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动脉僵硬度与虚弱 - 系统评价和荟萃分析。

Arterial stiffness and frailty - A systematic review and metaanalysis.

机构信息

Jagiellonian University Medical College, Department of Internal Medicine and Gerontology, Kraków, Poland.

Jagiellonian University Medical College, Department of Internal Medicine and Gerontology, Kraków, Poland.

出版信息

Exp Gerontol. 2021 Oct 1;153:111480. doi: 10.1016/j.exger.2021.111480. Epub 2021 Jul 12.

Abstract

Frailty and cardiovascular disease share some of the pathophysiologic features. Our objective was to review and metaanalyse the available published evidence on the topic. We performed a comprehensive literature search for studies where pulse wave velocity (PWV) or carotid-ankle vascular index (CAVI) has been linked with frailty in older persons. Of the initial 362 abstracts, after the application of the PRISMA approach, 5 were analysed in detail. We calculated within-study and pooled standardised mean differences of aortic stiffness measures between frail and non-frail (0.62 [0.31-0.92], p < 0.0001, I = 88%), and pre-frail and non-frail (0.32 [0.14-0.51], p = 0.0006, I = 72%) groups. In two studies it was possible to extract directly or calculate based on published data the odds ratios for the concomitant frailty, associated in one case with CAVI greater by 1 m/s and in another with cfPWV >13 m/s, indicating greater probability of concomitant frailty given greater aortic stiffness. Across the studies, the prevalence of hypertension, diabetes mellitus, hyperlipidaemia, and smoking tended to increase from non-frail, to pre-frail, and frail groups, presenting a possibility of important confounding, but also a common pathophysiology. In conclusion, the pooled analysis of the published cross-sectional study results indicates a relation between aortic stiffness and frailty in older subjects. However, well designed prospective studies are needed to answer the questions of causality.

摘要

虚弱和心血管疾病有一些共同的病理生理特征。我们的目的是回顾和荟萃分析关于这一主题的现有文献证据。我们对将脉搏波速度(PWV)或颈-踝血管指数(CAVI)与老年人虚弱相关联的研究进行了全面的文献检索。在最初的 362 篇摘要中,在应用 PRISMA 方法后,有 5 篇被详细分析。我们计算了主动脉僵硬测量值在虚弱和非虚弱(0.62 [0.31-0.92],p<0.0001,I=88%),以及虚弱前和非虚弱(0.32 [0.14-0.51],p=0.0006,I=72%)组之间的研究内和汇总标准化均数差。在两项研究中,可以直接提取或根据已发表的数据计算同时发生的虚弱的比值比,在一种情况下,与 CAVI 增加 1 m/s 相关,在另一种情况下,与 cfPWV>13 m/s 相关,表明在给定更大的主动脉僵硬的情况下,同时发生虚弱的可能性更大。在这些研究中,高血压、糖尿病、高脂血症和吸烟的患病率倾向于从非虚弱、虚弱前到虚弱组增加,这表明存在重要的混杂因素,但也存在共同的病理生理学。总之,对已发表的横断面研究结果的汇总分析表明,在老年患者中,主动脉僵硬与虚弱之间存在关系。然而,需要进行精心设计的前瞻性研究来回答因果关系的问题。

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