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首页> 外文期刊>Clinical drug investigation >Influence of Prevalent Vertebral Fracture on the Correlation between Change in Lumbar Spine Bone Mineral Density and Risk of New Vertebral Fracture: A Meta-Analysis of Randomized Clinical Trials
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Influence of Prevalent Vertebral Fracture on the Correlation between Change in Lumbar Spine Bone Mineral Density and Risk of New Vertebral Fracture: A Meta-Analysis of Randomized Clinical Trials

机译：普遍椎骨骨折对腰椎骨密度变化与新椎骨骨折风险的影响：术语分析对随机临床试验的荟萃分析

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摘要

Background and Objective The correlation between change in bone mineral density (BMD) and the incidence of new vertebral fracture has been drawing attention in regard to evaluation of fracture risk and drug efficacy. We investigated the impact of the prevalence of vertebral fracture on this correlation via a meta-regression analysis with a view to improving evaluation of the correlation. Methods A total of 19 postmenopausal osteoporosis clinical studies involving 62,432 patients in 46 placebo or treatment groups were identified through MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials. We performed a multivariate meta-regression analysis to examine the correlation between the percentage change in lumbar spine BMD from baseline at 3 years and the proportion of subjects experiencing new vertebral fractures, with or without the proportion of subjects with prevalent vertebral fracture as a covariate. We also analyzed the interaction between the subgroups divided by the proportion of subjects with prevalent vertebral fracture and the percentage change in lumbar spine BMD from baseline at 3 years. Results A multivariate meta-regression analysis showed a significant correlation between the change in lumbar spine BMD and the proportion of subjects experiencing new vertebral fracture, and a lower Akaike information criterion was obtained when the proportion of subjects with prevalent vertebral fracture was added as an explanatory variable. Significant interaction between the proportion of subjects with prevalent vertebral fracture and the change in lumbar spine BMD was shown. Conclusions The change in lumbar spine BMD, not BMD T-score at one timepoint, had a significant correlation with the incidence of vertebral fracture. The prediction of the fracture risk by change in lumbar spine BMD was improved by adjusting the proportion of subjects with prevalent vertebral fracture in the study population. The difference of prevalence of vertebral fracture among populations should be considered when the association between change in lumbar spine BMD and incidence of vertebral fracture is examined.
机译：背景和目的骨密度（BMD）变化与新椎骨骨折发生率之间的相关性在裂缝风险和药物功效的评估方面已经引起了注意力。我们通过META回归分析调查了椎骨骨折患病率对这种相关性的影响，以改善相关性评估。方法通过细胞，embase和Cochrane中央登记术，共鉴定了涉及46名安慰剂或治疗组患者的62,432名患者的临床研究。我们进行了多元荟萃回归分析，以检查3年腰椎BMD从基线的百分比变化与经历新椎骨骨折的受试者的比例，有或没有普遍椎骨骨折的受试者的比例。我们还分析了亚组之间的相互作用除以普遍椎骨骨折的比例，3年来从基线的腰椎BMD的变化。结果多元荟萃回归分析显示腰椎BMD的变化与经历新椎骨骨折的受试者的比例之间的显着相关性，并且当加入普遍椎骨骨折的受试者的比例作为解释性时获得了较低的Akaike信息标准多变的。显示了具有普遍椎骨骨折的受试者比例与腰椎BMD的变化之间的显着相互作用。结论腰椎BMD的变化，而不是一个时间点的BMD T分数，与椎体骨折的发生率有显着相关性。通过调节研究人群中具有普遍椎骨骨折的受试者的比例，改善了通过腰椎BMD的变化来预测腰椎BMD的裂缝风险。当检查腰椎脊柱BMD变化与椎骨骨折发生率之间的关联时，应考虑群体中椎骨骨折患病率的差异。

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  • 来源
    《Clinical drug investigation》 |2020年第1期|共9页
  • 作者

    Kobayashi Tsuyoshi; Kaneko Masayuki; Narukawa Mamoru;

  • 作者单位

    Kitasato Univ Grad Sch Pharmaceut Sci Dept Clin Med Pharmaceut Med Minato Ku 5-9-1 Shirokane;

    Kitasato Univ Grad Sch Pharmaceut Sci Dept Clin Med Pharmaceut Med Minato Ku 5-9-1 Shirokane;

    Kitasato Univ Grad Sch Pharmaceut Sci Dept Clin Med Pharmaceut Med Minato Ku 5-9-1 Shirokane;

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  • 正文语种 eng
  • 中图分类 药学;
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