越来越多的儿童癌症幸存者（CCS）面临治疗相关毒性（包括骨骼疾病）的风险。骨矿物质密度 (BMD) 是骨骼健康的指标，其减少与骨质疏松症和骨折有关。通过在完成治疗后对 BMD 进行系统回顾和荟萃分析来研究 CCS 的骨骼健康状况。我们检索了 Medline、Embase、Cochrane、和 Web of Science 于 2019 年 5 月发布，并于 2023 年 5 月更新。报告治疗完成后在 CCS 中用双能 X 射线吸收测定法测量的 BMD Z 分数的研究。我们对报告 BMD Z 分数的研究进行了汇总分析，随后我们进行了分析比较幸存者和健康对照组的 BMD 的研究。所有分析均根据 BMD 测量部位进行。在 4243 项研究中，纳入了 84 项 (N = 8106)。所有研究的平均停药时间从 2 个月到 24 年不等。全身的总体汇总平均 Z 分数为 -0.57（95% 置信区间 [CI] -0.59 至 -0.55），腰椎为 -0.84（95% CI -0.86 至 -0.83），腰椎为 -0.79（95% CI -0.86 至 -0.83）。股骨颈的 95% CI -0.81 至 -0.77），全髋关节的 -0.14（95% CI -0.18 至 -0.11）。当将幸存者与对照组进行比较时，所有地点的幸存者的 BMD 均显着降低。英文出版物，研究水平荟萃分析。我们显示 CCS 中 BMD Z 分数显着降低。鉴于 -1 SD 内骨折风险已经增加，这些结果强调了 CCS 中 BMD 监测和二级预防的必要性。版权所有 © 2024 美国儿科学会。

There is an increasing population of childhood cancer survivors (CCS) at risk for treatment-related toxicities, including skeletal morbidities. Bone mineral density (BMD) is a proxy for bone health and reductions are associated with osteoporosis and fractures.To investigate bone health in CCS by conducting a systematic review and meta-analysis of BMD after completed treatments.We searched Medline, Embase, Cochrane, and Web of Science in May 2019 and updated in May 2023.Studies reporting BMD Z-scores measured with dual-energy x-ray absorptiometry in CCS after treatment completion.We performed a pooled analysis of studies reporting BMD Z-scores and thereafter we analyzed studies comparing BMD in survivors and healthy controls. All analyses were performed based on the site of BMD measurement.Of 4243 studies, 84 were included (N = 8106). The mean time off-treatment across the studies ranged from 2 months to 24 years. The overall pooled mean Z-score was -0.57 (95% confidence interval [CI] -0.59 to -0.55) in the whole-body, -0.84 (95% CI -0.86 to -0.83) in the lumbar spine, -0.79 (95% CI -0.81 to -0.77) in the femoral neck and -0.14 (95% CI -0.18 to -0.11) in the total hip. When comparing survivors with controls, BMD was significantly lower in survivors at all sites.English publications, study-level meta-analysis.We showed a significant reduction of BMD Z-scores in CCS. Given the increased fracture risk already within -1 SD, these results emphasize the need for BMD surveillance and secondary prevention in CCS.Copyright © 2024 by the American Academy of Pediatrics.