School of Mental Health, Wenzhou Medical University, Wenzhou 325000, China.
Dementia Care and Research Center, Beijing Dementia Key Lab, Peking University Institute of Mental Health (Sixth Hospital), Beijing 100191, China; NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China.
Gen Hosp Psychiatry. 2022 Nov-Dec;79:118-127. doi: 10.1016/j.genhosppsych.2022.10.009. Epub 2022 Oct 20.
The present study aimed to systematically analyze the risk factors for RBD.
A systematic review and meta-analysis of case-control studies, cohort studies, and cross-sectional studies derived from the articles published in eight electronic databases before December 1, 2021. The primary outcome was the odds ratio (OR) and 95% confidence interval (95% CI), and heterogeneity was quantified using I. Subgroup analyses and meta-regression were used to explore sources of heterogeneity. Egger's test and sensitivity analysis were performed. The PROSPERO ID number of the present study is CRD42021293942.
We identified 26 studies (44,230 subjects) among 2022 citations, and 13 factors were considered. Male sex (OR = 1.36, 95% CI = 1.13-1.64), smoking (OR = 1.37, 95% CI: 1.26-1.50), depression (OR = 2.06, 95% CI = 1.66-2.56), antidepressant use (OR = 2.36, 95% CI = 1.98-2.82), duration of neuropsychiatric disorders(OR = 1.43, 95% CI = 1.13-1.73), levodopa equivalent daily dose (LEDD, OR = 60.15, 95% CI = 23.95-96.35) and observable motor dysfunction (OR = 2.43, 95% CI = 0.65-4.22) were associated with a higher risk of RBD. Tertiary education and above (OR = 0.58, 95% CI = 0.35-0.96) was associated with a lower RBD risk. Men (OR = 1.40, 95% CI: 1.10-1.78, I = 0%, P = 0.005) and older individual (OR = 2.73, 95% CI: 1.03-4.43, I = 60%, P = 0.002) were more likely to have iRBD.
Six modifiable risk factors and one protective factor were associated with RBD. Further research is required to understand the mechanisms and to develop preventative strategies.
本研究旨在系统分析 RBD 的危险因素。
对 2021 年 12 月 1 日前发表在 8 个电子数据库中的病例对照研究、队列研究和横断面研究进行系统回顾和荟萃分析。主要结局为比值比（OR）和 95%置信区间（95%CI），采用 I ² 衡量异质性。采用亚组分析和荟萃回归分析来探讨异质性的来源。采用 Egger 检验和敏感性分析。本研究的 PROSPERO 注册号为 CRD42021293942。
在 2022 条引文中共确定了 26 项研究（44230 名受试者），考虑了 13 个因素。男性（OR=1.36，95%CI=1.13-1.64）、吸烟（OR=1.37，95%CI：1.26-1.50）、抑郁（OR=2.06，95%CI=1.66-2.56）、使用抗抑郁药（OR=2.36，95%CI=1.98-2.82）、神经精神障碍持续时间（OR=1.43，95%CI=1.13-1.73）、左旋多巴等效日剂量（LEDD，OR=60.15，95%CI=23.95-96.35）和可观察运动功能障碍（OR=2.43，95%CI=0.65-4.22）与 RBD 风险增加相关。接受过高等教育（OR=0.58，95%CI=0.35-0.96）与较低的 RBD 风险相关。男性（OR=1.40，95%CI：1.10-1.78，I²=0%，P=0.005）和年龄较大的个体（OR=2.73，95%CI：1.03-4.43，I²=60%，P=0.002）更有可能患有 iRBD。
有 6 个可改变的危险因素和 1 个保护因素与 RBD 相关。需要进一步研究以了解其机制并制定预防策略。
