阿尔茨海默病患者及对照者血清或脑脊液β-淀粉样蛋白1-42水平的Meta分析

Meta analysis of serum or cerebrospinal fluid β-amyloid protein 1-42 level in patients with Alzheimer’s disease and controls

目的 系统评价阿尔茨海默病(AD)患者及对照者血清或脑脊液(CSF)β-淀粉样蛋白1-42(Aβ1-42)水平,评估Aβ1-42作为AD生物标志物的诊断潜力。方法 计算机检索中国期刊全文数据库、万方数据库、维普数据库、PubMed、EMBASE、Web of Science中对AD患者及对照者血清或CSF Aβ1-42进行检测的研究,检索时限从建库到2022年3月。根据纳入及排除标准进行文献筛选并提取基本资料,依据修改后的纽卡斯尔-渥太华量表(NOS)评价文献质量。采用RevMan5.3和Stata12软件做Meta分析并生成森林图,异质性较大时采用亚组分析寻找异质性来源,采用Egger’s检验评估纳入文献是否存在发表偏倚。结果 共纳入17篇文献,共计AD患者1 322例,对照者1 137例。Meta分析结果显示,AD患者的血清或CSF Aβ1-42水平低于对照者,差异具有统计学意义(P<0.00001)。对照者类型结果显示,两亚组总体标准化均数差(SMD)结果与未分组结果大体一致,组间异质性检验结果为χ~2=13.890,P=0.000。Egger’s检验结果显示,纳入文献可能存在发表偏倚(t=2.250,P=0.034)。结论 AD患者的血清或CSF Aβ1-42水平低于对照者,对照者的选择是导致异质性产生的主要原因。

Objective To systematically evaluate the serum or cerebrospinal fluid(CSF) β-amyloid protein 1-42(Aβ1-42)level in patients with Alzheimer’s disease(AD) and controls, and assess the diagnostic potential of Aβ1-42as a biomarker for AD. Methods China national knowledge infrastructure, Wanfang Database, VIP Database, PubMed, EMBASE and Web of Science were searched for studies on the detection of serum or CSF Aβ1-42in AD patients and controls, the search time limit was from inception to March 2022. According to the inclusion and exclusion criteria, the literatures were screened and the basic data were extracted. The quality of literature was evaluated according to Newcastle-Ottawa Scale(NOS). Metaanalysis was performed using RevMan5.3 and Stata12 softwares to generate forest maps. Subgroup analysis was used to find the source of heterogeneity when heterogeneity was large. Egger’s test was used to evaluate whether there was publication bias in the included literature. Results A total of 17 literatures were included, including 1 322 AD patients and 1 137controls. Meta-analysis result showed that the serum or CSF Aβ1-42level in AD patients was lower than that in controls,and the difference was statistically significant(P<0.00001). The controls type result showed that the overall standard mean difference(SMD) result of the two subgroups was generally consistent with the result of non-grouping, and the heterogeneity test result between groups was χ~2=13.890, P =0.000. Egger’s test result showed that the included literature may have publication bias(t=2.250, P=0.034). Conclusion Serum or CSF Aβ1-42level in AD patients is lower than that in controls,and the choice of the controls is the main reason for the heterogeneity.