骨质疏松与认知障碍关系的Meta分析

目的 系统评价骨质疏松与认知障碍的关系，为认知障碍患者的预防提供循证支持。方法 计算机全面检索Embase，Web of Science，PubMed，Cochrane Library，知网，中国生物医学文献数据库，万方，维普等数据库中关于认知障碍与骨质疏松关系的队列研究及病例-对照研究，时限均自建库至2021年4月23日。所得数据采用RevMan 5.3结合Stata 15.1软件进行Meta分析。结果 最终纳入7篇文献，共77417个患者。纳入文献均为中高等质量水平。Meta分析结果显示:与对照组相比，骨质疏松组认知障碍的发病率更高（OR=1.97，95% CI:1.37～2.82，P<0.001）。同时，亚组分析结果显示，不同性别［男性（OR=1.68，95% CI:1.22～2.32，P=0.001）、女性（OR=1.76，95% CI:1.28～2.42，P<0.001）］、年龄［老年（OR=1.77，95% CI:1.26～2.50，P=0.001）、中年（OR=2.38，95% CI:1.43～3.97，P=0.001）］、测量部位［腰椎（OR=2.18，95% CI:1.49～3.20，P<0.001）、股骨颈（OR=2.41，95% CI:1.23～4.73，P=0.010）］、认知障碍严重程度［痴呆（OR=2.22，95% CI:1.63～3.03，P<0.001）］、国家［亚洲（OR=2.31，95% CI:1.61～3.30，P<0.001）］下，认知障碍与骨质疏松症呈正关联。结论 骨质疏松与认知障碍的风险增加有关。

Association between cognitive impairment and osteoporosis: a Meta-analysis

To explore the association between osteoporosis and cognitive impairment, and to provide evidence-based support for preventing cognitive impairment. Methods Eight electronic literature databases were searched to retrieve cohort studies and case-control studies which were associated osteoporosis and cognitive impairment, including CNKI, VIP, Wan-fang, CBM, Cochrane library, PubMed, Web of Science and Embase, from the inception of the databases up to April 23, 2021. The RevMan 5.3 and Stata 15.1 were used to conduct the meta-analysis. Results A total of 7 articles were included, with a total of 77417 patients. The included literatures were all medium quality or above. Meta-analysis showed that compared to the control group, osteoporosis group had a higher risk of cognitive impairment(OR=1.97, 95%CI: 1.37-2.82, P<0.001). At the same time, subgroup analysis results showed that under different gender male(OR=1.68, 95%CI: 1.22-2.32, P=0.001), female(OR=1.76, 95%CI: 1.28-2.42, P<0.001)], age elderly(OR=1.77, 95%CI: 1.26-2.50, P=0.001), middle-aged(OR=2.38, 95%CI: 1.43-3.97, P=0.001)], measurement site lumbar spine(OR=2.18, 95%CI: 1.49-3.20, P<0.001), femoral neck(OR=2.41, 95%CI: 1.23-4.73, P=0.010)], cognitive impairment severity dementia(OR= 2.22, 95%CI: 1.63-3.03, P<0.001)] and country Asia(OR=2.31, 95%CI: 1.61-3.30, P<0.001)], there was a positive correlation between cognitive impairment and osteoporosis. Conclusion Osteoporosis is associated with an increased risk of cognitive impairment.