BMD下降与动脉粥样硬化发生相关性的系统评价

发布时间：2018-05-05 22:20

本文选题：动脉粥样硬化 + 血管异常　；参考：《浙江大学》2017年硕士论文

【摘要】：目的:关于BMD下降与动脉粥样硬化之间的关系,目前的文献存在争议,为了进一步明确二者之间的关系,我们对相关的文献进行如下系统回顾。研究方法:三名独立研究员系统检索了 PubMed、Embase和Cochrane Library等权威数据库,并手动检索灰色文献,系统筛选出截至2017年4月之前发表的所有相关文献研究,纳入所有直接探讨BMD下降与动脉粥样硬化性血管疾病(如颈动脉钙化(CAC)、心血管疾病(CVD)及冠脉疾病(CAD)等)发生以及临床转归之间关系的队列研究和病例对照性研究。研究结果:本次系统评价总共纳入了 26项研究,涉及患者人数共67447人。分析结果显示:与BMD正常人群相比,BMD下降人群动脉粥样硬化性血管疾病的发病率更高,且二者具有显著性差异(OR,1.81,95%CI[1.52,2.16],p0.00001)。单独筛选出绝经后的女性患者,也得出同样的结论(OR,2.23,95%CI[1.72,2.89],p0.00001)。按BMD下降严重程度进行亚组分析,结果提示,随着BMD的降低,动脉粥样硬化性血管疾病的发病率增加。调整年龄、性别、体重指数和其他心血管疾病危险因素等混杂因素后,BMD下降与动脉粥样硬化性血管疾病发病率增加之间仍然存在着显著的相关性(OR,2.66,95%CI[1.55,4.55],p=0.0004)。研究结论:我们研究的结果提示,BMD下降与动脉粥样硬化发生存在相关性。BMD下降可能是老年人群中动脉粥样硬化发生的独立预测因素,且BMD下降程度与动脉粥样硬化性血管疾病发病率呈正相关。未来需要后续研究进一步证实。
[Abstract]:Aim: to investigate the relationship between the decrease of BMD and atherosclerosis. In order to further clarify the relationship between BMD and atherosclerosis, the related literatures are reviewed as follows. Methods: three independent researchers systematically searched authoritative databases such as PubMed Embase and Cochrane Library, and manually searched grey literature, and systematically screened out all relevant literature studies published by April 2017. All cohort studies and case-control studies were conducted to investigate the relationship between BMD decline and atherosclerotic vascular diseases (such as carotid calcification, cardiovascular disease and coronary artery disease) and clinical outcome. Results: the systematic evaluation included a total of 26 studies involving a total of 67447 patients. The results showed that the incidence of atherosclerotic vascular disease was higher in patients with decreased BMD than that in normal controls, and there was a significant difference between the two groups. The same conclusion was obtained from the single screening of postmenopausal female patients. The same conclusion was obtained with CI = 2.2395 / CI [1.72 / 2.89] / p 0.00001. The subgroup analysis showed that the incidence of atherosclerotic vascular diseases increased with the decrease of BMD. After adjusting for age, sex, body mass index and other risk factors of cardiovascular disease, there was still a significant correlation between the decrease of BMD and the increased incidence of atherosclerotic vascular disease. Conclusion: the results of our study suggest that the decrease of BMD may be an independent predictor of atherosclerosis in the elderly. The decrease of BMD was positively correlated with the incidence of atherosclerotic vascular disease. Future studies need further confirmation.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R543.5

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