血尿酸水平与男性人群代谢综合征发病关系的系统综述与Meta分析

SYSTEMATIC REVIEW AND META ANALYSIS OF THE RELATIONSHIP BETWEEN SERUM URIC ACID LEVELS AND THE OCCURRENCE OF METABOLIC SYNDROME AMONG MALES

目的 采用系统综述与Meta分析定量分析基于队列研究的男性人群中血尿酸水平（SUA）与代谢综合征（MS）发病关系之间的研究。方法 检索PubMed、EMbase、CNKI、万方、维普等数据库对2016年5月以前的血尿酸与男性人群代谢综合征发病相关的队列研究,将完整记录尿酸最高剂量组与最低剂量组MS的发病率及相对危险度（RR）及95%可信区间（CI）的队列研究纳入研究,采用Meta分析进行定量合并,采用Q检验及I2检验进行异质性分析,采用漏斗图及Egger线性回归分析评估潜在发表偏倚。结果通过文献筛查,最终纳入7篇文献,共有男性受访者14 132人,MS发病人数2 220人,SUA最高水平组与最低水平组相比,二组MS发病率的合并RR值为2.27（95%CI,1.92~2.69）;亚组分析按吸烟、饮酒、运动等因素分组后显示,SUA与MS的发病相关;敏感性分析结果表明,依次剔除一个研究的合并RR值为2.19（1.78~2.68）到2.37（1.99~2.83）,研究结果比较稳定;Egger回归法分析结果表明,无发表偏倚的存在（P=0.855）。结论 通过对7项队列研究的结果进行Meta分析,发现在中老年男性人群中,SUA水平与MS的发病密切相关,在中老年男性人群中,SUA可作为MS发生的重要预测因子。

Objective To assess the relationship between serum uric acid level （SUA ） and metabolic syn‐drome （MS） in male population by systematic review and Meta analysis .Methods By retrieval of all relat‐ed research before the 2016 through the PubMed database ,we were inclusive of cohort study which com‐plete recorded the incidence of MS in the highest dose group and the lowest dose group of uric acid and rela ‐tive risk（RR） and 95% confidence interval（CI） .The random effects model was used in the analysis and the heterogeneity tested by Q test and I 2 test .The funnel plot and Egger＆#39;s linear regression analysis were used for the potential publication bias .Results Seven articles were included through the literature screening and 1 4132 male respondents in the study and the incidence of MS were 2 220 patients .The incidence of MS in the pooled RR values for 2 .27 （95% CI ,1 .92 ~ 2 .69） in highest SUA level compared with the lowest group .Subgroup analysis according to smoking ,drinking ,exercise and other factors showed that SUA was associated with the onset of MS .Sensitivity analysis in turn of excluding a research showed the pooled RR value was 2 .19（1 .78 ~ 2 .68）to2 .37（1 .99 ~ 2 .83） .Egger＆#39;s linear regression showed that there was no pub‐lication bias in the study（P= 0 .855） .Conclusion After the meta analysis of 7 cohort studies ,we find that the SUA level is closely related to the incidence of MS .SUA can be used as an important predictor for the occurrence of MS in the middle aged and elderly male population .