Background. Previous studies have reached mixed conclusions regarding the association between metabolic syndrome (MS) and osteoporosis. We aimed to perform a meta-analysis based on published studies that explored the association between osteoporosis and MS. Methods. To identify related literature, a systematic search of PubMed, Cochrane Library, and EMBASE databases from inception to June 2020 was performed. Original studies that reported the risk estimates of osteoporosis morbidity for two or three categories of bone mineral density (BMD) in patients with MS were selected. Two independent investigators screened and selected the articles. Summary odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using random-effects models. Results. Of 2632 identified studies, nine cross-sectional studies with 14 datasets were eligible for our meta-analysis. In seven studies (10 datasets), the summarized ORs of osteoporosis for MS were 0.72 (95% CI: 0.52–0.99). Subgroup analyses by gender showed that significant inverse associations were observed only in men (OR = 0.72, 95% CI: 0.55–0.96) but not in women (OR = 0.70, 95% CI: 0.41–1.22). The definition of MS, the source of the study population, and the adjustment of covariates affected the estimates. In two studies (4 datasets), there was no evidence for an association between MS and decreased BMD. Conclusions. Our findings demonstrated that MS was significantly associated with a lower osteoporosis risk. There might be gender differences in the association between MS and osteoporosis. In addition, the association was likely to relate to the definition of MS, the source of the study population, and the adjustment of covariates.

中文翻译：

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代谢综合征与骨质疏松症之间的关联：系统评价和荟萃分析

背景。以前的研究对代谢综合征 (MS) 与骨质疏松症之间的关系得出了不同的结论。我们旨在根据已发表的研究进行荟萃分析，这些研究探讨了骨质疏松症与 MS 之间的关联。方法。为识别相关文献，系统检索了 PubMed、Cochrane 图书馆和 EMBASE 数据库，从开始到 2020 年 6 月。选择了报告 MS 患者中两种或三种骨矿物质密度 (BMD) 的骨质疏松症发病率风险估计的原始研究。两名独立调查员筛选并选择了这些文章。使用随机效应模型计算汇总优势比 (OR) 和 95% 置信区间 (CI)。结果. 在 2632 项已确定的研究中，有 14 个数据集的 9 项横断面研究符合我们的荟萃分析条件。在七项研究（10 个数据集）中，MS 骨质疏松症的汇总 OR 为 0.72（95% CI：0.52-0.99）。按性别进行的亚组分析表明，仅在男性中观察到显着的负相关（OR = 0.72, 95% CI: 0.55-0.96），但在女性中未观察到（OR = 0.70, 95% CI: 0.41-1.22）。MS 的定义、研究人群的来源和协变量的调整影响了估计值。在两项研究（4 个数据集）中，没有证据表明 MS 与 BMD 降低之间存在关联。结论. 我们的研究结果表明，MS 与较低的骨质疏松症风险显着相关。MS与骨质疏松症之间的关联可能存在性别差异。此外，该关联可能与 MS 的定义、研究人群的来源和协变量的调整有关。