缺血性中风急性期同型半胱氨酸水平作为中风后抑郁的生物标志物：一项系统评价和荟萃分析。
Homocysteine level at the acute stage of ischemic stroke as a biomarker of poststroke depression: A systematic review and meta-analysis.
作者信息
Liang Yanling, Shi Xiangqun, Chen Lue, Li Yongxin, Zhong Jianping
机构信息
Department of Neurology, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde), Foshan, China.
出版信息
Front Psychiatry. 2023 Feb 13;13:1016700. doi: 10.3389/fpsyt.2022.1016700. eCollection 2022.
BACKGROUND
Studies on the association of homocysteine level with poststroke depression (PSD) have yielded conflicting results. This systematic review and meta-analysis aimed to evaluate the elevated homocysteine level at the acute stage of ischemic stroke in predicting PSD.
METHODS
Two authors systematically searched articles indexed in PubMed and Embase databases up to 31 January 2022. Studies evaluating the association of homocysteine level with the development of PSD in patients with acute ischemic stroke were selected.
RESULTS
A total of 10 studies involving 2,907 patients were identified. The pooled adjusted odds ratio (OR) of PSD was 3.72 [95% confidence intervals (CI) 2.03-6.81] for the top vs. bottom homocysteine level. The value of elevated homocysteine level in predicting PSD was stronger in ≥6-month follow-up (OR 4.81; 95% CI 3.12-7.43) than those in ≤ 3-month follow-up subgroup (OR 3.20; 95% CI 1.29-7.91). Moreover, a per unit increase in homocysteine level conferred a 7% higher risk of PSD.
CONCLUSION
Elevated homocysteine level in the acute stage of ischemic stroke may be an independent predictor of PSD.
背景
关于同型半胱氨酸水平与中风后抑郁（PSD）之间关联的研究结果相互矛盾。本系统评价和荟萃分析旨在评估缺血性中风急性期同型半胱氨酸水平升高对PSD的预测作用。
方法
两位作者系统检索了截至2022年1月31日在PubMed和Embase数据库中索引的文章。选择评估急性缺血性中风患者同型半胱氨酸水平与PSD发生之间关联的研究。
结果
共纳入10项研究，涉及2907例患者。同型半胱氨酸水平最高组与最低组相比，PSD的合并调整优势比（OR）为3.72[95%置信区间（CI）2.03 - 6.81]。在≥6个月随访中，同型半胱氨酸水平升高对PSD的预测价值（OR 4.81；95% CI 3.12 - 7.43）强于≤3个月随访亚组（OR 3.20；95% CI 1.29 - 7.91）。此外，同型半胱氨酸水平每升高一个单位，PSD风险增加7%。
结论
缺血性中风急性期同型半胱氨酸水平升高可能是PSD的独立预测因素。
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