【摘要】 目的探讨和评价母乳喂养对女性骨质疏松性骨折发生风险的影响。方法应用Meta分析的方法对截至2015年2月28日前发表在Pubmed、Embase以及CNKI、万方数据库中有关母乳喂养与骨质疏松性骨折的原始文献进行分析,数据采用Stata12.0软件进行处理,OR值作为效应指标,并对其进行剂量-效应关系分析。结果共有6篇病例对照研究、2篇队列研究,包含2 104例病例、4 765例对照纳入到该研究当中。同非哺乳组相比,哺乳组女性发生骨质疏松性骨折的风险是0.89(95%CI0.70~1.14)。在对发表年的亚组分析中,2000年以后的组别中,母乳喂养与骨质疏松性骨折的发生不具有统计学关联(OR=1.303,95%CI0.679~2.502),但在2000年以前的组别中,母乳喂养则可降低骨质疏松性骨折的发生率(OR=0.760,95%CI0.623~0.927)。剔除任何单个研究均不会明显改变对混合效应结局的评估。可视化的漏斗图和Begg(t=1.24,P=0.216)、Egger(t=1.57,P=0.168)定量检验显示所纳入的文献不存在发表偏倚。母乳喂养与骨质疏松性骨折之间不存在剂量-反应关系(非线性:χ~2=1.25,P=0.264;线性:χ~2=17.8,P=0.216)。结论尚不能认为母乳喂养与骨质疏松性骨折之间存在明显的统计学关联。更多还原

【Abstract】 Objective To explore the effect of breastfeeding on osteoporotic fracture risk in women.Methods Meta-analysis was applied to analyze the studies related to breastfeeding and osteoporotic fracture,which were published in Pubmed,Embase,CNKI and Wanfang databases until February 28,2015.The data were analyzed with Stata 12.0 software.Dose-effect analysis was also performed,with the ORvalue as the effect index.Results A total of 6case-control studies and 2cohort studies were included,involving 2 104 patients with osteoporotic fracture and 4 765 controls.The pooled ORof osteoporotic fracture risk was 0.89(95%CI0.70-1.14)in breastfeeding group when compared with non-breastfeeding group.According to the results of subgroup analysis for publication year,breastfeeding was not significantly related with osteoporotic fracture(OR=1.303,95%CI0.679-2.502)by the publication year of 2000 and after,while it was reported to reduce the osteoporotic fracture risk(OR=0.760,95%CI0.623-0.927)before 2000.Exclusion of any single study did not materially alter the combined risk estimate.The funnel chart,Begg’s(t=1.24,P=0.216)and Egger’s tests(t=1.57,P=0.168)did not show the evidence of publication bias.Significant dose-response relationship was not revealed between breastfeeding and osteoporotic fracture risk(non-linear:χ~2=1.25,P=0.264;linear:χ~2=17.8,P=0.216).Conclusion Breastfeeding is not statistically associated with osteoporotic fracture risk in women.更多还原