Reproductive Endocrinology and Regulation Laboratory, West China Second University Hospital, Sichuan University, Chengdu, China.
Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China.
Front Endocrinol (Lausanne). 2024 Aug 8;15:1388717. doi: 10.3389/fendo.2024.1388717. eCollection 2024.
This systematic review and meta-analysis aimed to investigate the association between circulating irisin levels and osteoporosis in women, exploring irisin's potential role in the pathophysiology and management of osteoporosis.
We searched PubMed, Embase, Web of Science, Cochrane Library, CNKI, WanFang, and VIP databases up to January 2023. The inclusion criteria were observational studies reporting on circulating irisin levels in women. The standardized mean difference (SMD) and correlation coefficients with a 95% confidence interval (CI) were used as the main effect measures under a random-effects model. Heterogeneity was evaluated using the Cochrane Q statistic and the statistics. Subgroup analysis and univariate meta-regression analysis were performed to identify the sources of heterogeneity. The quality of the included study was assessed by the Newcastle-Ottawa Score. The quality of evidence was evaluated using the GRADE system. Publication bias was assessed using Begg's and Egger's test, and the trim-and-fill method. Sensitivity analysis was performed to assess the stability of the results.
Fifteen studies with a total of 2856 participants met the criteria. The analysis showed significantly lower irisin levels in postmenopausal osteoporotic women compared to non-osteoporotic controls (SMD = -1.66, 95% CI: -2.43 to -0.89, < 0.0001; = 98%, < 0.00001) and in postmenopausal individuals with osteoporotic fractures than in non-fractures controls (SMD = -1.25, 95% CI: -2.15 to -0.34, = 0.007; = 97%, < 0.00001). Correlation analysis revealed that irisin levels positively correlated with lumbar spine BMD (r = 0.37, 95% CI: 0.18 to 0.54), femoral BMD (r = 0.30, 95% CI: 0.18 to 0.42), and femoral neck BMD (r = 0.31, 95% CI: 0.14 to 0.47) in women. Despite significant heterogeneity, the robustness of the results was supported by using the random effects model and sensitivity analysis.
The current evidence suggests that lower irisin levels are significantly associated with osteoporosis and fracture in postmenopausal women, suggesting its utility as a potential biomarker for early detection of osteoporosis and therapeutic target. However, further high-quality prospective research controlling for confounding factors is needed to clarify the relationship between irisin levels and osteoporotic outcomes.
https://www.crd.york.ac.uk/PROSPERO, identifier CRD42023410264.
本系统评价和荟萃分析旨在探讨循环鸢尾素水平与女性骨质疏松症之间的关联，探索鸢尾素在骨质疏松症病理生理学和管理中的潜在作用。
我们检索了 PubMed、Embase、Web of Science、Cochrane 图书馆、CNKI、WanFang 和 VIP 数据库，检索时间截至 2023 年 1 月。纳入标准为报告女性循环鸢尾素水平的观察性研究。采用随机效应模型，使用标准化均数差（SMD）和 95%置信区间（CI）的相关系数作为主要效应测量指标。使用 Cochrane Q 统计量和 统计量评估异质性。进行亚组分析和单变量荟萃回归分析以确定异质性的来源。使用 Newcastle-Ottawa 评分评估纳入研究的质量。使用 GRADE 系统评估证据质量。使用 Begg 和 Egger 检验以及修剪和填充法评估发表偏倚。进行敏感性分析以评估结果的稳定性。
共有 15 项研究，总计 2856 名参与者符合标准。分析显示，绝经后骨质疏松症女性的鸢尾素水平明显低于非骨质疏松症对照组（SMD = -1.66，95%CI：-2.43 至-0.89， < 0.0001； = 98%， < 0.00001），绝经后骨质疏松性骨折患者的鸢尾素水平明显低于非骨折对照组（SMD = -1.25，95%CI：-2.15 至-0.34， = 0.007； = 97%， < 0.00001）。相关性分析显示，鸢尾素水平与女性腰椎骨密度（r = 0.37，95%CI：0.18 至 0.54）、股骨骨密度（r = 0.30，95%CI：0.18 至 0.42）和股骨颈骨密度（r = 0.31，95%CI：0.14 至 0.47）呈正相关。尽管存在显著异质性，但使用随机效应模型和敏感性分析支持结果的稳健性。
目前的证据表明，较低的鸢尾素水平与绝经后妇女的骨质疏松症和骨折显著相关，提示其可用作骨质疏松症早期检测和治疗靶点的潜在生物标志物。然而，需要进一步开展高质量的前瞻性研究，以控制混杂因素，阐明鸢尾素水平与骨质疏松症结局之间的关系。
https://www.crd.york.ac.uk/PROSPERO，标识符 CRD42023410264。
