梅尼埃病的危险因素：系统评价和荟萃分析。
Risk factors for Meniere disease: a systematic review and meta-analysis.
机构信息
Department of Otolaryngology Head and Neck Surgery,Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, Sichuan, China.
Department of Otorhinolaryngology Head & Neck Surgery, West China Hospital, Sichuan University, 37 Guo Xue Lane, Chengdu, 610041, Sichuan, China.
出版信息
Eur Arch Otorhinolaryngol. 2022 Dec;279(12):5485-5496. doi: 10.1007/s00405-022-07505-5. Epub 2022 Jul 6.
PURPOSE
To summarized the latest evidence of risk factors for developing MD.
METHODS
We searched Medline, the Cochrane Central Register of Controlled Trials (CENTRAL), Embase, CBM, VIP, WanFANG, and CNKI, and ClinicalTrials.gov. till June 2021 for cohort and case-control studies investigating risk factors for MD. The exposure group was participants with a clinical diagnosis of MD which was made according to the diagnostic scale of the Equilibrium Committee of the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS), the control group was participants without MD. The outcome was determined by incidence or prognostic of MD. Paired reviewers independently screened citations, assessed bias risk of included studies using the Newcastle-Ottawa Scale. Odds ratios (OR), hazard ratios(HR), relative risk(RR) and 95% confidence interval (CI) were calculated for dichotomous data. The statistical analyses were carried out with the use of Review Manager 5.3. The level of statistical heterogeneity for pooled data were assessed by using I statistics and Q-test.
RESULTS
768 abstracts and articles were identified by our search, of which 25 studies (n = 1, 471, 944) were included. There were 18 cohort studies, 7 case-control studies. Three distinct subgroups (age, sex, sleep) were identified. There were a total of two studies involving age, two studies involving gender and two studies involving sleep disorder. High to moderate methodological quality established that age [hazard ratios (HR) 2.21, 95% CI 1.85-2.65, I = 0%] and sleep disorder[HR 1.68, 95% CI 1.47-1.93, I = 0%] were risk factors for MD. While there was little evidence showing that sex was not a risk factor for MD [HR 1.61, 95% CI 0.91-2.84, I = 74%].
CONCLUSION
The current evidence supports the suggestion that age and sleep disorder are risk factors for MD. Sex, gene, and hypothyroidism are tentative risk factors but conflicting/inconclusive results.
FUNDING
No external funding.
REGISTRATION
CRD42021248199 (Prospero).
目的
总结 MD 发病风险因素的最新证据。
方法
我们检索了 Medline、Cochrane 中心对照试验注册库（CENTRAL）、Embase、CBM、VIP、WanFANG 和 CNKI，以及截止到 2021 年 6 月的 ClinicalTrials.gov，以获取关于 MD 发病风险因素的队列研究和病例对照研究。暴露组为根据美国耳鼻喉科学-头颈外科学会（AAO-HNS）平衡委员会的诊断量表临床诊断为 MD 的参与者，对照组为无 MD 的参与者。结局由 MD 的发生率或预后确定。配对审查员独立筛选引用文献，并使用纽卡斯尔-渥太华量表评估纳入研究的偏倚风险。二分类数据采用比值比（OR）、风险比（HR）、相对风险（RR）和 95%置信区间（CI）进行计算。使用 Review Manager 5.3 进行统计分析。使用 I ²统计量和 Q 检验评估汇总数据的统计异质性水平。
结果
通过我们的检索共确定了 768 篇摘要和文章，其中 25 项研究（n=1471944）纳入研究。其中有 18 项队列研究，7 项病例对照研究。确定了 3 个不同的亚组（年龄、性别、睡眠）。总共涉及 2 项年龄相关研究、2 项性别相关研究和 2 项睡眠障碍相关研究。研究方法质量较高，确立了年龄（HR 2.21，95%CI 1.85-2.65，I²=0%）和睡眠障碍（HR 1.68，95%CI 1.47-1.93，I²=0%）是 MD 的危险因素。而性别不是 MD 的危险因素的证据较少（HR 1.61，95%CI 0.91-2.84，I²=74%）。
结论
目前的证据支持年龄和睡眠障碍是 MD 的危险因素的说法。性别、基因和甲状腺功能减退症是暂定的危险因素，但结果存在矛盾/不一致。
资金来源
无外部资金。
注册
CRD42021248199（PROSPERO）。
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