骨质疏松症风险和保护因素的孟德尔随机化研究：系统评价与荟萃分析
Mendelian randomization studies of risk and protective factors for osteoporosis: a systematic review and meta-analysis.
作者信息
Ji Wenhao, Pan Bin, Chen Xin, Lao Zhaobai, Yang Wanlei, Qian Yu
机构信息
Department of Orthopedics Surgery, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, Zhejiang, China.
The First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.
出版信息
Front Endocrinol (Lausanne). 2025 Jan 16;15:1486188. doi: 10.3389/fendo.2024.1486188. eCollection 2024.
BACKGROUND
Mendelian randomization is believed to attenuate the biases inherent in observational studies, yet a meta-analysis of Mendelian randomization studies in osteoporosis has not been conducted thus far. This study aims to evaluate the connection between potential causal factors and the risk of osteoporosis by synthesizing evidence from Mendelian randomization studies.
METHODS
The databases PubMed, Web of Science, and Embase were systematically searched for Mendelian randomization studies investigating factors influencing osteoporosis up to May 2024. Meta-analyses were conducted to assess the associations between various potential pathogenic factors and osteoporosis using Mendelian Randomization studies. The quality of the study was evaluated according to the Strengthening the Reporting of Observational Studies in Epidemiology via Mendelian Randomization (STROBE-MR) guidelines.
RESULTS
A total of 706 potentially relevant articles were screened, resulting in the inclusion of 53 studies in the systematic review, of which 30 were eligible for the meta-analysis. The combined findings from these 30 studies revealed that rheumatoid arthritis, inflammatory bowel disease, sex hormone binding globulin, depression, non-alcoholic fatty liver disease, primary biliary cholangitis and asthma are associated with increased risk of osteoporosis, while basal metabolic rate and gut microbiota (NB1n) serves as a protective factor. However, the association between obesity, type 2 diabetes mellitus, metformin, ulcerative colitis, leisure sedentary behaviors, systemic lupus erythematosus, serum iron and osteoporosis was found to be nonsignificant.
CONCLUSION
In summary, our meta-analysis indicates that significant causal relationships with osteoporosis's onset and progression have been established for rheumatoid arthritis, inflammatory bowel disease, primary biliary cholangitis, non-alcoholic fatty liver disease, depression, sex hormone binding globulin, basal metabolic rate, gut microbiota (NB1n), and asthma.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/, identifier PROSPERO CRD42024540504.
背景
孟德尔随机化被认为可以减轻观察性研究中固有的偏差，但迄今为止尚未对骨质疏松症的孟德尔随机化研究进行荟萃分析。本研究旨在通过综合孟德尔随机化研究的证据来评估潜在因果因素与骨质疏松症风险之间的联系。
方法
系统检索了PubMed、Web of Science和Embase数据库，以查找截至2024年5月调查影响骨质疏松症因素的孟德尔随机化研究。使用孟德尔随机化研究进行荟萃分析，以评估各种潜在致病因素与骨质疏松症之间的关联。根据通过孟德尔随机化加强观察性研究报告（STROBE-MR）指南评估研究质量。
结果
共筛选出706篇潜在相关文章，最终纳入系统评价的有53项研究，其中30项符合荟萃分析的条件。这30项研究的综合结果显示，类风湿性关节炎、炎症性肠病、性激素结合球蛋白、抑郁症、非酒精性脂肪性肝病、原发性胆汁性胆管炎和哮喘与骨质疏松症风险增加相关，而基础代谢率和肠道微生物群（NB1n）是保护因素。然而，肥胖、2型糖尿病、二甲双胍、溃疡性结肠炎、休闲久坐行为、系统性红斑狼疮、血清铁与骨质疏松症之间的关联不显著。
结论
总之，我们的荟萃分析表明，类风湿性关节炎、炎症性肠病、原发性胆汁性胆管炎、非酒精性脂肪性肝病、抑郁症、性激素结合球蛋白、基础代谢率、肠道微生物群（NB1n）和哮喘与骨质疏松症的发病和进展存在显著因果关系。
系统评价注册
https://www.crd.york.ac.uk/prospero/，标识符PROSPERO CRD42024540504。
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