Department of Biomedical Sciences, University of Sassari, 07100, Sassari, Italy.
Clinical and Interventional Pulmonology, University Hospital Sassari (AOU), 07100, Sassari, Italy.
Clin Exp Med. 2023 Jul;23(3):751-758. doi: 10.1007/s10238-022-00833-0. Epub 2022 May 5.
Patients with chronic obstructive pulmonary disease (COPD) often suffer from other conditions, such as cardiovascular disease, that further increase the risk of adverse outcomes in this group. Serum homocysteine concentrations are positively associated with cardiovascular risk and have also been reported to be increased in COPD. This meta-analysis investigated the association between homocysteine concentrations and COPD. A systematic search of publications in the electronic databases PubMed, Web of Science, Scopus, and Google Scholar, from inception to September 2021, was conducted using the following terms: "Homocysteine" or "Hcy" and "Chronic Obstructive Pulmonary Disease" or "COPD". Weighted mean differences (WMDs) were calculated to evaluate differences in homocysteine concentrations between COPD patients and non-COPD subjects. Risk of bias and certainty of evidence were assessed using the Joanna Briggs Institute Critical Appraisal Checklist and GRADE, respectively. Nine studies in 432 COPD patients (mean age 65 years, 65% males) and 311 controls (mean age 65 years, 56% males) were identified. Pooled results showed that serum homocysteine concentrations were significantly higher in patients with COPD (WMD = 2.91 µmol/L, 95% CI 2.00-3.82 µmol/L; p < 0.001; high certainty of evidence). No publication bias was observed. Our results support the hypothesis that increased homocysteine concentrations are significantly associated with COPD and may account, at least in part, for the increased cardiovascular risk in these patients.
患有慢性阻塞性肺疾病 (COPD) 的患者常伴有其他疾病，如心血管疾病，这进一步增加了该人群不良结局的风险。血清同型半胱氨酸浓度与心血管风险呈正相关，并且据报道在 COPD 中也会增加。本荟萃分析调查了同型半胱氨酸浓度与 COPD 之间的关系。从 2021 年 9 月开始，通过使用以下术语在电子数据库 PubMed、Web of Science、Scopus 和 Google Scholar 中进行了文献的系统搜索：“同型半胱氨酸”或“Hcy”和“慢性阻塞性肺疾病”或“COPD”。计算加权均数差（WMD）以评估 COPD 患者与非 COPD 患者之间同型半胱氨酸浓度的差异。使用 Joanna Briggs 研究所的批判性评估清单和 GRADE 分别评估偏倚风险和证据确定性。共纳入了 9 项研究，共纳入了 432 名 COPD 患者（平均年龄 65 岁，65%为男性）和 311 名对照者（平均年龄 65 岁，56%为男性）。汇总结果表明，COPD 患者的血清同型半胱氨酸浓度明显升高（WMD=2.91μmol/L，95%CI 2.00-3.82μmol/L；p<0.001；证据确定性高）。未观察到发表偏倚。我们的研究结果支持这样的假设，即同型半胱氨酸浓度的增加与 COPD 显著相关，并且至少部分解释了这些患者心血管风险增加的原因。
