同型半胱氨酸水平与代谢性心血管疾病相关性的meta分析
Meta-analysis of the relationship between homocysteine level and metabolic cardiovascular disease
孙静 1赵燚 2林怡 1雷蓝 1孙仙2
作者信息
- 1. 宁夏医科大学临床医学院(银川,750004)
- 2. 宁夏医科大学公共卫生学院宁夏医科大学国家卫生健康委员会代谢性心血管疾病研究重点实验室宁夏环境因素与慢性病控制重点实验室
- 折叠
摘要
目的:通过meta分析评估同型半胱氨酸(homocysteine,Hcy)水平与代谢性心血管疾病发生及死亡风险的相关性.方法:计算机检索Pubmed、中国知网(CNKI)、万方数据库和维普数据库,检索时限为建库至2023年7月24日.经过文献筛选、资料提取和质量评价,采用RevMan 5.3软件进行meta分析.结果:共纳入16篇文献,其中7篇为队列研究,9篇为随机对照试验(randomized controlled trial,RCT).队列研究meta分析结果显示,与Hcy水平正常者相比,Hcy水平较高者全因死亡率(RR=2.38,95％CI:1.71～3.32)、代谢性心血管疾病(RR=1.91,95％CI:1.46～2.49)、卒中(RR=2.26,95％CI:1.91～2.67)和冠心病(RR=2.32,95％CI:1.40～3.83)的发生/死亡风险增加;RCT研究meta分析结果显示,叶酸联合B族维生素干预可降低人体内Hcy水平(RR=-2.85,95％CI:-3.86～-1.83),但试验组和对照组全因死亡率、代谢性心血管疾病、心肌梗死和卒中的发生/死亡风险均无统计学意义(均P＞0.05).结论:队列研究结果显示,体内Hcy水平升高会增加代谢性心血管疾病的发生风险和全因死亡风险.RCT结果显示,叶酸联合B族维生素干预虽然能降低体内Hcy水平,但远期内并不能观测到对代谢性心血管疾病的影响.
Abstract
Objective:The study was aimed to evaluate the correlation between homocysteine(Hcy)levels and the risk of metabolic cardiovascular diseases and death through meta-analysis.Methods:Pubmed,CNKI,Wan-fang Database,and VIP Database were searched by computer to collect literature till July 24th,2023.After litera-ture screening,data extraction,and quality evaluation,meta-analysis was conducted using RevMan 5.3 software.Results:A total of 16 articles were included,of which 7 were cohort studies and 9 were RCTs.The meta-analysis results from cohort studies showed that comparing with those with normal Hcy levels,those with higher Hcy lev-els had a higher risk of all-cause mortality(RR=2.38,95％CI1.71-3.32),metabolic cardiovascular diseases(RR=1.91,95％CI 1.46-2.49),stroke(RR=2.26,95％CI1.91-2.67),and coronary heart diseases(RR=2.32,95％CI1.40-3.83).The meta-analysis results from RCTs showed that folic acid combined with B vita-mins intervention could reduce Hcy levels in the human body(RR=-2.85,95％CI-3.86--1.83),but there were no significant differences in the incidence of all-cause mortality,metabolic cardiovascular diseases,myocardi-al infarction and stroke in the experimental and control groups(P＞0.05).Conclusion:The results of cohort stud-ies indicate that an increase in Hcy levels in the body over a period of time increases the risk of metabolic cardio-vascular diseases and all-cause mortality.The results of RCTs indicate that although exogenous folic acid com-bined with B vitamins intervention can reduce Hcy levels in the body for a certain period of time,while the long-term impact on metabolic cardiovascular diseases cannot be observed.
关键词
同型半胱氨酸/代谢性心血管疾病/meta分析/队列研究/随机对照试验Key words
homocysteine/metabolic cardiovascular disease/meta analysis/cohort study/randomized con-trolled trial引用本文复制引用
基金项目
国家自然科学联合基金项目(U22A20360)
出版年
2024
NETL
NSTL
万方数据