同型半胱氨酸水平与卒中风险的关系：前瞻性队列研究的剂量-反应荟萃分析。
Association of homocysteine level with risk of stroke: A dose-response meta-analysis of prospective cohort studies.
机构信息
Department of Epidemiology and Health Statistics, School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China.
Department of Mental Health, Bao'an Chronic Diseases Prevent and Cure Hospital, Shenzhen, Guangdong, People's Republic of China.
出版信息
Nutr Metab Cardiovasc Dis. 2020 Oct 30;30(11):1861-1869. doi: 10.1016/j.numecd.2020.07.026. Epub 2020 Jul 24.
BACKGROUND AND AIMS
Homocysteine (Hcy) level has been increasingly linked with stroke and ischemic stroke (IS). However, a dose-response meta-analysis of prospective cohort studies of the association is lacking. We aimed to explore the quantitative dose-response association of Hcy level with stroke and IS in a meta-analysis of prospective cohort studies.
METHODS AND RESULTS
We performed a systematic search of PubMed, Embase and Web of Science databases up to April 25, 2019 for prospective cohort studies assessing the association of Hcy level with stroke and IS. We used random-effect models to estimate the pooled relative risk (RRs) (with 95% confidence intervals [CIs]) for the association of Hcy with risk of stroke and IS. Restricted cubic splines were used to evaluate possible linear or nonlinear association of Hcy level with stroke and IS. We included 10 prospective cohort studies (7 articles) with 11,061 participants in the meta-analysis. Hcy level was associated with increased risk of stroke (RR = 1.58, 95% CI 1.25-2.00, I = 39.5%) and IS (RR = 1.54, 95% CI 1.21-1.97, I = 36.4%) for the highest versus the lowest categories. We found a linear association between Hcy level and stroke (P = 0.660) and IS (P = 0.981). For each 1-μmol/L increase in Hcy, the pooled RR was 1.06 (95% CI 1.01-1.12, I = 59.0%) for stroke and 1.05 (95% CI 1.00-1.11, I = 58.6%) for IS.
CONCLUSION
This meta-analysis indicated that elevated Hcy level was associated with increased risk of stroke and IS.
背景与目的
同型半胱氨酸（Hcy）水平与中风和缺血性中风（IS）的关系日益密切。然而，目前缺乏前瞻性队列研究对其相关性进行定量剂量反应分析。我们旨在通过对前瞻性队列研究的荟萃分析来探讨 Hcy 水平与中风和 IS 的定量剂量反应关系。
方法与结果
我们对PubMed、Embase 和 Web of Science 数据库进行了系统检索，检索时间截至 2019 年 4 月 25 日，以评估 Hcy 水平与中风和 IS 之间关联的前瞻性队列研究。我们使用随机效应模型来估计 Hcy 与中风和 IS 风险之间关联的合并相对风险（RR）（95%置信区间[CI]）。限制性立方样条用于评估 Hcy 水平与中风和 IS 之间可能的线性或非线性关联。我们纳入了 10 项前瞻性队列研究（7 篇文章），共纳入 11061 名参与者进行荟萃分析。Hcy 水平与中风（RR=1.58，95%CI 1.25-2.00，I=39.5%）和 IS（RR=1.54，95%CI 1.21-1.97，I=36.4%）的最高类别与最低类别相比，风险增加。我们发现 Hcy 水平与中风（P=0.660）和 IS（P=0.981）之间存在线性关联。对于 Hcy 每增加 1μmol/L，中风的合并 RR 为 1.06（95%CI 1.01-1.12，I=59.0%），IS 的合并 RR 为 1.05（95%CI 1.00-1.11，I=58.6%）。
结论
本荟萃分析表明，Hcy 水平升高与中风和 IS 的风险增加相关。
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