低估算肾小球滤过率与脑小血管疾病风险之间的关联：一项荟萃分析。

Association between Low Estimated Glomerular Filtration Rate and Risk of Cerebral Small-Vessel Diseases: A Meta-Analysis.

作者信息

Liu Yuanyuan, Lv Pu, Jin Haiqiang, Cui Wei, Niu Chenguang, Zhao Mingming, Fan Chenghe, Teng Yuming, Pan Bing, Peng Qing, Luo Jingjing, Zheng Lemin, Huang Yining

机构信息

Department of Neurology, Peking University First Hospital, Beijing, China.

The Institute of Cardiovascular Sciences and Institute of Systems Biomedicine, School of Basic Medical Sciences, and Key Laboratory of Molecular Cardiovascular Sciences of Ministry of Education, Peking University Health Science Center, Beijing, China.

出版信息

J Stroke Cerebrovasc Dis. 2016 Mar;25(3):710-6. doi: 10.1016/j.jstrokecerebrovasdis.2015.11.016. Epub 2016 Jan 8.

DOI:10.1016/j.jstrokecerebrovasdis.2015.11.016

PMID:26774868

Abstract

BACKGROUND

Although chronic kidney disease has been linked to cerebral small-vessel disease (CSVD), a definite relationship between them has not been established. This study assessed whether low estimated glomerular filtration is associated with risk of different subtypes of CSVDs.

METHODS

Electronic databases were systematically searched for studies reporting an odds ratio of the association between low estimated glomerular filtration and CSVD risk. Sixteen studies, including 10,534 participants, were identified. A fix effects model was applied and odds ratios (ORs) with 95% confidence intervals were presented.

RESULTS

Overall, risk of CSVDs was greater in individuals with low estimated glomerular filtration (OR = 2.20). Stratified analyses consistently showed significant associations across different subtypes, with pooled OR being greatest in subjects with silent cerebral infarction (SCI) (OR = 2.71) and cerebral microbleed (OR = 2.70). A pooled estimate of studies showing OR as a continuous variable showed results consistent with the former analysis (OR = .98 per standard deviation decrease) in low estimated glomerular filtration.

CONCLUSIONS

This study revealed that low estimated glomerular filtration was significantly associated with risk of CSVDs. Low estimated glomerular filtration was most strongly associated with SCI (OR = 2.71) among subtypes of CSVDs.

摘要

背景

尽管慢性肾脏病已被认为与脑小血管病（CSVD）有关，但二者之间尚未建立明确的关系。本研究评估了低估算肾小球滤过率是否与不同亚型的CSVD风险相关。

方法

系统检索电子数据库，查找报告低估算肾小球滤过率与CSVD风险之间关联比值比的研究。共纳入16项研究，包括10534名参与者。采用固定效应模型，并给出比值比（OR）及95%置信区间。

结果

总体而言，低估算肾小球滤过率个体发生CSVD的风险更高（OR = 2.20）。分层分析在不同亚型中均一致显示出显著关联，合并OR在无症状性脑梗死（SCI）患者中最高（OR = 2.71），在脑微出血患者中次之（OR = 2.70）。将OR作为连续变量的研究汇总估计结果与之前分析一致（低估算肾小球滤过率每降低一个标准差，OR = 0.98）。