绝经后骨质疏松症的患病率及危险因素：基于多因素logistic回归的系统综述与meta分析。
完整摘要 · 中文译文
目的：本荟萃分析旨在探讨绝经后骨质疏松症（PMO）的患病率及危险因素，为临床早期识别高危人群提供依据。 方法：我们系统检索了截至2026年5月的英文数据库（PubMed、Cochrane Library、Embase、Web of Science）和中文数据库（CNKI、万方数据、维普数据库、Sinomed），纳入采用多因素logistic回归分析PMO危险因素的观察性研究。荟萃分析按照PRISMA指南进行。数据提取后，使用STATA 15.0计算合并比值比（OR）及其95%置信区间（CI）。 结果：共纳入37项研究，涉及32,366名绝经后女性。其中，36项研究报告了骨质疏松症的患病率，总体患病率为33.87%。荟萃分析确定以下因素与PMO风险增加显著相关：年龄（OR = 1.16）；绝经年限（OR = 1.23）；绝经年限>10年（OR = 2.81）；生育次数（OR = 1.32）；生育≥2次（OR = 3.07）；吸烟（OR = 1.55）；缺乏运动（OR = 1.66）；既往骨折史（OR = 1.86）；糖尿病（OR = 2.24）；相反，较高的体质指数（BMI）（OR = 0.80）、较晚的绝经年龄（OR = 0.92）和雌激素替代治疗（OR = 0.45）被确定为保护因素。以下因素未发现显著关联：骨质疏松症家族史；规律运动；高血压；补钙。 结论：Osteopor 骨质疏松症在绝经后女性中高度流行，尤其是在本荟萃分析中占多数的东亚人群中。研究确定了若干独立危险因素，包括年龄、绝经后时间较长、多产、吸烟、缺乏体力活动、既往骨折和糖尿病。雌激素替代疗法显示出很强的保护作用。虽然多个因素存在较高的统计学异质性，但已通过随机效应模型和敏感性分析加以处理，这些主要来源于中国队列的研究结果在解读时应考虑到这种变异性。尽管如此，它们为该高危人群的早期风险分层和针对性预防策略提供了可靠的框架。 系统综述注册：https://www.crd.york.ac.uk/prospero/，注册号 CRD420251274575。
完整摘要 · 英文原文
OBJECTIVE: This meta-analysis aimed to investigate the prevalence and risk factors for Postmenopausal Osteoporosis (PMO) to provide a basis for early clinical identification of high-risk populations. METHODS: We systematically searched English databases (PubMed, Cochrane Library, Embase, Web of Science) and Chinese databases (CNKI, Wanfang Data, VIP Database, Sinomed) up to May 2026 for observational studies using multivariate logistic regression to analyze risk factors for PMO. The meta-analysis was conducted following the PRISMA guidelines. After data extraction, pooled odds ratios (OR) with 95% confidence intervals (CI) were calculated using STATA 15.0. RESULTS: A total of 37 studies involving 32,366 postmenopausal women were included. Among these, 36 studies reported the prevalence of osteoporosis, yielding an overall prevalence of 33.87%. The meta-analysis identified the following factors as significantly associated with an increased risk of PMO: Age (OR = 1.16); Postmenopausal duration (OR = 1.23); Postmenopausal duration > 10 years (OR = 2.81); Number of births (OR = 1.32); With ≥ 2 births (OR = 3.07); Smoking (OR = 1.55); Lack of exercise (OR = 1.66); History of previous fracture (OR = 1.86); Diabetes mellitus (OR = 2.24); Conversely, a higher body mass index (BMI) (OR = 0.80), older age at menopause (OR = 0.92), and estrogen replacement therapy (OR = 0.45) were identified as protective factors. No significant association was found for the following factors: Family history of osteoporosis; Regular exercise; Hypertension; Calcium supplementation. CONCLUSION: Osteoporosis is highly prevalent among postmenopausal women, particularly within the East Asian cohorts that comprised the majority of this meta-analysis. Several independent risk factors were identified, including age, longer postmenopausal duration, multiparity, smoking, physical inactivity, previous fracture, and diabetes. Estrogen replacement therapy showed a strong protective effect. While high statistical heterogeneity for several factors was addressed using random-effects models and sensitivity analyses, these findings-derived predominantly from Chinese cohorts-should be interpreted with consideration of this variability. Nevertheless, they provide a robust framework for early risk stratification and targeted prevention strategies in this high-risk population. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/, identifier CRD420251274575.