痛风/高尿酸血症降低阿尔茨海默病风险:基于最新证据的荟萃分析。
Gout/hyperuricemia reduces the risk of Alzheimer's disease: A meta-analysis based on latest evidence.
机构信息
Department of Neurology, Hefei Hospital Affiliated to Anhui Medical University (The Second People's Hospital of Hefei), Hefei, Anhui, China.
Graduate school, The Fifth Clinical Medical College of Anhui Medical University, Hefei, Anhui, China.
出版信息
Brain Behav. 2023 Oct;13(10):e3207. doi: 10.1002/brb3.3207. Epub 2023 Sep 4.
OBJECTIVE
Previous studies have found the potential role of gout or hyperuricemia in subsequent development of Alzheimer's disease (AD) but reported inconsistent results. We conducted the current meta-analysis to evaluate whether an association exists between gout/ hyperuricemia and AD.
METHODS
We systematically searched PubMed and EMBASE for the published cohort studies that measured the risk of AD in subject with gout/ hyperuricemia up to May 20, 2023. Data extraction was employed by two authors independently. Rev Man 5.3 and Stata 15.0 software were used to calculate the relative ratio (RR) or hazard ratio (HR) for including studies. Subgroup analysis was performed to assess the sources of heterogeneity. A random-effects model was adopted when heterogeneity was present. The funnel plot, Begg's test, and and Egger's test were used to assess publication bias.
RESULTS
After rigorous screening, seven eligible studies were included in the final analyses. Pooled results indicated that gout or hyperuricemia decreases the risk of AD (RR: 0.69, 95% CI: 0.64∼0.72), with a high heterogeneity of 93%. Subgroup analyses showed that regional distribution was the source of heterogeneity. Egger's and Begg's tests as well as visual inspection of funnel plot suggested no publication bias in the studies.
CONCLUSION
The findings suggested that gout or hyperuricemia might have a protective effect against AD. This negative correlation should be verified by more cohort studies due to the existence of substantial heterogeneity.
目的
先前的研究发现痛风或高尿酸血症可能与阿尔茨海默病(AD)的后续发展有关,但报告结果不一致。我们进行了本次荟萃分析,以评估痛风/高尿酸血症与 AD 之间是否存在关联。
方法
我们系统地检索了 PubMed 和 EMBASE 数据库,以查找截至 2023 年 5 月 20 日发表的测量痛风/高尿酸血症患者 AD 风险的队列研究。由两位作者独立进行数据提取。使用 RevMan 5.3 和 Stata 15.0 软件计算包括研究的相对比值(RR)或风险比(HR)。进行亚组分析以评估异质性来源。存在异质性时采用随机效应模型。使用漏斗图、贝格检验和埃格检验评估发表偏倚。
结果
经过严格筛选,最终有 7 项符合条件的研究纳入了最终分析。汇总结果表明,痛风或高尿酸血症降低 AD 的风险(RR:0.69,95%CI:0.64∼0.72),存在 93%的高度异质性。亚组分析表明,区域分布是异质性的来源。Egger 检验、贝格检验和漏斗图的直观检查均表明研究中不存在发表偏倚。
结论
研究结果表明,痛风或高尿酸血症可能对 AD 具有保护作用。由于存在显著的异质性,需要更多的队列研究来验证这种负相关关系。