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抗骨质疏松治疗改变绝经后妇女的身体成分：系统评价和荟萃分析。

Anti-osteoporosis treatments changed body composition in postmenopausal women: A systematic review and meta-analysis.

机构信息

Endocrinology Department, First Affiliated Hospital of Army Medical University (Third Military Medical University), Chongqing, China.

Department of Endocrinology, General Hospital of Central Theater Command, Wuhan, Hubei Province, China.

出版信息

Medicine (Baltimore). 2022 Sep 9;101(36):e30522. doi: 10.1097/MD.0000000000030522.

DOI:10.1097/MD.0000000000030522
PMID:36086691
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10980404/
Abstract

BACKGROUND

Whether the widespread anti-osteoporosis treatments in postmenopausal women also benefit the change of body composition (lean body mass [LBM] and body fat mass [FM]) remains controversial. In order to solve this issue and find out the most effective treatment, we conducted this meta-analysis.

METHODS

We searched the literature, via PubMed, Embase, Scopus, Web of Science, and Cochrane to screen citations from inception to March 26, 2022, for inclusion in this study. Only clinical trials that used anti-osteoporosis treatments in postmenopausal women and displayed the alteration of body composition were included. Stata 14.0 was used for the meta-analysis.

RESULTS

Our meta-analysis results presented that: compared with placebo, hormone replacement therapy (HRT) was associated with increased LBM (standardized mean differences [SMD] = 0.32, 95% confidence interval [CI] = 0.02-0.61) and reduced FM (SMD = -0.30, 95% CI = -0.51 to -0.09) in postmenopausal women. Compared with placebo, physical exercise training showed an effect of decreasing FM (SMD = -0.66, 95% CI = -0.94 to -0.38) but not significant influence LBM (SMD = 1.31, 95% CI = -0.29 to 2.91). The network meta-analysis of our study showed that oral estrogen and progestogen plus exercise (OEPE) treatment might be the most effective anti-osteoporosis treatment (surface under the cumulative ranking curve 99.9) to reduce FM in postmenopausal women.

CONCLUSIONS

anti-osteoporosis treatments, especially HRT, affect body composition. Furthermore, the combination of HRT and exercise training are the most effective treatment to reduce FM while maintaining LBM.

摘要

背景

广泛应用于绝经后女性的抗骨质疏松治疗是否有益于身体成分的改变（瘦体重[LBM]和体脂肪量[FM]）仍存在争议。为了解决这个问题并找到最有效的治疗方法，我们进行了这项荟萃分析。

方法

我们通过PubMed、Embase、Scopus、Web of Science 和 Cochrane 检索文献，筛选从建库至 2022 年 3 月 26 日的引文，纳入本研究。仅纳入使用抗骨质疏松治疗绝经后女性并显示身体成分改变的临床试验。使用 Stata 14.0 进行荟萃分析。

结果

我们的荟萃分析结果表明：与安慰剂相比，激素替代疗法（HRT）与增加 LBM（标准化均数差[SMD]=0.32，95%置信区间[CI]：0.02-0.61）和减少 FM（SMD=-0.30，95%CI：-0.51 至-0.09）相关。与安慰剂相比，体育锻炼训练对减少 FM 有作用（SMD=-0.66，95%CI：-0.94 至-0.38），但对 LBM 无显著影响（SMD=1.31，95%CI：-0.29 至 2.91）。我们研究的网络荟萃分析表明，口服雌激素和孕激素加运动（OEPE）治疗可能是减少绝经后女性 FM 最有效的抗骨质疏松治疗方法（累积排序曲线下面积 99.9）。

结论

抗骨质疏松治疗，特别是 HRT，会影响身体成分。此外，HRT 联合运动训练是减少 FM 而保持 LBM 的最有效治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a70/10980404/4a8a0a7e8169/medi-101-e30522-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a70/10980404/056abdc66626/medi-101-e30522-g001.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a70/10980404/4a8a0a7e8169/medi-101-e30522-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a70/10980404/056abdc66626/medi-101-e30522-g001.jpg
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