Department of Spine Surgery, Institute of Drug Clinical Trial for Orthopedic Diseases, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, China.
Department of Rheumatology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, China.
BMC Musculoskelet Disord. 2019 Nov 13;20(1):532. doi: 10.1186/s12891-019-2863-y.
Circulatory osteocalcin (OC) has been widely used as a biomarker to indicate bone turnover status in postmenopausal osteoporosis (PMO). However, the change of serum OC (sOC) level in PMO cases compared to postmenopausal controls remains controversial.
We searched the online database of PubMed and Cochrane Library. A meta-analysis of case-control studies was performed to compare the pooled sOC level between PMO patients and postmenopausal controls. Subgroup analysis according to potential confounding factors (different OC molecules and regions of the study population) was also performed.
Ten case-control studies with 1577 postmenopausal women were included in this meta analysis. We found no significant difference in the pooled sOC level [mean difference (MD) = 1.84, 95% confidence interval (CI): (- 1.49, 5.16), p = 0.28] between PMO patients and controls. Subgroup analysis also revealed no significant difference in intact OC [MD = 1.76, 95%CI: (- 1.71, 5.23), p = 0.32] or N-terminal mid-fragment of the OC molecule [MD = 0.67, 95%(- 5.83, 7.18), p = 0.84] between groups. For different regions, no significant difference in sOC was found in Asian population between cases and controls [MD = -0.06, 95%(- 6.02, 5.89), p = 0.98], while the pooled sOC level was significantly higher in European PMO cases than controls [MD = 3.15, 95%(0.90, 5.39), p = 0.006].
Our analysis revealed no significant difference in sOC level between PMO cases and controls according to all the current eligible studies. OC molecules are quite heterogeneous in the circulation and can be influenced by glucose metabolism. Therefore, sOC is currently not a good indicator for the high bone turnover status in PMO. More trials with standardized methodologies for the evaluation of circulatory OC are awaited to update our current findings.
循环骨钙素（OC）已被广泛用作绝经后骨质疏松症（PMO）中指示骨转换状态的生物标志物。然而，PMO 病例与绝经后对照者相比，血清 OC（sOC）水平的变化仍存在争议。
我们检索了 PubMed 和 Cochrane 图书馆的在线数据库。对病例对照研究进行荟萃分析，以比较 PMO 患者与绝经后对照组的 sOC 水平。还根据潜在混杂因素（不同的 OC 分子和研究人群的区域）进行了亚组分析。
纳入了本荟萃分析的 10 项病例对照研究，共纳入了 1577 名绝经后妇女。我们发现 PMO 患者与对照组之间的 sOC 水平无显著差异[平均差值（MD）=1.84，95%置信区间（CI）：（-1.49，5.16），p=0.28]。亚组分析也显示，完整 OC[MD=1.76，95%CI：（-1.71，5.23），p=0.32]或 OC 分子的 N 端中段[MD=0.67，95%（-5.83，7.18），p=0.84]之间无显著差异。对于不同的地区，亚洲人群中病例和对照组之间的 sOC 无显著差异[MD=-0.06，95%（-6.02，5.89），p=0.98]，而欧洲 PMO 病例的 sOC 水平明显高于对照组[MD=3.15，95%（0.90，5.39），p=0.006]。
根据所有当前合格的研究，我们的分析显示 PMO 病例与对照组之间的 sOC 水平无显著差异。OC 分子在循环中非常异构，并且可以受到葡萄糖代谢的影响。因此，sOC 目前并不是 PMO 中高骨转换状态的良好指标。需要更多具有标准化方法评估循环 OC 的试验来更新我们的现有发现。
