Department of Endocrinology, The First Hospital of Lanzhou University, No. 1 West Donggang Road, Lanzhou, Gansu, 730000, China.
The First Clinical Medical College of Lanzhou University, No. 1 West Donggang Road, Lanzhou, Gansu, 730000, China.
Osteoporos Int. 2021 Oct;32(10):1911-1919. doi: 10.1007/s00198-021-05961-z. Epub 2021 May 6.
Air pollution is a major threat to global health, which is associated with several adverse health outcomes and increased mortality. Few studies have investigated the association between air pollution and osteoporosis, and their findings were inconclusive. Our objective is to determine whether exposure to outdoor air pollution is causally associated with risk of osteoporosis. A systematic literature search of PubMed, Web of Science, Embase, and Cochrane Library for publications up to December 2020 was conducted for studies reporting the association between air pollution and osteoporosis. Meta-analysis was performed to estimate the pooled effect size of air pollution on osteoporosis using the relative risk (RR) and 95% confidence intervals (95% CI). Quality assessment was conducted, and all statistical analyses were performed by RevMan 5.3 software. Our search identified 9 eligible studies involving 9,371,212 patients. Meta-analysis revealed that there was an increased risk of osteoporosis (total body BMD and hip fracture) as a result of exposure to air pollution including PM and NO. However, no significant excess risk of osteoporosis was found regardless of PM, NO, and O. In spite of a few number of epidemiological studies selected in the present literature review, this study indicated that the increased exposure to air pollutants was positively associated with high risk of osteoporosis. Further cohort studies with large sample sizes are needed to investigate different constituents and the duration of exposure of air pollutants.
空气污染是全球健康的主要威胁，它与多种不良健康后果和死亡率增加有关。很少有研究调查空气污染与骨质疏松症之间的关系，其结果也不一致。我们的目的是确定暴露于户外空气污染是否与骨质疏松症的风险有关。我们对截至 2020 年 12 月的 PubMed、Web of Science、Embase 和 Cochrane Library 中的出版物进行了系统的文献检索，以寻找报告空气污染与骨质疏松症之间关系的研究。使用相对风险（RR）和 95%置信区间（95%CI），使用 Meta 分析来估计空气污染对骨质疏松症的综合效应大小。进行了质量评估，所有统计分析均由 RevMan 5.3 软件完成。我们的搜索确定了 9 项符合条件的研究，涉及 9371212 名患者。Meta 分析显示，由于暴露于包括 PM 和 NO 在内的空气污染物，骨质疏松症（全身骨密度和髋部骨折）的风险增加。然而，无论 PM、NO 和 O，都没有发现骨质疏松症的风险显著增加。尽管在本文献综述中选择了少数几项流行病学研究，但这项研究表明，空气污染暴露增加与骨质疏松症高风险呈正相关。需要进一步进行队列研究，以调查不同成分和暴露于空气污染物的时间长短。
