Guo Zhen-Lang, Xu Jing-Li, Lai Ren-Kui, Wang Shu-Sheng
The Second Clinical College, Guangzhou University of Chinese Medicine Department of Cardiovasology Department of Urology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.
Medicine (Baltimore). 2017 Aug;96(34):e7852. doi: 10.1097/MD.0000000000007852.
Even though several studies comparing vasectomy and cardiovascular disease (CVD) risk have been reported, most are small series with conflicting results. However, the extent of the risk is still uncertain. We therefore explored whether an association exists between vasectomy and CVD incidence and mortality.
We searched PubMed, Embase, Web of Science, and Cochrane Library databases for relevant studies published before January 2017. Multivariate adjusted odds ratio (OR) and associated 95% confidence intervals (CIs) and those by subgroups were extracted and pooled using random-effects models.
Overall, 12 observational studies (2 cross-sectional studies, 4 case-control studies, and 6 retrospective cohort studies) comprising 299,436 participants were identified. There was no statistically significant relationship between vasectomy and CVD risk (OR: 0.90, 95% CI: 0.81-1.00). Moreover, vasectomy was not associated with CVD mortality (OR: 0.90, 95% CI: 0.81-1.00), coronary heart disease (CHD) incidence (OR: 0.94, 95% CI: 0.88-1.01), stroke incidence (OR: 0.90, 95% CI: 0.72-1.13), and myocardial infarction (MI) incidence (OR: 0.95, 95% CI: 0.88-1.02), with no significant publication bias. In subgroup analyses, the findings on the association between vasectomy and CVD risk were consistent.
Our findings suggest that vasectomy is not associated with the excess risk of CVD incidence and mortality. Nevertheless, large-volume, well-designed observational studies, with different ethnic populations, low risk of bias, and adjusted confounding factors, are awaited to confirm and update the findings of this analysis.
尽管已有多项关于输精管切除术与心血管疾病（CVD）风险比较的研究报道，但大多数都是小样本系列研究，结果相互矛盾。然而，风险程度仍不确定。因此，我们探讨了输精管切除术与CVD发病率和死亡率之间是否存在关联。
我们在PubMed、Embase、Web of Science和Cochrane图书馆数据库中检索了2017年1月之前发表的相关研究。采用随机效应模型提取并汇总多变量调整后的比值比（OR）及相关的95%置信区间（CI）以及亚组分析的结果。
共纳入12项观察性研究（2项横断面研究、4项病例对照研究和6项回顾性队列研究），涉及299,436名参与者。输精管切除术与CVD风险之间无统计学显著关系（OR：0.90，95%CI：0.81 - 1.00）。此外，输精管切除术与CVD死亡率（OR：0.90，95%CI：0.81 - 1.00）、冠心病（CHD）发病率（OR：0.94，95%CI：0.88 - 1.01）、中风发病率（OR：0.90，95%CI：0.72 - 1.13）和心肌梗死（MI）发病率（OR：0.95，95%CI：0.88 - 1.02）均无关联，且无明显的发表偏倚。在亚组分析中，输精管切除术与CVD风险之间的关联结果一致。
我们的研究结果表明，输精管切除术与CVD发病率和死亡率的额外风险无关。然而，仍需要大量设计良好、针对不同种族人群、偏倚风险低且调整了混杂因素的观察性研究来证实和更新本分析的结果。
