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心肺适能作为中风风险的定量预测因子:一项剂量反应荟萃分析。

Cardiorespiratory fitness as a quantitative predictor of the risk of stroke: a dose-response meta-analysis.

机构信息

Department of Neurosurgery, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, 400010, China.

出版信息

J Neurol. 2020 Feb;267(2):491-501. doi: 10.1007/s00415-019-09612-6. Epub 2019 Nov 4.

Abstract

BACKGROUND AND PURPOSE

Cardiorespiratory fitness (CRF) is closely related to our health, but whether high cardiorespiratory fitness could reduce stroke risk remains controversial. We used a meta-analysis to examine the overall association between cardiorespiratory fitness and stroke incidence.

METHODS

A systematic search was performed in PubMed, EMBASE, and Web of science. We estimated the overall relative risk (RR) of stroke incidence for high levels of CRF individuals versus individuals with low levels of CRF. Meanwhile, we made a quantitative analysis of the association between CRF and the risk of stroke.

RESULTS

14 cohort studies containing 1,409,340 participants were included in this meta-analysis, and 23,894 stroke patients were observed. The meta-analysis documented that the high-CRF individuals had a 42% lower risk of stroke (RR_0.58; 95% CI 0.51-0.66) compared with low-CRF individuals. Besides, subgroup analysis showed that the inverse association of CRF with the risk of stroke was consistent. There are 29% lower risk of ischemic stroke (RR_0.71; 95% CI 0.54-0.93) and 31% lower risk of hemorrhagic stroke (RR_0.69; 95% CI 0.47-1.00). Dose-response analysis showed that every "unit-dose" increment of five metabolic equivalents (METs) reduced a 15% lower risk of stroke (RR_0.85; 95% CI 0.79-0.91).

CONCLUSION

This meta-analysis provides the evidence that better CRF was with a lower risk of stroke incidence.

摘要

背景与目的

心肺适能(CRF)与我们的健康密切相关,但较高的心肺适能是否能降低中风风险仍存在争议。我们使用荟萃分析来检查心肺适能与中风发病率之间的总体关联。

方法

我们在 PubMed、EMBASE 和 Web of Science 中进行了系统搜索。我们估计了高水平 CRF 个体与低水平 CRF 个体相比,中风发病率的总体相对风险(RR)。同时,我们对 CRF 与中风风险之间的关系进行了定量分析。

结果

本荟萃分析纳入了 14 项包含 1409340 名参与者的队列研究,观察到 23894 例中风患者。荟萃分析表明,与低水平 CRF 个体相比,高水平 CRF 个体中风风险降低了 42%(RR_0.58;95%CI 0.51-0.66)。此外,亚组分析表明,CRF 与中风风险之间的反比关系是一致的。缺血性中风的风险降低了 29%(RR_0.71;95%CI 0.54-0.93),出血性中风的风险降低了 31%(RR_0.69;95%CI 0.47-1.00)。剂量反应分析表明,每增加五个代谢当量(MET)的“单位剂量”,中风风险降低 15%(RR_0.85;95%CI 0.79-0.91)。

结论

本荟萃分析提供了证据表明,更好的 CRF 与较低的中风发病率风险相关。

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