Epidemiological Study Of Analysis On Influencing Factors In Osteoporosis(OP) And Its Treatment Effects By Statins

Objective: (1)By collecting questionnaire of cases material in OP patients, to screen risk factors and protective factors, and provide a fundamental basis for OP early prevention or intervention;(2)Through systematic evaluation of statins treatment effects in increase BMD values,reduce risk of fracture and bone turnover maker ,to provide basis for effects of OP,selection of statins ,such as dose and duration,etc.Methods: (1)Final clinical diagnosis of OP patients were adopted dual-energy X-ray absorption, combined with medical record and clinical manifestation; According to the number of patients, we selected 100 OP patients as cases, and selected 106 who were not diagnosis of OP as control, then we implemented Case-control study, adopted univariate and multivariate analyses to screen related influence factors.(2)According to exclusive and inclusive criteria, we collected literatures which including the effects of statin on OP at chinese biological and medical database (CBMdisc), CNKI database, Medline, Ovid and Springer database, then performed comprehensive quantitative analysis by Meta analysis. Weighted mean difference (WMD)or standardized mean difference(SMD) were chosen in quantitative data; odd ratio(OR) and its 95% confidence interval(CI) were adopted in enumeration data.Results: (1) Between study and control group, there were no significant difference in the age,sex and native place; (2)Results of multivariate logistic analyses in 206 objects suggested smoking, mainly engaged in mental labor, often eat animal protein, brinish fish and salted vegetable were risk factors of OP, OR value were 5.433,4.271,3.208,1.992 individually; having healthy spouses, higher education level, love sports, often eat green vegetables and milk were protective factors of OP, OR values were 0.112,0.217,0.302,0.343,0.361,respectively;(3)we analysed personal life style and some physiological features of 141 women, it showed that mainly engaged in mental labor, preference for brinish fish and salted vegetable, eat animal protein, many gravidity or parity history, late of menarche were related to OP, OR value were 3.717,2.866,2.079,1.922,1.251 individually. In addition, having healthy spouses, love sports, eat milk ,often eat green vegetable, late age at natural menopause had protective effects, OR values range were at 0.134 to 0.732; (4)Through multivariate logistic regression ,there were no distinguished interaction between ofen drink milk and sports, smoking and job property. (5) 28 literatures had been chosen in Meta analysis, including 9 case-control study,11 cohort study and 8 RCT, a total of 285434 subjects from 14 different countries were included; (6) Comprehensive and quantitative results for including literatures suggested that compared with control group, statin group had significant difference in improving BMD values in femoral neck WMD=0.02, 95% CI (0.01,0.03) and reducing hip fracture total OR=0.50, 95%CI (0.47,0.54), increasing serum bone formation marker BGP content, SMD= 0.93, 95%CI(0.10,1.76); while larger dose use of statins, it may increase serum bone absorption marker CTx content,SMD=1.12, 95% CI (0.05,2.19),we found no sinnific- ant significant difference in improving BMD value in lumbar spine, Z=0.76,P=0.45.Conclusion: (1) By multivariate screening,four of risk factors in OP were smoking, mainly engaged in mental labor, often eat animal protein, brinish fish and salted vegetable; five protective factors were having healthy spouses, higher education level, love sports, often eat green vegetables and milk; (2) The study in women suggested that except common risk factors in male and female group, the risk of many gravidity or parity history ,and late of menarche should arouse attention; meanwhile, the study also showed that there are five protective factors in women, they were having healthy spouses, love sports, eat milk ,often eat green vegetable and late age at natural menopause. OP was a chronic disease occurred in middle-aged and the elderly population, its incidence (prevalence) was affected by many factors, the etiology of OP is complex, our study provided meaningful reference for comprehensive prevention of OP.Such as increase self health care consciousness, create reasonable diet and lifestyle, advocate beneficial behavior and calcium supplement are important;As for women, besides reduce the times of gravidity or parity, shorten the period of lactation properly, keep calcium content,pay attention to endocrine secretion metabolism after natural menopause, such as appropriate amount of estrogen supplement is necessary to the prevention and control of OP. (3)Through comprehensive quantitative analysis of statins intervention of BMD values, bone fracture OR and bone turnover marker, our results provided for novel and valuable reference in further explore its effects in OP population.; (4)statins may improve BMD value in femoral neck, reduce hip fracture OR and increase BGP content in plasma; and it may improve serum CTx content with larger dose of statins; but we found no BMD value improvement in lumbar spine, It is necessary to further adjust design plan, such as large-scale and prospective RCT to explore more suitable kind, dose duration of statins; (5)According to the shape of funnel plots, the study can not completely the possibility of publication bias, but its effects had not influence the reliability of our results.