Dose-response Meta-analysis of the influencing factors and fractures in school-age children and youth

YIN Cuiping; WANG Nan; LIU Ran

doi:10.11852/zgetbjzz2022-1058

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Chinese Journal of Child Health Care ›› 2023, Vol. 31 ›› Issue (5) : 529-534. DOI: 10.11852/zgetbjzz2022-1058

Meta Analysis

Dose-response Meta-analysis of the influencing factors and fractures in school-age children and youth

YIN Cuiping, WANG Nan, LIU Ran

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Abstract

Objective To systematically evaluate the influencing factors of fractures (FR) in school-age children and adolescents, and to assess the association based on a dose-response Meta-analysis. Methods Observational studies on the FR in school-age children and adolescents published from Jan.2000 to Jan.2022 were retrived from the databases of CBM, CNKI, Wanfang Data, and VIP.The articles were screened strictly to extract valid data.Stata 16.0 was applied to combine the odds ratio (OR) of effect sizes, Q-test and I² test were used to evaluate the heterogeneity of outcome indicators in the literature, and Begg's test was used to detect publication bias.Finally, the dose-response relationship between FR and influencing factors was performed. Results A total of 14 articles (2 cohort studies, 3 case-control studies and 9 cross-sectional studies) involving 30 769 cases and 45 857 controls were included.Meta-analysis showed that boys (OR=2.91, 95%CI: 2.76 - 3.06), moderate-to-vigorous physical activities (OR=1.55, 95%CI: 1.33 - 1.77), FR history (OR=3.56, 95%CI: 2.18 - 4.94), July/August (OR=4.19, 95% CI: 3.30 - 5.08) and rural area (OR=2.17, 95%CI: 1.02 - 3.32) were risk factors for the developing of FR, while high secondary school (OR=0.39, 95%CI: 0.11 - 0.67) was a protective factor for FR.The dose-response analysis showed a non-linear correlation between age and FR risks (χ²=13.26, P<0.01).The correlations of body mass index (χ²=6.71, P=0.082), physical activity time (χ²=3.18, P=0.107) and household income (χ²=1.47, P=0.690) with FR risks were linear. Conclusion Gender, physical activity time, fracture history, month, and urban/rural area may lead to the differences in the incidence of FR in school-age children and adolescents, and the effect of age on FR showed a non-linear relationship of "increasing and then decreasing", which needs to be confirmed by further clinical studies and epidemiological surveys.

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school-age children and adolescents / fracture / Meta-analysis / dose-response analysis

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YIN Cuiping, WANG Nan, LIU Ran. Dose-response Meta-analysis of the influencing factors and fractures in school-age children and youth[J]. Chinese Journal of Child Health Care. 2023, 31(5): 529-534 https://doi.org/10.11852/zgetbjzz2022-1058

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