Summary

Metabolic syndrome is of increasing concern globally. The aspects of this disease and its interaction with other morbidities should be discussed in detail. By investigating the effects of metabolic syndrome on the bone fracture rate, we have shown a protective role for metabolic syndrome in the male population.

Purpose

There is controversy on the effects of metabolic syndrome on bone health and fracture risk. This systematic review and meta-analysis reappraises the literature on the subject and quantitatively evaluates the fracture risk in individuals with metabolic syndrome.

Methods

PubMed, Embase, Web of Science, and Scopus were searched for all relevant articles. Studies were selected if they included the rate of any type of fracture in individuals with metabolic syndrome. Non-English studies, review articles, case reports, and editorials were excluded. The titles and abstracts were screened to identify relevant studies and the data was extracted from these. The data were analyzed to determine the estimated effect at a 95% confidence interval. Publication bias was assessed using the Egger’s test, and funnel plots were drawn. The heterogeneity of the results was determined according to I² statistics.

Results

Of the 3141 articles from the initial search, 20 studies were selected for review and included 13 cross-sectional and seven cohort studies. A meta-analysis of all studies showed no association between metabolic syndrome and fractures across the entire population (HR = 0.954; p = 0.410). However, separate analysis of the cohort studies showed a decreased risk over the entire population (HR = 0.793; p = 0.000) and in males (HR = 0.671; p = 0.000), but not in females (HR = 1.029; p = 0.743).

Conclusion

This systematic review and meta-analysis showed that the current literature suggests that metabolic syndrome is a protective factor for bone fractures in males but has no net effect on fractures among females.

中文翻译：

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代谢综合征会增加骨折的风险吗？系统评价和荟萃分析

概括

代谢综合征在全球范围内日益受到关注。应详细讨论这种疾病的各个方面及其与其他疾病的相互作用。通过研究代谢综合征对骨折率的影响，我们已经显示出代谢综合征在男性人群中的保护作用。

目的

关于代谢综合征对骨骼健康和骨折风险的影响存在争议。该系统回顾和荟萃分析重新评估了有关该主题的文献，并定量评估了代谢综合征患者的骨折风险。

方法

在 PubMed、Embase、Web of Science 和 Scopus 中搜索了所有相关文章。如果研究包括代谢综合征患者任何类型骨折的发生率，则选择这些研究。非英语研究、评论文章、病例报告和社论被排除在外。筛选标题和摘要以识别相关研究，并从中提取数据。分析数据以确定 95% 置信区间的估计效果。使用 Egger 检验评估发表偏倚，并绘制漏斗图。根据I ²统计量确定结果的异质性。

结果

在最初搜索的 3141 篇文章中，选择了 20 项研究进行审查，包括 13 项横断面研究和 7 项队列研究。对所有研究的荟萃分析显示，代谢综合征与整个人群的骨折之间没有关联（HR = 0.954；p  = 0.410）。然而，队列研究的单独分析显示整个人群（HR = 0.793；p  = 0.000）和男性（HR = 0.671；p  = 0.000）的风险降低，但女性（HR = 1.029；p  = 0.743 ）的风险降低）。

结论

该系统评价和荟萃分析表明，目前的文献表明代谢综合征是男性骨折的保护因素，但对女性骨折没有净影响。