Objective:Tsystematic evaluation and Meta analysis were used to evaluate the effectiveness of TCM compound in the treatment of senile osteoporosis and to analyze the regularity of its medication.Methods:Electronic ret...Objective:Tsystematic evaluation and Meta analysis were used to evaluate the effectiveness of TCM compound in the treatment of senile osteoporosis and to analyze the regularity of its medication.Methods:Electronic retrieval of CNKI,Wangfang Data,VIP,CBM,PubMed,Embase,Cochrane Library and other databases was conducted to include the clinical randomized controlled trial(RCT)of TCM compound as intervention measures for the treatment of senile osteoporosis as the study object.The retrieval time was set up until October 2019.The two researchers independently screened the literature according to inclusion criteria,extracted the data,and evaluated the quality of the included studies using Cochrane 5.1.0 bias risk assessment tool,and then used RevMan5.3 software for data analysis.Results:a total of 19 RCT literatures were included in the experimental group.In the control group,844 patients were treated with calcium or non-calcium.Meta analysis showed that total effective rate(RR=1.30,95%ci:1.19-1.43,P<0.05),lumbar vertebral bone density(MD=0.02,95%ci:0.01-0.04,P<0.05),femoral neck bone density(MD=0.01,95%ci:0.00~0.02,P<0.05),VAS score(MD=-1.04,95%ci:-1.67~0.40,P<0.05),BMC value(MD=0.06,95%ci:0.01~0.11,P=0.03),radial bone density(MD=0.04,95%ci:0.03~0.05,P<0.05),TCM syndrome score(MD=-6.76,95%ci:-7.94^-5.59,P<0.05),and TCM syndrome efficacy rate(RR=1.49,95%ci:1.28~1.73,P<0.05)were all statistically significant.ALP(MD=4.72,95%ci:-6~15.44,P=0.39),estradiol(MD=10.45,95%ci:-1.75~22.64,P=0.09),root bone index(MD=0.01,95%ci:-0.17~0.18,P=0.95),other bone mineral density(MD=0.11,95%ci:-0.01~0.22,P=0.06),urinary calcium/urinary creatinine(MD=-0.09,95%ci:There was no significant difference in serum calcium(MD=-0.01,95%ci:-0.11~0.09,P=0.83),serum phosphorus(MD=0.03,95%ci:-0.01~0.07,P=0.09).Among the Chinese herbal compounds used,astragalus is the most frequently used tonic.Conclusion:traditional Chinese medicine compound is effective in treating senile osteoporosis,and it is mainly used as tonic.展开更多
Background:Both simvastatin and metformin have demonstrated potential efficacy in osteoporosis(OP)treatment.However,there is a lack of systematic studies comparing their anti-osteoporotic effects.This study aims to co...Background:Both simvastatin and metformin have demonstrated potential efficacy in osteoporosis(OP)treatment.However,there is a lack of systematic studies comparing their anti-osteoporotic effects.This study aims to compare the effects of simvastatin and metformin on OP through Mendelian randomization(MR)studies and animal experiments.Methods:Initially,we will analyze the causal impact of simvastatin or metformin treatment on OP prevalence and three common clinical OP diagnostic markers(bone mineral density(BMD),serum osteocalcin(OCN),and tartrate-resistant acid phosphatase(TRAP)levels)using genome-wide association study(GWAS)summary statistics.Additionally,we established animal models to further analyze and compare the anti-osteoporosis effects of simvastatin and metformin.8 male C57BL/6J mice(3-month-old)and 24 male C57BL/6J mice(18-month-old)were treated with simvastatin or metformin for 12 weeks.OP pathology was assessed using histology,immunohistochemistry,biomechanical tests,micro-computed tomography,and osteogenic differentiation assays.Results:In the MR analysis,metformin treatment was significantly associated with lower OP prevalence(OR(95%CI)=0.933(0.902–0.965),β=-0.0694,P<0.001)and higher BMD(OR(95%CI)=3.719(1.750–7.908),β=1.3136,P<0.001).In the animal experiment,both drugs increased bone mass,improved bone microstructure,and promoted osteoblast differentiation.However,metformin appeared more effective in several aspects.It significantly inhibited bone marrow adipocyte and osteoclast differentiation in aged mice compared to simvastatin.Additionally,metformin better promoted the expression of osteoprotegerin(OPG)and collagen type I(Col-I)in bone tissue and maintained the structure and biomechanical properties of cancellous bone.Conclusion:Both drugs significantly preserved bone homeostasis.Particularly,compared with simvastatin,metformin exhibited superior effects in inhibiting adipogenesis,enhancing the OPG/RANKL pathway,and promoting cancellous bone reconstruction.Metformin may serve as a valuable adjunct in preventing and treating OP in the elderly.展开更多
基金National key research and development plan (2018YFC1704703)
文摘Objective:Tsystematic evaluation and Meta analysis were used to evaluate the effectiveness of TCM compound in the treatment of senile osteoporosis and to analyze the regularity of its medication.Methods:Electronic retrieval of CNKI,Wangfang Data,VIP,CBM,PubMed,Embase,Cochrane Library and other databases was conducted to include the clinical randomized controlled trial(RCT)of TCM compound as intervention measures for the treatment of senile osteoporosis as the study object.The retrieval time was set up until October 2019.The two researchers independently screened the literature according to inclusion criteria,extracted the data,and evaluated the quality of the included studies using Cochrane 5.1.0 bias risk assessment tool,and then used RevMan5.3 software for data analysis.Results:a total of 19 RCT literatures were included in the experimental group.In the control group,844 patients were treated with calcium or non-calcium.Meta analysis showed that total effective rate(RR=1.30,95%ci:1.19-1.43,P<0.05),lumbar vertebral bone density(MD=0.02,95%ci:0.01-0.04,P<0.05),femoral neck bone density(MD=0.01,95%ci:0.00~0.02,P<0.05),VAS score(MD=-1.04,95%ci:-1.67~0.40,P<0.05),BMC value(MD=0.06,95%ci:0.01~0.11,P=0.03),radial bone density(MD=0.04,95%ci:0.03~0.05,P<0.05),TCM syndrome score(MD=-6.76,95%ci:-7.94^-5.59,P<0.05),and TCM syndrome efficacy rate(RR=1.49,95%ci:1.28~1.73,P<0.05)were all statistically significant.ALP(MD=4.72,95%ci:-6~15.44,P=0.39),estradiol(MD=10.45,95%ci:-1.75~22.64,P=0.09),root bone index(MD=0.01,95%ci:-0.17~0.18,P=0.95),other bone mineral density(MD=0.11,95%ci:-0.01~0.22,P=0.06),urinary calcium/urinary creatinine(MD=-0.09,95%ci:There was no significant difference in serum calcium(MD=-0.01,95%ci:-0.11~0.09,P=0.83),serum phosphorus(MD=0.03,95%ci:-0.01~0.07,P=0.09).Among the Chinese herbal compounds used,astragalus is the most frequently used tonic.Conclusion:traditional Chinese medicine compound is effective in treating senile osteoporosis,and it is mainly used as tonic.
基金funded by the Applied Basic Research Foundation of Tianjin(22JCQNJC00230)the Beijing-Tianjin-Hebei Basic Research Cooperation Project(23JCZXJC00050/J230007)the Tianjin Health and Technology Project(TJWJ2024QN056)。
文摘Background:Both simvastatin and metformin have demonstrated potential efficacy in osteoporosis(OP)treatment.However,there is a lack of systematic studies comparing their anti-osteoporotic effects.This study aims to compare the effects of simvastatin and metformin on OP through Mendelian randomization(MR)studies and animal experiments.Methods:Initially,we will analyze the causal impact of simvastatin or metformin treatment on OP prevalence and three common clinical OP diagnostic markers(bone mineral density(BMD),serum osteocalcin(OCN),and tartrate-resistant acid phosphatase(TRAP)levels)using genome-wide association study(GWAS)summary statistics.Additionally,we established animal models to further analyze and compare the anti-osteoporosis effects of simvastatin and metformin.8 male C57BL/6J mice(3-month-old)and 24 male C57BL/6J mice(18-month-old)were treated with simvastatin or metformin for 12 weeks.OP pathology was assessed using histology,immunohistochemistry,biomechanical tests,micro-computed tomography,and osteogenic differentiation assays.Results:In the MR analysis,metformin treatment was significantly associated with lower OP prevalence(OR(95%CI)=0.933(0.902–0.965),β=-0.0694,P<0.001)and higher BMD(OR(95%CI)=3.719(1.750–7.908),β=1.3136,P<0.001).In the animal experiment,both drugs increased bone mass,improved bone microstructure,and promoted osteoblast differentiation.However,metformin appeared more effective in several aspects.It significantly inhibited bone marrow adipocyte and osteoclast differentiation in aged mice compared to simvastatin.Additionally,metformin better promoted the expression of osteoprotegerin(OPG)and collagen type I(Col-I)in bone tissue and maintained the structure and biomechanical properties of cancellous bone.Conclusion:Both drugs significantly preserved bone homeostasis.Particularly,compared with simvastatin,metformin exhibited superior effects in inhibiting adipogenesis,enhancing the OPG/RANKL pathway,and promoting cancellous bone reconstruction.Metformin may serve as a valuable adjunct in preventing and treating OP in the elderly.
