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抗坏血酸补充剂与男性和女性肾结石发病率:一项系统评价和荟萃分析。

Ascorbic Acid Supplements and Kidney Stones Incidence Among Men and Women: A systematic review and meta-analysis.

作者信息

Jiang Kehua, Tang Kun, Liu Haoran, Xu Hua, Ye Zhangqun, Chen Zhiqiang

机构信息

Department of Urology, Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

出版信息

Urol J. 2019 May 5;16(2):115-120. doi: 10.22037/uj.v0i0.4275.

Abstract

PURPOSE

The relationship of ascorbic acid (AA) supplements and risk of kidney stones among men and women is controversial. This systematic evaluation was performed to obtain comprehensive evidence about the relationship of AA supplements and risk of kidney stones among men and women.

MATERIAL AND METHODS

A systematic search of Pubmed, the Cochrane Library, Web of Science, Embase was performed to identify studies that exhibited the relationship of AA supplements and risk of kidney stones among men and women were published up to Mar 2017. Outcomes of interest included kidney stones incidence and risk factors.

RESULTS

Four studies estimating the association between AA supplements and risk of kidney stones were included for meta-analysis. The kidney stones incidence was significantly higher in men than women with AA supplements (OR= 1.62; 95% CI: 1.09 to 2.42; P=0.02). AA supplements (250-499mg/d, 1000-1499mg/d) was remarkably correlated with the risk of renal stones among men (OR= 1.14, 95% CI: 1.00 to 1.28, P=0.04; OR= 1.12, 95% CI: 1.11 to 1.13, P<0.00001; respectively). However, AA supplements (500-999 mg/d, >1500 mg/d) did not correlate with the risk of renal stones among men (OR= 1.20, 95% CI: 0.99 to 1.46, P=0.06; OR= 1.28, 95% CI: 1.00 to 1.63, P= 0.05; respectively). In addition, AA supplements (250-499mg/d, 500-999mg/d, 1000-1499mg/d, >1500mg/d) did not remarkably correlate with the risk of renal stones among women (OR= 1.00, 95% CI: 0.82 to 1.22, P=0.98; OR= 1.08, 95% CI: 0.99 to 1.18, P=0.09; OR= 0.99, 95% CI: 0.90 to 1.08, P=0.77; OR= 0.99, 95% CI: 0.99 to 1.09, P=0.88; respectively).

CONCLUSIONS

AA supplements was remarkably correlated with higher risk for kidney stones incidence in men, but not in women. Further multicenter, prospective and long-term follow-up RCTs are required to verify these findings.

摘要

目的

维生素C(AA)补充剂与男性和女性肾结石风险之间的关系存在争议。进行这项系统评价以获取关于AA补充剂与男性和女性肾结石风险关系的全面证据。

材料与方法

对PubMed、Cochrane图书馆、科学网、Embase进行系统检索,以识别截至2017年3月发表的显示AA补充剂与男性和女性肾结石风险关系的研究。感兴趣的结果包括肾结石发病率和风险因素。

结果

纳入四项评估AA补充剂与肾结石风险关联的研究进行荟萃分析。服用AA补充剂的男性肾结石发病率显著高于女性(OR = 1.62;95%CI:1.09至2.42;P = 0.02)。AA补充剂(250 - 499mg/d、1000 - 1499mg/d)与男性肾结石风险显著相关(OR = 1.14,95%CI:1.00至1.28,P = 0.04;OR = 1.12,95%CI:1.11至1.13,P < 0.00001;分别)。然而,AA补充剂(500 - 999mg/d、>1500mg/d)与男性肾结石风险无相关性(OR = 1.20,95%CI:0.99至1.46,P = 0.06;OR = 1.28,95%CI:1.00至1.63,P = 0.05;分别)。此外,AA补充剂(250 - 499mg/d、500 - 999mg/d、1000 - 1499mg/d、>1500mg/d)与女性肾结石风险无显著相关性(OR = 1.00,95%CI:0.82至1.22,P = 0.98;OR = 1.08,95%CI:0.99至1.1·8,P = 0.09;OR = 0.99,95%CI:0.90至1.08,P = 0.77;OR = 0.99,95%CI:0.99至1.09,P = 0.88;分别)。

结论

AA补充剂与男性肾结石发病率较高风险显著相关,但与女性无关。需要进一步进行多中心、前瞻性和长期随访的随机对照试验来验证这些发现。

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