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代谢综合征患者的肺功能:一项荟萃分析。

Pulmonary Function in Metabolic Syndrome: A Meta-Analysis.

机构信息

Department of Anesthesiology, Qilu Hospital of Shandong University, Jinan, Shandong, China.

Department of Geriatric Medicine, Qilu Hospital of Shandong University, Jinan, Shandong, China.

出版信息

Metab Syndr Relat Disord. 2022 Dec;20(10):606-617. doi: 10.1089/met.2022.0045. Epub 2022 Sep 20.


DOI:10.1089/met.2022.0045
PMID:36125502
Abstract

This study aims to systematically evaluate the association between metabolic syndrome (MS) and pulmonary function through meta-analysis. Electronic databases, including PubMed, Embase, Web of Science, and Cochrane Library, were systematically searched to obtain articles associated with MS and lung function published before December 31, 2021. According to the including and excluding criteria, certain studies were obtained and data were extracted. The Newcastle Ottawa Scale was used to evaluate the quality of the studies. A pooled standardized mean difference (SMD) was calculated by means of random-effects meta-analysis. Different effect models were used according to the heterogeneity. Meta-regression and sensitivity analyses were performed to examine the possible sources of heterogeneity. The Begg's funnel plot and Egger's test were used to evaluate publication bias. Analyses were performed using Stata MP, version14.0 (StataCorp LP, College Station, TX, USA). A total of 15 studies, involving 10,285 cases of MS and 25,416 cases of control, were included in this meta-analysis on the relationship between MS and forced vital capacity (FVC). The pooled SMD for FVC was -0.247 (95% CI = -0.327 to -0.2167,  < 0.001) using random effect model, indicating the decrease of FVC in the patients with MS. In the same studies, the pooled SMD for forced expiratory volume in 1 sec (FEV) was -0.205 (95% CI = -0.3278 to -0.133,  < 0.001), indicating the decrease of FEV also existed in the MS cases. A total of 13 studies, involving 8167 cases of MS and 19,788 cases of control, were included in this meta-analysis on the relationship between MS and FEV/FVC. The pooled SMD for FEV/FVC was 0.011 (95% CI = -0.072 to 0.093,  = 0.798) using random effect model, indicating that there was no significant difference between the patients with MS and the control. After introducing the diastolic blood pressure and glycemia into the regression model of the relationship between MS and FVC, the variance of the studies (tau2) decreased from 0.0190 to 0.006694 and 0.007205, which could explain 66.70% and 78.04% of the sources of heterogeneity, and the values were 0.038 and 0.023. The results suggested that hypertension (diastolic pressure) and hyperglycemia were the factors linked to the heterogeneity among the included studies on both FVC and FEV. The Begg's funnel plot and Egger's test both showed no evidence of publication bias. Our results show that FVC and FEV decrease in MS patients, while FEV/FVC has no significant difference compared with the control group. It indicates that the patients with MS have restrictive ventilatory functional disturbance. Meta-regression analysis suggests that hypertension (diastolic pressure) and hyperglycemia are the factors linked to the heterogeneity among the included studies on both FVC and FEV.

摘要

本研究旨在通过荟萃分析系统评估代谢综合征(MS)与肺功能之间的关联。系统检索了 PubMed、Embase、Web of Science 和 Cochrane Library 等电子数据库,以获取截至 2021 年 12 月 31 日发表的与 MS 和肺功能相关的文章。根据纳入和排除标准,获得了某些研究并提取了数据。使用纽卡斯尔-渥太华量表(Newcastle Ottawa Scale)评估研究质量。采用随机效应荟萃分析计算标准化均数差(SMD)。根据异质性情况,使用不同的效应模型。进行了荟萃回归和敏感性分析,以检查异质性的可能来源。使用 Begg 漏斗图和 Egger 检验评估发表偏倚。使用 Stata MP,版本 14.0(StataCorp LP,德克萨斯州 College Station)进行分析。

共有 15 项研究,涉及 10285 例 MS 病例和 25416 例对照,纳入了本次荟萃分析,以评估 MS 与用力肺活量(FVC)之间的关系。使用随机效应模型,FVC 的汇总 SMD 为-0.247(95%CI=-0.327 至-0.2167,<0.001),表明 MS 患者的 FVC 下降。在相同的研究中,1 秒用力呼气量(FEV)的汇总 SMD 为-0.205(95%CI=-0.3278 至-0.133,<0.001),表明 MS 病例中也存在 FEV 下降。共有 13 项研究,涉及 8167 例 MS 病例和 19788 例对照,纳入了本次荟萃分析,以评估 MS 与 FEV/FVC 之间的关系。使用随机效应模型,FEV/FVC 的汇总 SMD 为 0.011(95%CI=-0.072 至 0.093,=0.798),表明 MS 患者与对照组之间无显著差异。在将舒张压和血糖纳入 MS 与 FVC 关系的回归模型后,研究的方差(tau2)从 0.0190 降至 0.006694 和 0.007205,分别可解释 66.70%和 78.04%的异质性来源,值分别为 0.038 和 0.023。结果表明,高血压(舒张压)和高血糖是导致 FVC 和 FEV 纳入研究异质性的因素。Begg 漏斗图和 Egger 检验均未发现发表偏倚的证据。

我们的结果表明,MS 患者的 FVC 和 FEV 下降,而 FEV/FVC 与对照组相比无显著差异。这表明 MS 患者存在限制性通气功能障碍。荟萃回归分析表明,高血压(舒张压)和高血糖是导致 FVC 和 FEV 纳入研究异质性的因素。

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