to evaluate and quantify the association between the site of the fracture and AS by performing a meta-analysis.
A systematic literature search was performed on Medline database from 1966 to August 15, 2016 and Embase database from 1980 to August 15, 2016. Studies were evaluated by 2 independent reviewers and quantitative estimates regarding the association between ankylosing spondylitis and the risk of any, hip, or vertebral fracture were presented. After the heterogeneity of selected studies was assessed by using Cochran I statistics, the random effect model was used to combine effect size. Publication bias was measured by Egger and Begg's regression tests.
A total of 6 articles were involved in our study. The results of meta-analysis revealed that AS was strongly associated with the risk of vertebral fracture (odds ratio [OR] = 4.25, 95% confidence interval [CI] = 1.07-7.42) and was not significantly associated with the risk of any fracture (OR=2.00, 95%CI = 0.94-3.06) or hip fracture (OR=1.28, 95%CI =0.16-2.40).
In the present study, a general knowledge of the association between AS and the risk of 3 kinds of fractures were presented, which could improve the ways of prevention of fracture in the patients with AS.
强直性脊柱炎（AS）是一种炎性风湿性疾病，与骨折风险增加密切相关。很大一部分AS患者遭受骨折，本研究的目的是通过进行荟萃分析来评估和量化骨折部位与AS之间的关联。
对1966年至2016年8月15日的Medline数据库以及1980年至2016年8月15日的Embase数据库进行系统的文献检索。由2名独立的评审员对研究进行评估，并给出关于强直性脊柱炎与任何骨折、髋部骨折或椎体骨折风险之间关联的定量估计。在使用Cochran I统计量评估所选研究的异质性后，采用随机效应模型合并效应量。通过Egger和Begg回归检验测量发表偏倚。
我们的研究共纳入6篇文章。荟萃分析结果显示，AS与椎体骨折风险密切相关（优势比[OR]=4.25，95%置信区间[CI]=1.07-7.42），与任何骨折风险（OR=2.00，95%CI=0.94-3.06）或髋部骨折风险（OR=1.28，95%CI=0.16-2.40）无显著关联。
在本研究中，呈现了AS与3种骨折风险之间关联的一般知识，这可以改善AS患者骨折的预防方法。
