ABSTRACT

Objectives: Type 1 diabetes mellitus (T1D) has been disclosed to be associated with an elevated risk of cardiovascular disease (CVD), as well as increased risks of losing bone mass and progression of osteoporosis (OP). Osteoprotegerin (OPG), as a decoy receptor, has been demonstrated to play a critical role in bone metabolism homeostasis and vascular atherosclerotic diseases. This meta-analysis aimed to investigate the associations between OPG levels and T1D.

Methods: Related literatures were searched and identified from the database of the Cochrane Library database, PubMed and EMbase inception to August 3, 2019 in English. The pooled standard mean difference (SMD) with its 95% confidence interval (CI) was calculated in using random-effect model analysis. Chi-square Q statistic and I² test were performed to evaluate and quantified the presence of heterogeneity.

Results: Twelve studies with 1288 subjects (794 T1D patients and 494 healthy controls) were finally included. The incorporated results indicated that T1D patients have higher plasma/serum OPG levels than in healthy individuals (SMD = 0.64, 95% CI: 0.06, 1.22). Subgroup analyses suggested that Caucasian and glycosylated hemoglobin A1c (HbA1c) <8.5% groups showed higher OPG levels, however, there was no significant differences of OPG levels regarding subgroups of BMI ≥ or <25, children-adolescents or adults and HbA1c ≥8.5%.

Conclusions: The current evidence suggested that circulating OPG levels are significantly higher in T1D than in healthy controls, and the increase of OPG levels are influenced by factors of race and HbA1c.

摘要

目的：已发现 1 型糖尿病 (T1D) 与心血管疾病 (CVD) 风险升高以及骨量丢失和骨质疏松症 (OP) 进展的风险增加有关。骨保护素（OPG）作为一种诱饵受体，已被证明在骨代谢稳态和血管动脉粥样硬化疾病中起着关键作用。这项荟萃分析旨在调查 OPG 水平与 T1D 之间的关联。

方法：从Cochrane Library数据库、PubMed和EMbase inception至2019年8月3日英文检索相关文献。使用随机效应模型分析计算合并标准平均差 (SMD) 及其 95% 置信区间 (CI)。进行卡方Q统计和I ² 检验以评估和量化异质性的存在。

结果：最终纳入了 12 项研究，涉及 1288 名受试者（794 名 T1D 患者和 494 名健康对照者）。综合结果表明，T1D 患者的血浆/血清 OPG 水平高于健康个体（SMD = 0.64, 95% CI: 0.06, 1.22）。亚组分析表明，白种人和糖化血红蛋白 A1c (HbA1c) <8.5% 的组显示出较高的 OPG 水平，然而，对于 BMI ≥ 或 <25、儿童-青少年或成人和 HbA1c ≥8.5% 的亚组，OPG 水平没有显着差异.

结论：目前的证据表明，T1D 患者的循环 OPG 水平显着高于健康对照组，并且 OPG 水平的升高受种族和 HbA1c 因素的影响。