人巨细胞病毒感染与 2 型糖尿病的相关性：系统评价和荟萃分析。
Associations between human cytomegalovirus infection and type 2 diabetes mellitus: a systematic review and meta-analysis.
机构信息
Key Laboratory of Basic and Clinical Research of Heilongjiang Province, Eye Hospital, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.
Key Laboratory of Basic and Clinical Research of Heilongjiang Province, Eye Hospital, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
出版信息
BMJ Open. 2023 Aug 24;13(8):e071934. doi: 10.1136/bmjopen-2023-071934.
OBJECTIVE
Multiple studies have reported a potential contribution of human cytomegalovirus (HCMV) to the pathogenesis of type 1 diabetes and post-transplantation diabetes. However, the association between HCMV and type 2 diabetes mellitus (T2DM) remains unclear. In this paper, we employ the meta-analysis approach to investigate the potential correlation between HCMV infection and T2DM.
METHOD
The data of our study were collected from PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure and WAN FANG databases from inception to November 2022. Using the Review Manager V.5.4 software, the meta-analysis was performed.
RESULTS
A total of 18 139 patients from 22 studies were included in our analysis. In the Asian subgroup, the patients with T2DM group had a significantly higher frequency of HCMV infection and older age compared with the healthy group. In the European, the frequency of HCMV infection in the T2DM was lower than the healthy group, although this difference was not statistically significant. After adjusting for demographic factors, the adjusted OR of T2DM for risk of by HCMV status was not found to be significant (adjusted OR=1.19, 95% CI=0.88 to 1.62, p>0.05). Additionally, T2DM with vasculopathy had a significantly higher rate of HCMV infection compared with those without vasculopathy (OR=1.87, 95% CI=1.24 to 2.83, p<0.05). Among T2DM with HCMV infection, there were significant increases in fasting blood glucose levels and the proportion of CD8+ T lymphocytes. Conversely, fasting blood insulin levels, the proportion of CD4+ T lymphocyte and the CD4+/CD8+ ratio were significantly decreased compared with the healthy group.
CONCLUSION
At present, the available evidence does not provide a clear understanding of whether there is a significant association between T2DM and HCMV infection. Additionally, T2DM with HCMV infection exhibited significantly worse blood glucose regulation and immune markers, as well as a higher frequency of vasculopathy.
PROSPERO REGISTRATION NUMBER
CRD42022342066.
目的
多项研究报告称，人类巨细胞病毒（HCMV）可能参与了 1 型糖尿病和移植后糖尿病的发病机制。然而，HCMV 与 2 型糖尿病（T2DM）之间的关联尚不清楚。在本文中，我们采用荟萃分析的方法来研究 HCMV 感染与 T2DM 之间的潜在相关性。
方法
我们的数据来自于 PubMed、Embase、Web of Science、Cochrane Library、中国国家知识基础设施和万方数据库，检索时间截至 2022 年 11 月。使用 Review Manager V.5.4 软件进行荟萃分析。
结果
共纳入 22 项研究的 18139 例患者。在亚洲亚组中，与健康组相比，T2DM 组患者的 HCMV 感染率更高，年龄更大。在欧洲，T2DM 组的 HCMV 感染率低于健康组，但差异无统计学意义。在调整了人口统计学因素后，HCMV 状态与 T2DM 风险的调整比值比（OR）没有发现有统计学意义（调整 OR=1.19，95%CI=0.88 至 1.62，p>0.05）。此外，有血管病变的 T2DM 患者的 HCMV 感染率明显高于无血管病变的患者（OR=1.87，95%CI=1.24 至 2.83，p<0.05）。在 T2DM 合并 HCMV 感染的患者中，空腹血糖水平和 CD8+T 淋巴细胞比例显著升高。相反，空腹胰岛素水平、CD4+T 淋巴细胞比例和 CD4+/CD8+比值与健康组相比显著降低。
结论
目前，现有的证据尚不能明确 HCMV 感染与 T2DM 之间是否存在显著关联。此外，合并 HCMV 感染的 T2DM 患者的血糖调节和免疫标志物明显更差，且血管病变的发生率更高。
PROSPERO 注册号：CRD42022342066。
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