Shandong University of Traditional Chinese Medicine, Jingshi Road16369, Jinan, 250014, China.
Department of Orthopaedics, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jingshi Road16369, Jinan, 250014, China.
J Orthop Surg Res. 2020 Feb 27;15(1):81. doi: 10.1186/s13018-020-01603-y.
The incidence of osteoporotic fractures has increased rapidly, and because of the poor prognosis and high mortality associated with osteoporotic fractures, they remain a prospective research area globally. One way to reduce their incidence is to investigate their intervention risk factors in the elderly. Hence, this study explores the correlation between serum 25-hydroxyvitamin D [25(OH)D] levels and osteoporotic fractures in elderly patients through a meta-analysis.
We conducted our literature search mainly in PubMed and Embase for identifying studies that investigated the relationship between serum 25(OH)D levels and the risk for osteoporotic fractures. We performed categorical analysis, heterogeneity checks, publication bias analysis, and subgroup analyses.
In total, 20 studies were included, of which 4 were case-cohort studies and 16 were cohort studies. A total of 41,738 patients from 20 studies were included in the meta-analysis, of which 5916 had fractures, including 3237 hip fractures. By combining the lowest and highest categories of relative risks (RRs) and 95% confidence intervals (CIs), it was suggested that lower serum 25-hydroxyvitamin D levels may be a risk factor for fractures. RR (95% CI) for total and hip fractures were 1.11 (0.99, 1.24) and 0.89 (0.80, 0.98) after adjustments.
Our study showed that compared to low serum 25(OH)D levels, high serum 25(OH)D levels reduce the risk of hip fractures in the patients aged 60 years or older. In contrast, serum 25(OH)D has no significant relationship with total fracture risk.
骨质疏松性骨折的发病率迅速上升，由于骨质疏松性骨折预后差、死亡率高，它们仍然是全球的一个前瞻性研究领域。降低其发病率的一种方法是研究老年人中与骨质疏松性骨折相关的干预危险因素。因此，本研究通过荟萃分析探讨了老年患者血清 25-羟维生素 D [25(OH)D]水平与骨质疏松性骨折之间的相关性。
我们主要在 PubMed 和 Embase 中进行文献检索，以确定研究血清 25(OH)D 水平与骨质疏松性骨折风险之间关系的研究。我们进行了分类分析、异质性检查、发表偏倚分析和亚组分析。
共纳入 20 项研究，其中 4 项为病例对照研究，16 项为队列研究。共有 20 项研究的 41738 例患者纳入荟萃分析，其中 5916 例发生骨折，包括 3237 例髋部骨折。通过合并最低和最高相对风险（RR）和 95%置信区间（CI）类别，表明较低的血清 25-羟维生素 D 水平可能是骨折的危险因素。校正后总骨折和髋部骨折的 RR（95%CI）分别为 1.11（0.99，1.24）和 0.89（0.80，0.98）。
我们的研究表明，与低血清 25(OH)D 水平相比，高血清 25(OH)D 水平可降低 60 岁及以上患者髋部骨折的风险。相比之下，血清 25(OH)D 与总骨折风险无显著关系。
