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Letter to the Editor regarding "The relationship between serum vitamin D and fracture risk in the elderly: a meta-analysis".
Journal of Orthopaedic Surgery and Research ( IF 2.6 ) Pub Date : 2020-08-07 , DOI: 10.1186/s13018-020-01811-6
Qiujiang Li 1, 2 , Xingxia Long 3 , Lijun Cai 1, 2
Affiliation  

Dear Editor:

We read with great interest the meta-analysis by Wang et al [1]. entitled “The relationship between serum vitamin D and fracture risk in the elderly: a meta-analysis.” We congratulate the authors for publishing their study in this journal. Yet upon the review of this article, there are serious issues that nullify the conclusions. We seek certain clarifications from the authors.

First, the authors extensively searched the published literature through electronic databases (PubMed and Embase) and manually retrieved the references of the included studies, but these databases seemed to be not enough to retrieve all the eligible studies. Alternatively, other databases do exist, such as Cochrane Library, NLM Gateway, and BIOSIS previews as well as unpublished data like grey literature, which may contribute to get a more comprehensive collection of eligible studies.

Secondly, about the adaptation of systematic review guidelines and registrations, there have been systematic review and meta-analysis protocol registration established that help to maintain a level of homogeneity and quality across all meta-analyses and systematic reviews being conducted. The meta-analysis was performed following the guideline of PRISMA, but the pre-defined protocol was not registered in any platform, such as the Cochrane Library and PROSPERO [2, 3]. Not only do the registration provides transparency in the review, but also improves the quality of conduct of the review and its subsequent reporting.

Thirdly, In total, 20 studies met inclusion criteria and were included in the meta-analysis. Given the characteristics of the study of Swanon et al. [4] in Table 1, such as the study type, number of total fractures, number of hip fractures, country and period, were similar to the study of Cauley et al. [5], we doubt this is the case. Upon close examination, a main reason we found was both of the two studies were case-cohort within the Osteoporotic Fractures in Men Study (MrOS), which recruited 5994 community-dwelling men at six clinical centers in the USA (Birmingham, Alabama, Minneapolis, Minnesota, Palo Alto, California, Monongahela Valley near Pittsburgh, Pennsylvania, Portland, Oregon, and San Diego, California) between March 2000 and April 2002 for a study on musculoskeletal aging. If extracting duplicate data for the sample, it would be likely to lead to an incorrect conclusion, misleading clinical practice. Therefore, in case that several articles from the same trial were published, the study that had the most relevant information or the longest follow-up period might be most appropriate.

Fourthly, Wang et al. [1] revealed that BMI (body mass index) may be a key risk factor to cause osteoporosis and osteoporotic fractures in patients (patients aged 65 and above). Therefore, it is better to perform a subgroup analysis of the low and normal and high BMI in the current study to clear the effect of BMI. Finally, we hope that the authors address the points presented and that the overall discussion of the presented points will only serve to benefit the research community at large.

Not applicable.

  1. 1.

    Wang N, Chen Y, Ji J, et al. The relationship between serum vitamin D and fracture risk in the elderly: a meta-analysis. J Orthop Surg Res. 2020;15(1):81.

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  2. 2.

    David M, Alessandro L, Jennifer T, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 2009;151:264–9 W64.

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    Stroup Donna F, Berlin Jesse A, Morto Sally C, et al. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis of observational studies in epidemiology (MOOSE) group. JAMA. 2000;283:2008–12.

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    Swanson CM, Srikanth P, Lee CG, et al. Associations of 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D with bone mineral density, bone mineral density change, and incident nonvertebral fracture. J Bone Miner Res. 2015;30(8):1403–13.

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  5. 5.

    Cauley JA, Parimi N, Ensrud KE, et al. Serum 25-hydroxyvitamin D and the risk of hip and nonspine fractures in older men. J Bone Miner Res. 2010;25(3):545–53.

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Author notes
  1. Qiujiang li and Xingxia long contributed equally to this manuscript

Affiliations

  1. Graduate School of Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region, China

    Qiujiang Li & Lijun Cai

  2. Department of Spine Surgery, People’s Hospital of Ningxia Hui Autonomous Region, No. 56, Zhengyuan Street, Yinchuan, 750000, Ningxia Hui Autonomous Region, China

    Qiujiang Li & Lijun Cai

  3. Graduate School of Huzhou University, Huzhou, Zhejiang Province, China

    Xingxia Long

Authors
  1. Qiujiang LiView author publications

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  2. Xingxia LongView author publications

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  3. Lijun CaiView author publications

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Contributions

QL wrote this manuscript. XL and LC reviewed the selected studies in Wang et al.’s review. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Lijun Cai.

Ethics approval and consent to participate

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Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests

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Li, Q., Long, X. & Cai, L. Letter to the Editor regarding “The relationship between serum vitamin D and fracture risk in the elderly: a meta-analysis”. J Orthop Surg Res 15, 306 (2020). https://doi.org/10.1186/s13018-020-01811-6

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中文翻译:

给编辑的信,内容为“血清维生素D与老年人骨折风险之间的关系:荟萃分析”。

亲爱的编辑:

我们非常感兴趣地阅读了Wang等人的荟萃分析[1]。题为“老年人血清维生素D与骨折风险之间的关系:荟萃分析”。我们祝贺作者在此期刊上发表了他们的研究。然而,在对本文进行审阅时,仍然存在一些严重的问题使结论无效。我们寻求作者的某些澄清。

首先,作者通过电子数据库(PubMed和Embase)广泛搜索了已发表的文献,并手动检索了所包含研究的参考文献,但这些数据库似乎不足以检索所有符合条件的研究。或者,确实存在其他数据库,例如Cochrane库,NLM Gateway和BIOSIS预览以及未发布的数据(例如灰色文献),这可能有助于获得更全面的合格研究资料。

其次,关于系统评价指南和注册的改编,已经建立了系统评价和荟萃分析方案注册,有助于在所有荟萃分析和进行的系统评价中保持同质性和质量水平。荟萃分析是按照PRISMA的指南进行的,但是预定义的协议未在任何平台上注册,例如Cochrane Library和PROSPERO [2,3]。注册不仅提供了审查的透明度,而且还提高了审查及其后续报告的执行质量。

第三,总共有20项研究符合纳入标准,并被纳入荟萃分析。考虑到Swanon等人研究的特点。[4]表1中的研究类型,总骨折数,髋部骨折数,国家和时期等与Cauley等人的研究相似。[5],我们怀疑情况是否如此。经过仔细检查,我们发现的主要原因是两项研究都是男性骨质疏松性骨折病例研究(MrOS),该研究在美国的六个临床中心(伯明翰,阿拉巴马州,明尼阿波利斯)招募了5994名社区居民于2000年3月至2002年4月之间在美国加利福尼亚州明尼苏达州,帕洛阿尔托市,宾夕法尼亚州匹兹堡附近的莫农加希拉河谷,俄勒冈州波特兰市和加利福尼亚州的圣地亚哥)进行肌肉骨骼老化研究。如果要提取样本的重复数据,可能会导致错误的结论,误导临床实践。因此,如果发表了同一试验的几篇文章,则最相关的信息或最长的随访时间的研究可能是最合适的。

第四,王等。[1]揭示,BMI(体重指数)可能是导致患者(65岁及以上)骨质疏松和骨质疏松性骨折的关键危险因素。因此,最好在当前研究中对低,正常和高BMI进行亚组分析,以清除BMI的影响。最后,我们希望作者解决提出的要点,并且对提出的要点的整体讨论只会使整个研究界受益。

不适用。

  1. 1。

    王娜,陈Y,季健,等。老年人血清维生素D与骨折风险的关系:荟萃分析。J Orthop外科水库。2020; 15(1):81。

    文章Google学术搜索

  2. 2。

    David M,Alessandro L,Jennifer T等。系统评价和荟萃分析的首选报告项目:PRISMA声明。安实习生。2009; 151:264–9 W64。

    文章Google学术搜索

  3. 3。

    Stroup Donna F,柏林Jesse A,Morto Sally C等。流行病学观察性研究的荟萃分析:报告建议。流行病学(MOOSE)组观察性研究的荟萃分析。贾玛 2000; 283:2008-12。

    文章Google学术搜索

  4. 4。

    Swanson CM,Srikanth P,Lee CG等。25-羟基维生素D和1,25-二羟基维生素D与骨矿物质密度,骨矿物质密度变化和非椎骨骨折相关性。J骨矿工研究。2015; 30(8):1403-13。

    CAS文章Google学术搜索

  5. 5,

    Cauley JA,Parimi N,Ensrud KE等。血清25-羟基维生素D与老年男性髋部和非脊柱骨折的风险。J骨矿工研究。2010; 25(3):545–53。

    CAS文章Google学术搜索

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  1. 李秋江和星霞长期以来对这份手稿做出了同等的贡献

隶属关系

  1. 宁夏医科大学研究生院,宁夏银川

    李秋江&蔡立军

  2. 宁夏回族自治区人民医院脊柱外科,宁夏回族自治区银川市正远街56号,750000

    李秋江&蔡立军

  3. 湖州大学研究生院,浙江省湖州市

    星下龙

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  1. 李秋江查看作者著作

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QL撰写了这份手稿。XL和LC在Wang等人的综述中回顾了所选的研究。所有作者阅读并认可的终稿。

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Li,Q.,Long,X. and Cai,L.给编者的信,内容为“血清维生素D与老年人骨折风险之间的关系:荟萃分析”。Ĵ骨科外科杂志RES 15, 306(2020)。https://doi.org/10.1186/s13018-020-01811-6

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更新日期:2020-08-08
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