| Institution: | 1. Department of Rehabilitation, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200092, China;2. Department of Rehabilitation, Chongming Branch of Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 202150, China;3. Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China;1. Anesthesia and Intensive Care Unit, S. Maria Maddalena Hospital, AUSL Toscana Nordovest, Volterra, Pisa, Italy;2. CNR, National Reseach Council of Italy, IRIB - Institute for Biomedical Research and Innovation, Via Torre Bianca c/o Istituto Marino, Mortelle, Messina, Italy;3. Department of Medicine, Clinical Pathway for Respiratory Failure, S. Maria Maddalena Hospital, AUSL Toscana Nordovest, Volterra, Pisa, Italy;4. Volterra Research Foundation, ONLUS, Volterra, Pisa, Italy;5. Surgery Unit, S. Maria Maddalena Hospital, AUSL Toscana Nordovest, Volterra, Pisa, Italy;6. Rehabilitation Unit, Auxilium Vitae Volterra, Volterra, Pisa, Italy;7. Departement of Clinical and Experimental Medicine, Messina University, Italy;1. Department of Marriage and Family Therapy, Crean College of Health and Behavioral Sciences, Chapman University, Orange, CA, USA;2. Department of Obstetrics and Gynecology, University of California, Irvine, Orange, CA, USA;3. Department of Psychology, Crean College of Health and Behavioral Sciences, Chapman University, Orange, CA, USA;1. Department of Physical Therapy for Cardiovascular/Respiratory Disorder and Geriatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt;2. Physical Therapy Department for Musculoskeletal Disorder and Its Surgery, Faculty of Physical Therapy, Cairo University, Giza, Egypt;3. Department of Internal Medicine and Geriatrics, Faculty of Physical Therapy, Badr University in Cairo, Cairo, Egypt;4. Basic Science Department, Faculty of Physical Therapy, Delta University for Science and Technology, International Coastal Road, Gamassa, Dakahlia, Egypt;1. Department of Traditional Chinese Medicine, Taipei Medical University Hospital, Taipei, Taiwan;2. Department of Nursing, MacKay Medical College, New Taipei City, Taiwan;3. Department of Medical Research, Taitung MacKay Memorial Hospital, Taitung, Taiwan;1. University of Minnesota Twin Cities, Minneapolis, MN, USA;2. Arizona State University, Phoenix, AZ, USA |
| Abstract: | BackgroundThe intestinal flora is involved in the bone development of children through a variety of mechanisms, but it remains unclear whether intervention of the intestinal flora can enhance children's bone development.MethodsSix databases (PubMed, Web of Science, Embase, Cochrane Library, Cumulative Index to Nursing and Allied Health, and China National Knowledge Infrastructure) were searched for all English and Chinese studies published up to August 2021. Stata version 16.0 (StataCorp, College Station, TX, USA) was used. Bone mass density and biochemical markers related to bone metabolism were reported as the primary outcome, and the secondary outcomes were anthropometric parameters such as height, height Z score for age, and height velocity. Intergroup differences were determined by standardized mean differences (SMDs) and 95% confidence intervals (CIs).ResultsA total of 3245 participants from 20 RCTs and 370 participants from 8 crossover trials were included in the study. Significant differences were found in bone mineral density (SMD 0.47; 95% CI, 0.28 to 0.66; p < 0.001; I2 = 0.00%) and total serum calcium (SMD 1.07; 95% CI, 0.39 to 1.74; p < 0.001; I2 = 61.9%), as well as in height Z score for age (SMD = 0.11; 95% CI, 0.00 to 0.22; P = 0.044; I2 = 0%). The overall quality of evidence ranged from moderate to very low.ConclusionsThis systematic review and meta-analysis suggested that intestinal flora intervention was an effective method of improving bone mineral density, serum calcium, and height in infants, children, and adolescents. Future studies with a larger sample size and longer intervention period are needed.The protocol of this systematic review was registered in PROSPERO and the registered number was CRD42021282606. |
