Orthopaedics Department, Luohe Central Hospital, Luohe, 462000, Henan, People's Republic of China.
Institute of TCM Diagnostics, Hunan University of Chinese Medicine, 300 Xueshi Rd, Science-Education Industrial Park, Yuelu Region, Changsha, 410208, Hunan, People's Republic of China.
Arch Osteoporos. 2020 Feb 23;15(1):24. doi: 10.1007/s11657-020-0691-1.
A meta-analysis was performed to explore the association of coronary artery disease (CAD) with bone mineral density (BMD). Low BMD was not found to be associated with prevalence of CAD. Though the BMD of CADs is significantly lower than that of non-CADs, the confounding effect of aging could not be excluded as CADs might be more prevalent in older patients.
PURPOSE/INTRODUCTION: The clinical association of coronary artery disease (CAD) with bone mineral density (BMD) has been increasingly reported, but findings on the relationship between the two age-related processes are conflicting. The aim of our study was to conduct a meta-analysis to evaluate the associations between CAD and BMD.
We searched PubMed, Embase, and Cochrane Library. Odds ratio (OR) and 95% confidence interval (CI) were pooled to assess the association between low BMD and the prevalence of CAD. For continuous data, standardized mean difference (SMD) with its 95% CI was pooled. Correlation coefficients of BMD and Gensini score were pooled after being transformed by Fischer z-transformation. Subgroup and meta-regression analyses were performed to explore the sources of heterogeneity.
The meta-analysis involved 4170 participants from 11 studies. Pooled ORs for the incidence of CAD in patients with low BMD versus patients with normal BMD was 1.58 (95% CI 0.99-2.52, P = 0.06), and no statistical difference was found in men and women subgroups. After confounding age, the combined OR was 1.60 (95% OR 0.69-3.72, P = 0.27). Pooling data for comparing BMD of CADs and non-CADs were - 0.28 (95% CI - 0.47 to - 0.09, P = 0.004) in femoral neck and calcaneus, - 0.42 (95% CI - 0.89-0.05, P = 0.08) in lumbar spine, and - 0.25 (95% CI - 0.40 to - 0.11, P = 0.000) in the overall. A significance was detected in pooled correlation analysis between CAG Gensini score and BMD (COR = - 0.4435 [- 0.6647; - 0.1508], P = 0.004). No sources of heterogeneity were acquired, and no publication bias was identified.
Low BMD was not associated with the prevalence of CAD. Without age adjustment, the BMD of CADs is significantly lower than that of non-CADs, and the patients with lower BMD are inclined to more severe coronary artery lesions.
目的/引言：冠状动脉疾病（CAD）与骨密度（BMD）的临床关联已被越来越多地报道，但这两个与年龄相关的过程之间的关系的研究结果却存在冲突。我们的研究目的是进行荟萃分析，以评估 CAD 与 BMD 之间的关联。
我们检索了 PubMed、Embase 和 Cochrane 图书馆。使用优势比（OR）和 95%置信区间（CI）来评估低 BMD 与 CAD 患病率之间的关联。对于连续数据，使用标准化均数差（SMD）及其 95%CI 进行合并。使用 Fischer z 转换对 BMD 和 Gensini 评分的相关系数进行转换后进行合并。进行亚组和荟萃回归分析以探索异质性的来源。
荟萃分析纳入了来自 11 项研究的 4170 名参与者。低 BMD 患者与正常 BMD 患者发生 CAD 的汇总 OR 为 1.58（95%CI 0.99-2.52，P=0.06），且在男性和女性亚组中未发现统计学差异。在排除年龄混杂因素后，合并 OR 为 1.60（95%OR 0.69-3.72，P=0.27）。比较 CAD 和非 CAD 的 BMD 数据汇总结果为：股骨颈和跟骨处为-0.28（95%CI-0.47 至-0.09，P=0.004），腰椎处为-0.42（95%CI-0.89 至-0.05，P=0.08），整体为-0.25（95%CI-0.40 至-0.11，P=0.000）。在 CAG Gensini 评分与 BMD 的汇总相关性分析中，差异具有统计学意义（COR=-0.4435[-0.6647；-0.1508]，P=0.004）。未发现异质性来源，也未发现发表偏倚。
低 BMD 与 CAD 的患病率无关。在未进行年龄调整的情况下，CAD 的 BMD 明显低于非 CAD 的 BMD，且 BMD 较低的患者更容易出现更严重的冠状动脉病变。
