SES、慢性肾脏病与美国的种族：系统评价和荟萃分析。
SES, Chronic Kidney Disease, and Race in the U.S.: A Systematic Review and Meta-analysis.
机构信息
Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland.
Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
出版信息
Am J Prev Med. 2017 Nov;53(5):730-739. doi: 10.1016/j.amepre.2017.06.036. Epub 2017 Aug 30.
CONTEXT
The risk of chronic kidney disease (CKD) in the U.S. is higher in individuals with low SES than in those with high SES. However, differences in these risks between African Americans and whites are unclear.
EVIDENCE ACQUISITION
Studies published through August 30, 2016 in Medline and EMBASE were searched. From the seven studies (1,775,267 participants) that met inclusion criteria, association estimates were pooled by race in meta-analysis. The ratio of association estimates and the corresponding 95% CIs for African Americans and whites were also pooled in meta-analysis. Additionally, meta-regression analysis was used to explore whether race is related to the strength of SES-CKD association. The analysis was conducted in September 2016.
EVIDENCE SYNTHESIS
The risk of CKD in low-SES people was 58% higher in African Americans (relative risk=1.58, 95% CI=1.33, 1.84) and 91% higher in whites (relative risk=1.91, 95% CI=1.47, 2.35) compared with their high-SES counterparts. The relative risk of CKD in low SES (versus high SES) was lower in African Americans than in whites (relative risk ratio=0.71, 95% CI=0.65, 0.77). Results from meta-regression analyses also indicated that race is potentially related to the strength of the association between low SES and CKD (p for difference between whites and African Americans=0.001).
CONCLUSIONS
The risk of CKD in low SES (versus high SES) is higher in whites than in African Americans.
背景
在美国，社会经济地位较低的个体患慢性肾脏病（CKD）的风险高于社会经济地位较高的个体。然而，非裔美国人和白人之间这些风险的差异尚不清楚。
证据采集
检索了截止到 2016 年 8 月 30 日在 Medline 和 EMBASE 上发表的研究。从符合纳入标准的七项研究（1775267 名参与者）中，通过荟萃分析按种族对关联估计值进行了汇总。还通过荟萃分析对非裔美国人和白人的关联估计值及其相应的 95%CI 进行了汇总。此外，还进行了荟萃回归分析以探究种族是否与 SES-CKD 关联的强度有关。该分析于 2016 年 9 月进行。
证据综合
与 SES 较高的人群相比，低 SES 人群中非裔美国人发生 CKD 的风险高 58%（相对风险=1.58，95%CI=1.33，1.84），白人的风险高 91%（相对风险=1.91，95%CI=1.47，2.35）。低 SES（与高 SES 相比）中非裔美国人发生 CKD 的相对风险低于白人（相对风险比=0.71，95%CI=0.65，0.77）。荟萃回归分析的结果也表明，种族可能与低 SES 和 CKD 之间关联的强度有关（白人和非裔美国人之间的差异 p 值=0.001）。
结论
低 SES（与高 SES 相比）发生 CKD 的风险在白人中高于非裔美国人。
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