Abstract: Background　Benign paroxysmal positional vertigo （BPPV） is the most common type of vertigo.While its etiology is not clear，a growing number of studies have shown that BPPV is closely associated with osteoporosis/osteopenia.Osteoporosis/osteopenia may be a risk factor of BPPV，but there is no definite conclusion yet.It is important to clarify the relationship between BPPV and osteoporosis/osteopenia for the etiology and the prevention and treatment of BPPV.Objective　To systematically evaluate the association between BPPV and osteoporosis/osteopenia.Methods　Relevant studies from home and abroad on the relationship between BPPV and osteoporosis/osteopenia were identified by searching PubMed，EMBase，Cochrane Library，ScienceDirect，Web of Science，Wanfang Data Knowledge Service Platform and CNKI from the founding of each database to March 2018.RevMan 5.3 software was used for meta-analysis.Pooled odds ratios（OR） and 95% confidence intervals（CI） were used to assess the combined effect.Results　A total of 9 studies involving 1 982 individuals were included，which were all case-control studies.The results of meta analysis showed that both the incidence of osteoporosis 〔OR=3.22，95%CI（2.08，4.97），P<0.000 01〕 and osteopenia 〔OR=1.72，95%CI（1.11，2.67），P<0.000 1〕 in BPPV groups were significantly higher than those in control groups.The results of subgroup analysis showed that the incidence of osteoporosis in female 〔OR=2.74，95%CI（1.93，3.89），P<0.000 01〕 and xanthoderm BPPV patients 〔OR=3.75，95%CI（2.87，4.90），P<0.000 01〕 were higher than those in control groups，and the incidence of osteopenia in female 〔OR=1.68，95%CI（1.04，2.70），P=0.03〕 and xanthoderm BPPV patients 〔OR=1.54，95%CI（1.00，2.36），P=0.05〕 were higher than those in control groups.Conclusion　BPPV patients are more likely to have osteoporosis/osteopenia，especially in female and xanthoderm patients，suggesting that osteoporosis/osteopenia may be a risk factor of BPPV.

Key words: Vertigo, Osteoporosis, Osteopenia, Meta-analysis

摘要： 背景　良性发作性位置性眩晕（BPPV）是最常见的眩晕类型，其病因尚不明确，越来越多研究表明BPPV与骨质疏松/低骨量关系密切，骨质疏松/低骨量是BPPV危险因素，但尚无明确定论，阐明BPPV与骨质疏松/低骨量关系对BPPV病因学的研究以及BPPV的预防及治疗均有重要意义。目的　系统评价BPPV与骨质疏松/低骨量的关系。方法　计算机检索PubMed、EMBase、Cochrane Library、ScienceDirect、Web of Science、万方数据知识服务平台、中国知网（CNKI）等数据库，检索时限为各数据库建库至2018年3月，收集国内外有关BPPV与骨质疏松/低骨量关系的研究。使用RevMan 5.3软件进行Meta分析，采用比值比（OR）和95%可信区间（CI）评估合并效应量。结果　最终纳入9篇文献，均为病例对照研究，包含1 982例研究对象。Meta分析结果显示，BPPV组患者骨质疏松〔OR=3.22，95%CI（2.08，4.97），P<0.000 01〕和低骨量〔OR=1.72，95%CI（1.11，2.67），P<0.000 1〕发生率均高于对照组。亚组分析结果示，BPPV组女性患者〔OR=2.74，95%CI（1.93，3.89），P<0.000 01〕、黄种人患者〔OR=3.75，95%CI（2.87，4.90），P<0.000 01〕骨质疏松发生率高于对照组。BPPV组女性患者〔OR=1.68，95%CI（1.04，2.70），P=0.03〕、黄种人患者〔OR=1.54，95%CI（1.00，2.36），P=0.05〕低骨量发生率高于对照组。结论　BPPV患者更易患骨质疏松/低骨量，尤其是在女性及黄种人中，提示骨质疏松/低骨量可能是BPPV发病的危险因素。

关键词: 眩晕, 骨质疏松, 低骨量, Meta分析