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胆结石作为心血管疾病风险升高的预测指标:对超过740万参与者的荟萃分析和荟萃回归

Gallstones as a predictor of elevated cardiovascular disease risk: A meta-analysis and meta-regression of over 7.4 million participants.

作者信息

Hasan Refli, Allahbakhshi Fatemeh, Shlyk Andrey D, Allahbakhshi Khadija

机构信息

Department of Internal Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia.

Department of Cardiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

PLoS One. 2025 Mar 19;20(3):e0314661. doi: 10.1371/journal.pone.0314661. eCollection 2025.

Abstract

INTRODUCTION

Gallstone disease (GD) is a prevalent condition frequently encountered in surgical units worldwide. The objective of this comprehensive systematic review and meta-analysis study was to examine the relationship between gallstones and the risk of cardiovascular diseases (CVDs).

METHODS

To conduct our study, we performed a systematic review and meta-analysis. We gathered relevant studies from reputable databases, including Web of Science, Scopus, PubMed, Cochrane, Google Scholar, and Embase. The quality of the articles was assessed using the Newcastle-Ottawa Scale checklist. To assess heterogeneity among the studies, we utilized statistical tests such as the Chi-square test, I² statistic, and forest plots. Meta-regression analysis considered variables such as the year of the study, study design, sample size, study quality assessment score, geographical region, average age of subjects, and follow-up duration. Additionally, we evaluated publication bias using Begg's and Egger's tests.

RESULTS

Data from 22 studies conducted between 1985 and 2023 were analyzed. The combined number of participants across these studies was 7,496,303. The meta-analysis results revealed that individuals with GD had a higher risk of CVDs (Risk Ratio (RR): 1.29; 95% CI: 1.22-1.36; P <  0.001). Subgroup analysis showed consistent results across good quality studies (RR: 1.20, 95% CI: 11.12-1.28; P <  0.001), moderate quality studies (RR: 1.41, 95% CI: 1.15-1.74; P <  0.001), and low-quality studies (RR: 1.22, 95% CI: 1.15-1.30; P <  0.001). In the meta-regression analysis, none of the variables had a significant relationship with the observed heterogeneity (P-value > 0.10). In a sensitivity analysis, the estimated RR remained consistent, confirming the robustness of the meta-analysis results.

CONCLUSION

Our findings suggest an association between gallstone disease and an increased risk of CVDs. It seems that one of the important factors of this relationship is having common causes for the formation of gallstones and cardiovascular diseases. However, gallstones can be considered an important sign of increased risk of cardiovascular diseases.

摘要

引言

胆结石疾病(GD)是一种在全球外科科室中经常遇到的普遍病症。这项全面的系统评价和荟萃分析研究的目的是检验胆结石与心血管疾病(CVD)风险之间的关系。

方法

为开展我们的研究,我们进行了一项系统评价和荟萃分析。我们从知名数据库收集了相关研究,包括科学网、Scopus、PubMed、Cochrane、谷歌学术和Embase。使用纽卡斯尔-渥太华量表清单评估文章质量。为评估研究之间的异质性,我们使用了卡方检验、I²统计量和森林图等统计检验。荟萃回归分析考虑了研究年份、研究设计、样本量、研究质量评估得分、地理区域、受试者平均年龄和随访持续时间等变量。此外,我们使用Begg检验和Egger检验评估发表偏倚。

结果

分析了1985年至2023年期间进行的22项研究的数据。这些研究的参与者总数为7496303人。荟萃分析结果显示,患有GD的个体患CVD的风险更高(风险比(RR):1.29;95%置信区间:1.22 - 1.36;P < 0.001)。亚组分析显示,在高质量研究(RR:1.20,95%置信区间:11.12 - 1.28;P < 0.001)、中等质量研究(RR:1.41,95%置信区间:1.15 - 1.74;P < 0.001)和低质量研究(RR:1.22,95%置信区间:1.15 - 1.30;P < 0.001)中结果一致。在荟萃回归分析中,没有一个变量与观察到的异质性有显著关系(P值 > 0.10)。在敏感性分析中,估计的RR保持一致,证实了荟萃分析结果的稳健性。

结论

我们的研究结果表明胆结石疾病与CVD风险增加之间存在关联。这种关系的一个重要因素似乎是胆结石和心血管疾病的形成有共同原因。然而,胆结石可被视为心血管疾病风险增加的一个重要标志。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/894a/11922230/51901a1be811/pone.0314661.g001.jpg

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