Department of Neurology, Minzu Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi Zhuang Autonomous Region, China.
Department of Neurology, Red Cross Hospital of Yulin City, Yulin, Guangxi Zhuang Autonomous Region, China.
PLoS One. 2024 May 31;19(5):e0303832. doi: 10.1371/journal.pone.0303832. eCollection 2024.
Osteoprotegerin (OPG) is supposed to participate in the development of atherosclerosis and cardio-cerebrovascular disease. However, the results of research on relationship between OPG and ischemic stroke (IS) are controversial. Therefore, we carried out the first systematic review and meta-analysis to evaluate prognostic effect of osteoprotegerin in patients with IS.
We comprehensively searched databases of PubMed, Embase, and the Cochrane Library through 21 August 2023 to identify observational studies that evaluated effect of OPG on poor functional outcome (modified Rankin Scale [mRS] Score of 3-6) and mortality in patients with IS. Adjusted odds ratios (aOR) with a 95% confidence interval (CI) of each included study were used as much as possible to assess the pooled effect.
Five studies that enrolled 4,506 patients in total fulfilled our inclusion criteria. Three studies were included in the pooled analysis for each endpoint since one of the included studies had provided data on poor functional outcome as well as mortality. OPG was neither associated with poor functional outcome (aOR 1.29, 95% CI 0.90-1.85) nor with mortality (aOR 1.57, 95% CI 0.90-2.74) in patients with IS.
There is insufficient evidence to demonstrate the correlation between OPG and mortality or poor functional outcome in IS patients. OPG cannot be applied to predict worse neurological function in IS patients based on the current evidence.
骨保护素（OPG）被认为参与了动脉粥样硬化和心脑血管疾病的发展。然而，关于 OPG 与缺血性脑卒中（IS）之间关系的研究结果存在争议。因此，我们进行了首次系统评价和荟萃分析，以评估 OPG 在 IS 患者中的预后作用。
我们通过 2023 年 8 月 21 日全面检索了 PubMed、Embase 和 Cochrane 图书馆的数据库，以确定评估 OPG 对 IS 患者不良功能结局（改良 Rankin 量表[mRS]评分 3-6）和死亡率的观察性研究。尽可能使用调整后的优势比（aOR）及其 95%置信区间（CI）来评估汇总效应。
共有 5 项研究，总计纳入了 4506 例患者，符合我们的纳入标准。由于其中一项纳入的研究同时提供了不良功能结局和死亡率的数据，因此有 3 项研究被纳入了每个终点的汇总分析。OPG 与 IS 患者的不良功能结局（aOR 1.29，95%CI 0.90-1.85）或死亡率（aOR 1.57，95%CI 0.90-2.74）均无相关性。
目前尚无足够的证据表明 OPG 与 IS 患者的死亡率或不良功能结局之间存在关联。基于现有证据，OPG 不能用于预测 IS 患者更差的神经功能。
