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多种维生素与脆性髋部骨折风险:系统评价和荟萃分析。

Multivitamins and risk of fragility hip fracture: a systematic review and meta-analysis.

机构信息

Musculoskeletal Translational Innovation Initiative, Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Avenue, RN115, Boston, MA, 02215, USA.

Boston University School of Medicine, Boston, MA, USA.

出版信息

Arch Osteoporos. 2021 Feb 11;16(1):29. doi: 10.1007/s11657-021-00893-x.

Abstract

PURPOSE

Hip fracture is a severe complication of osteoporosis and is associated with a significant healthcare burden worldwide. This meta-analysis explores the association between combined multivitamin use and hip fracture risk. Our results provide more patient-centered insight into the impact of supplement use on osteoporosis outcomes.

METHODS

We searched three online databases in August 2019 and included studies that reported on multivitamin use in patients with osteoporotic hip fractures. The inclusion criteria were (1) adult patients with osteoporotic hip fractures, (2) availability of full-text articles in English, and (3) at least 1 year of follow-up. No suitable randomized controlled trials could be identified for inclusion in the analysis. The quality of the included studies was assessed using the Newcastle-Ottawa Scale (NOS).

RESULTS

Eight studies containing 80,148 subjects in total were included in this study. Among these, 4237 cases of fragility hip fracture were reported. The average age was 69±5.3 years, and 21% of subjects were male. Multivitamin use was found to be significantly associated with a lower risk of sustaining a fragility hip fracture (OR 0.49, 95%CI: 0.32-0.77). The Begg and Mazumdar test and funnel plot indicated that no significant publication bias was present.

CONCLUSION

Combined multivitamins are amongst the most widely used supplements and are often preferred over single vitamins. Our meta-analysis indicates that multivitamin use is significantly protective against osteoporotic hip fracture. In the future, randomized controlled trials should be performed to establish multivitamins as effective preventative measures for this injury.

摘要

目的

髋部骨折是骨质疏松症的严重并发症,在全球范围内与巨大的医疗保健负担相关。本荟萃分析探讨了联合使用多种维生素与髋部骨折风险之间的关系。我们的研究结果为补充剂使用对骨质疏松症结局的影响提供了更具患者为中心的见解。

方法

我们于 2019 年 8 月在三个在线数据库中进行了检索,并纳入了报告骨质疏松性髋部骨折患者使用多种维生素情况的研究。纳入标准为:(1)患有骨质疏松性髋部骨折的成年患者;(2)可提供英文全文文章;(3)随访时间至少 1 年。未找到合适的随机对照试验纳入分析。使用纽卡斯尔-渥太华量表(NOS)评估纳入研究的质量。

结果

共有 8 项研究,总计 80148 例患者纳入本研究。其中,报告了 4237 例脆性髋部骨折病例。平均年龄为 69±5.3 岁,21%的患者为男性。研究发现,使用多种维生素与降低脆性髋部骨折风险显著相关(OR 0.49,95%CI:0.32-0.77)。贝叶斯检验和漏斗图表明,不存在显著的发表偏倚。

结论

多种维生素是最广泛使用的补充剂之一,通常比单一维生素更受欢迎。我们的荟萃分析表明,多种维生素的使用对预防骨质疏松性髋部骨折具有显著的保护作用。未来应开展随机对照试验,以确定多种维生素是否是预防这种损伤的有效措施。

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