尿酸水平与疟原虫感染严重程度的关联:系统评价和荟萃分析。

Association of uric acid levels with severity of Plasmodium infections: a systematic review and meta-analysis.

机构信息

Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, Thailand.

Research Center in Tropical Pathobiology, Walailak University, Nakhon Si Thammarat, Thailand.

出版信息

Sci Rep. 2023 Sep 11;13(1):14979. doi: 10.1038/s41598-023-42217-8.

Abstract

Elevated uric acid (UA) levels have been reported in malaria patients and are particularly prominent in severe malaria cases. This study aims to synthesize the difference in UA levels between malaria patients and uninfected controls, and between patients with severe and non-severe malaria. A comprehensive literature search was carried out across databases such as Embase, MEDLINE, Ovid, PubMed, Scopus, ProQuest, and Google Scholar to identify relevant studies for inclusion. The methodological quality of the included studies was evaluated independently by two reviewers using the JBI critical appraisal tool for observational studies. A meta-analysis was performed to calculate the pooled effect sizes, expressed as Hedges' g, with 95% confidence intervals (CIs). The Hedges' g was pooled using the random-effects model. An initial search yielding a total of 1122 articles, and a final total of 19 studies being included in the review. Elevated UA levels were observed more prominently in malaria patients, especially those with severe manifestations, when compared to uninfected controls. The conducted meta-analysis demonstrated a significant elevation in UA levels in patients suffering from malaria as compared to uninfected controls (P < 0.01, Hedges's g = 1.40, 95% CI 0.84-1.95, I = 95.81, 16 studies). The conducted meta-analysis demonstrated a significant elevation in UA levels in patients suffering from severe malaria as compared to non-severe malaria (P < 0.01, Hedges's g = 3.45, 95% CI 1.06-5.83, I = 98.73, 6 studies). In summary, these findings provide valuable insights into the potential use of UA as a biomarker for malaria infection and determination of its severity. Further research is needed to validate these findings and to explore the underlying mechanisms that contribute to the elevation of UA levels during malaria infection.

摘要

尿酸(UA)水平升高已在疟疾患者中报道,尤其在严重疟疾病例中更为突出。本研究旨在综合分析疟疾患者与未感染对照者、严重疟疾与非严重疟疾患者之间 UA 水平的差异。通过 Embase、MEDLINE、Ovid、PubMed、Scopus、ProQuest 和 Google Scholar 等数据库进行全面的文献检索,以确定纳入的相关研究。两名评审员使用 JBI 观察性研究批判性评价工具独立评估纳入研究的方法学质量。使用随机效应模型对汇总效应大小(以 Hedges'g 表示)进行荟萃分析,并计算 95%置信区间(CI)。最初的搜索共产生了 1122 篇文章,最终共有 19 项研究纳入综述。与未感染对照者相比,UA 水平在疟疾患者中更为明显,尤其是在有严重表现的患者中。进行的荟萃分析表明,与未感染对照者相比,患有疟疾的患者 UA 水平显著升高(P<0.01,Hedges'g=1.40,95%CI 0.84-1.95,I=95.81,16 项研究)。进行的荟萃分析表明,与非严重疟疾患者相比,患有严重疟疾的患者 UA 水平显著升高(P<0.01,Hedges'g=3.45,95%CI 1.06-5.83,I=98.73,6 项研究)。总之,这些发现为 UA 作为疟疾感染的生物标志物及其严重程度的确定提供了有价值的见解。需要进一步的研究来验证这些发现,并探讨导致疟疾感染期间 UA 水平升高的潜在机制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e31/10495360/d3c3a2903d74/41598_2023_42217_Fig1_HTML.jpg

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