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Meta-Analysis
, 19 (1), 128

Microarchitectural Changes in the Mandibles of Ovariectomized Rats: A Systematic Review and Meta-Analysis

Affiliations
Meta-Analysis

Microarchitectural Changes in the Mandibles of Ovariectomized Rats: A Systematic Review and Meta-Analysis

Jeong-Hee Lee et al. BMC Oral Health.

Abstract

Background: This study aimed to examine radiologic microarchitectural changes in the mandibles of ovariectomized (OVX) rats through a systematic review and meta-analysis and to identify factors of the OVX rat model that influence on the bone microstructure.

Methods: Eligible articles were identified by searching electronic databases, including Embase, Medline, Web of Science, and KoreaMed, for articles published from January 1966 to November 2017. Two reviewers independently performed study selection, data extraction, and quality assessment. The pooled standardized mean difference (SMD) with 95% confidence intervals was calculated using a random-effects model. Subgroup analysis and meta-regression were performed to explore the effect of potential sources on the outcomes. The reliability of the results was assessed by sensitivity analysis and publication bias.

Results: Of 1160 studies, 16 studies (120 OVX and 120 control rats) were included in the meta-analysis. Compared to the control group, the OVX rats' trabecular bone volume fraction (SMD = - 2.41, P < 0.01, I2 = 81%), trabecular thickness (SMD = - 1.73, P < 0.01, I2 = 73%) and bone mineral density (SMD = - 0.95, P = 0.01, I2 = 71%) displayed the bone loss consistent with osteoporosis. The trabecular separation (SMD = 1.66, P < 0.01, I2 = 51%) has widen in the OVX mandibular bone in comparison to the control group. However, the trabecular number showed no indication to detect the osteoporosis (SMD = - 0.45, P = 0.38, I2 = 76%). The meta-regression indicated that longer post-OVX periods led to greater changes in bone mineral density (β = - 0.104, P = 0.017). However, the rats' age at OVX was not linked to bone microstructure change.

Conclusions: Using meta-regression and sensitivity analysis techniques, heterogeneity across the micro CT studies of OVX-induced osteoporosis was found. The major factors of heterogeneity were the region of interest and post-OVX period. Our assessment can assist in designing experiments to maximize the usefulness of OVX rat model.

Keywords: Mandible; Meta-analysis; Microtomography; Osteoporosis; Ovariectomy; X-ray.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of literature search, and selection criteria adapted from PRISMA. OVX, ovariectomy; CT, computed tomography; BMD, bone mineral density
Fig. 2
Fig. 2
Forest plot comparing BV/TV between OVX and sham groups. ■, SMD of each study; horizontal lines represent the 95% CI for the data; ◆, combined overall effect. BV/TV, trabecular bone volume fraction; OVX, ovariectomy; SMD, standardized mean difference; SD, standard deviation; CI, confidence interval
Fig. 3
Fig. 3
Forest plot comparing Tb.Th between OVX and sham groups. ■, SMD of each study; horizontal lines represent the 95% CI for the data; ◆, combined overall effect. Tb.Th, trabecular thickness; OVX, ovariectomy; SMD, standardized mean difference; SD, standard deviation; CI, confidence interval
Fig. 4
Fig. 4
Forest plot comparing Tb.Sp between OVX and sham groups. ■, SMD of each study; horizontal lines represent the 95% CI for the data; ◆, combined overall effect. Tb. Sp, trabecular separation; OVX, ovariectomy; SMD, standardized mean difference; SD, standard deviation; CI, confidence interval
Fig. 5
Fig. 5
Forest plot comparing Tb. N between OVX and sham groups. ■, SMD of each study; horizontal lines represent the 95% CI for the data; ◆, combined overall effect. Tb.N, trabecular number; OVX, ovariectomy; SMD, standardized mean difference; SD, standard deviation; CI, confidence interval
Fig. 6
Fig. 6
Forest plot comparing BMD between OVX and sham groups. ■, SMD of each study; horizontal lines represent the 95% CI for the data; ◆, combined overall effect. BMD, bone mineral density; OVX, ovariectomy; SMD, standardized mean difference; SD, standard deviation; CI, confidence interval
Fig. 7
Fig. 7
Meta-regression of the relationship between post-OVX periods and bone mineral density. Each circle represents the SMD of an individual study, with the circle size denoting the precision of the estimate. OVX, ovariectomy; SMD, standardized mean difference
Fig. 8
Fig. 8
Contour-enhanced funnel plot for the analysis of publication bias, combined with a trim-and-fill analysis. a Funnel plot of publication bias in BV/TV changes in the OVX rats. b Funnel plot of publication bias in Tb.Th changes in the OVX rats. c Funnel plot of publication bias in Tb.Sp changes in the OVX rats. d Funnel plot of publication bias in Tb. N changes in the OVX rats. e Funnel plot of publication bias in BMD changes in the OVX rats. OVX, ovariectomy; BV/TV, trabecular bone volume fraction; Tb.Th, trabecular number; Tb. Sp, trabecular thickness; Tb.N, trabecular separation; BMD, bone mineral density

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