Nahavandipour Arvin, Krogh Nielsen Marie, Sørensen Torben L, Subhi Yousif
Department of Ophthalmology, Zealand University Hospital, Roskilde, Denmark.
Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Acta Ophthalmol. 2020 Aug;98(5):434-444. doi: 10.1111/aos.14402. Epub 2020 Mar 16.
Age-related macular degeneration (AMD) is the most prevalent cause of irreversible vision loss in industrialized countries. Several studies have investigated systemic interleukin-6 (IL-6) levels of patients with AMD. In this study, we systemically reviewed the literature to provide an overview of the field and used meta-analyses to provide a summary estimate of the standardized mean difference (SMD) of systemic IL-6 between patients with AMD and control individuals. We searched the literature databases PubMed/MEDLINE, Embase, Web of Science and the Cochrane Central on 1 June 2019 for relevant studies on humans. Two authors independently extracted data and evaluated risk of bias. We identified 19 studies for the qualitative review with a total of more than 3586 individuals (1865 controls and 1721 with AMD). We found an overall random-effects SMD in systemic IL-6 levels 0.63 (95% CI: 0.28 to 0.99, p = 0.0005) corresponding to a medium effect size. In a subgroup analysis, we found that early AMD was not strongly associated with elevated IL-6 levels (0.12, 95% CI: -0.01 to 0.24, p = 0.06), which was in contrast to the significantly elevated IL-6 levels in patients with geographic atrophy (1.21, 95% CI: 0.41 to 2.01, p = 0.003) and patients with neovascular AMD (0.99, 95% CI: 0.34 to 1.63, p = 0.003). Our results show that the evidence today suggests an increased systemic IL-6 in patients with AMD, but that this may be a phenomenon more closely related to the late subtypes of AMD.
年龄相关性黄斑变性（AMD）是工业化国家不可逆视力丧失的最常见原因。多项研究调查了AMD患者的全身白细胞介素-6（IL-6）水平。在本研究中，我们系统回顾了文献以概述该领域，并使用荟萃分析来总结估计AMD患者与对照个体之间全身IL-6的标准化平均差异（SMD）。我们于2019年6月1日在文献数据库PubMed/MEDLINE、Embase、Web of Science和Cochrane Central中搜索了关于人类的相关研究。两位作者独立提取数据并评估偏倚风险。我们确定了19项研究用于定性综述，共有超过3586名个体（1865名对照和1721名AMD患者）。我们发现全身IL-6水平的总体随机效应SMD为0.63（95%CI：0.28至0.99，p = 0.0005），对应中等效应大小。在亚组分析中，我们发现早期AMD与IL-6水平升高没有强烈关联（0.12，95%CI：-0.01至0.24，p = 0.06），这与地图状萎缩患者（1.21，95%CI：0.41至2.01，p = 0.003）和新生血管性AMD患者（0.99，95%CI：0.34至1.63，p = 0.003）中IL-6水平显著升高形成对比。我们的结果表明，目前的证据表明AMD患者全身IL-6升高，但这可能是一种与AMD晚期亚型更密切相关的现象。
