母乳喂养与女性骨质疏松性骨折发生风险的Meta分析

发布时间：2018-01-26 07:26

本文关键词： 母乳喂养骨质疏松性骨折 Meta分析　出处：《华中科技大学学报(医学版)》2016年02期 　论文类型：期刊论文

【摘要】：目的探讨和评价母乳喂养对女性骨质疏松性骨折发生风险的影响。方法应用Meta分析的方法对截至2015年2月28日前发表在Pubmed、Embase以及CNKI、万方数据库中有关母乳喂养与骨质疏松性骨折的原始文献进行分析,数据采用Stata12.0软件进行处理,OR值作为效应指标,并对其进行剂量-效应关系分析。结果共有6篇病例对照研究、2篇队列研究,包含2 104例病例、4 765例对照纳入到该研究当中。同非哺乳组相比,哺乳组女性发生骨质疏松性骨折的风险是0.89(95%CI0.70~1.14)。在对发表年的亚组分析中,2000年以后的组别中,母乳喂养与骨质疏松性骨折的发生不具有统计学关联(OR=1.303,95%CI0.679~2.502),但在2000年以前的组别中,母乳喂养则可降低骨质疏松性骨折的发生率(OR=0.760,95%CI0.623~0.927)。剔除任何单个研究均不会明显改变对混合效应结局的评估。可视化的漏斗图和Begg(t=1.24,P=0.216)、Egger(t=1.57,P=0.168)定量检验显示所纳入的文献不存在发表偏倚。母乳喂养与骨质疏松性骨折之间不存在剂量-反应关系(非线性:χ~2=1.25,P=0.264;线性:χ~2=17.8,P=0.216)。结论尚不能认为母乳喂养与骨质疏松性骨折之间存在明显的统计学关联。
[Abstract]:Objective to investigate and evaluate the effect of breast feeding on the risk of osteoporosis fracture in women. Methods Meta analysis was used to analyze the risk of osteoporosis fracture in women before February 28th 2015. Embase and CNKI, Wanfang database about breast-feeding and osteoporotic fracture of the original literature were analyzed, the data were processed by Stata12.0 software. OR value was used as an effect index and the dose-effect relationship was analyzed. Results there were 6 case-control studies and 2 cohort studies, including 2 104 cases. A total of 4,765 controls were included in the study, compared with the non-lactation group. The risk of osteoporotic fracture in lactating women was 0.89% 95 CI 0.70 1. 14%. In the subgroup analysis of the year of publication, in the group after 2000. There was no statistical correlation between breast feeding and the occurrence of osteoporotic fracture, but in the group before 2000. Breast feeding can reduce the incidence of osteoporotic fracture (OR0.760). 95 CI 0.623 / 0.927. Excluding any single study would not significantly change the assessment of the outcome of mixed effects. Visual funnel charts and Begg(t=1.24. P0. 216. Eggerus tl. 1.57. Quantitative test showed that there was no publication bias in the literature included. There was no dose-response relationship between breast feeding and osteoporotic fracture (nonlinear: 蠂 2 / 1.25). P0. 264; Conclusion there is no statistical relationship between breast feeding and osteoporotic fracture.
【作者单位】：华中科技大学同济医学院公共卫生学院流行病与卫生统计学系;
【基金】：国家自然科学基金资助项目(No.81102185,81573232)
【分类号】：R580;R683
【正文快照】： 在母乳喂养的过程中,母亲每天约有300~400mg的钙经乳汁进入婴幼儿体内,以维持婴幼儿正常的体格发育[1]。哺乳期间,母亲体内25羟维生素D、甲状旁腺激素和催乳素水平升高,破骨细胞活性增强,破骨细胞分泌各种蛋白酶、乳酸和柠檬酸,使得骨基质和骨盐溶解并释放骨钙入血,骨含量和骨

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