阻塞性睡眠呼吸暂停低通气综合征与血浆YKL-40水平相关性的Meta分析

The association of level of plasma YKL-40 in obstructive sleep apnea hypopnea syndrome patients:a meta-analysis

目的系统评价甲壳质酶蛋白（YKL-40）在阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者中的表达水平及与疾病的相关性。方法计算机检索PubMed、EMbase、MEDLINE、CNKI、WanFangData和VIP数据库，同时辅以Google学术检索等，搜集血浆YKL．40水平与OSAHS相关性的病例-对照研究，检索时限均为建库至2017年4月。由2位研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后，采用RevMan5．3软件进行Meta分析。结果最终纳入5个研究，OSAHS患者和对照人群共755例。Meta分析结果显示：与对照组相比，OSAHS患者的血浆YKL-40水平更高[SMD=1．20，95％CI（0．33，2．06），P=0．007]；亚组分析结果显示，亚洲人群OSAHS患者的血浆YKL-40水平较对照组更高[SMD=1．79，95％CI（0．83，2．75），P=0．0002]。轻．中症与重症组OSAHS患者血浆YKL-40水平比较结果显示，轻症OSAHS患者的血浆YKL-40水平更低[SMD=-0．83，95％CI（-1．46，-0．19），P=0．01]。结论现有证据表明，YKL-40水平与OSAHS的发病可能有关。受纳入研究数量和质量限制，上述结论尚需开展更多高质量研究予以验证。

Objective To systematically review the association between the level of plasma YKL-40 and obstructive sleep apnea hypopnea syndrome （OSAHS）. Methods We searched PubMed, EMbase, MEDLINE, CNKI, WanFang Data, VIP database and supplemented by Google academic retrieval to collect case-control studies about the association between the level of plasma YKL-40 and O SAHS from inception to April 2017. Two reviewers independently screened literature, extracted data and evaluated the risk of bias of included studies. And then, meta-analysis was performed by RevMan 5.3 software. Results A total of 5 case-control studies were included, involving 755 OSAHS patients and control population. The results of meta-analysis showed that the level of plasma YKL-40 in OSAHS patients was higher than that in control group （SMD=1.20, 95%CI 0.33 to 2.06, P=0.007）. The subgroup analysis showed that the level of plasma YKL-40 in OSAHS patients from Asia was significantly higher than that in control group （SMD=1.79, 95%CI 0.83 to 2.75, P=0.000 2）. The comparison between different severity of OSAHS showed that the wild- medium group had lower plasma level of YKL-40 than the severe group （SMD=-0.83, 95%CI -1.46 to -0.19, P=0.01）. Conclusion YKL-40 may play an important role in the pathogenesis of OSAHS. Due to limited quantity and quality of the included studies, more high quality studies are needed to verify above conclusions.