同型半胱氨酸与衰弱发生风险关系的meta分析

Association between homocysteine and the risk of frailty:a meta-analysis

目的 采用meta分析方法系统评价同型半胱氨酸与衰弱发生风险之间的相关性。方法 计算机检索Scopus、EMbase、the Cochrane Library、PubMed、Web of Science、Opengrey、中国生物医学文献数据库、CNKI数据库、万方数据库、维普数据库中关于同型半胱氨酸与衰弱关系的观察性研究,检索时间为建库至2022年4月10日,按照纳入及排除标准筛选文献、提取数据并评价纳入文献的方法学质量,应用Revman5.3和Stata14.0软件进行数据分析。结果 共纳入12篇文献,总样本量12 352例,衰弱组2 172例,对照组10 180例,meta分析结果显示,衰弱组同型半胱氨酸水平高于对照组,两组比较差异有统计学意义(SMD=0.64,95%CI:0.32~0.96,P<0.001)。亚组分析结果显示,不同的研究地区[亚洲(SMD=0.82,95%CI:0.22~1.42)、欧洲(SMD=0.37,95%CI:0.30~0.43)]、研究场所[医院(SMD=1.12,95%CI:0.46~1.76)]、衰弱评估工具[Freid衰弱表型(SMD=0.63,95%CI:0.06~1.20)、Frail量表(SMD=0.40,95%CI:0.32~0.48)]、数据类型[原始数据(SMD=0.84,95%CI:0.27~1.42)、转换后数据(SMD=0.39,95%CI:0.26~0.53)]中的同型半胱氨酸水平升高均可增加衰弱的发生风险(P<0.05)。结论 现有的结果表明同型半胱氨酸水平高可能是衰弱发生的危险因素。但是受纳入文献数量和研究方法的影响,此结果需进一步探究。

Objective To evaluate the correlation between homocysteine and the risk of frailty through a meta-analysis.Methods The observational studies on association between homocysteine and frailty were retrieved from the databases,including Scopus,EMbase,the Cochrane Library,PubMed,Web of Science,Opengrey,CBM,CNKI,WanFang,and VIP.The retrieval time was from the establishment of the databases to April 10,2022.According to inclusion and exclusion criterion,literature screening,information extraction and quality evaluation of literature methodology were implemented in sequence.Revman5.3 software and Stata14.0 software were used for data analysis.Results A total of 12 literatures with 12,352 participants were enrolled in this analysis,including 2,172 patients in the frailty group and 10,180 controls in the control group.Meta-analysis showed that level of homocysteine in the frailty group was higher than that in the control group(SMD=0.64,95%CI:0.32-0.96,P<0.001).Subgroup analyses revealed that increased homocysteine levels in different study regions Asia(SMD=0.82,95%CI:0.22-1.42),Europe(SMD=0.37,95%CI:0.30-0.43),setting hospital(SMD=1.12,95%CI:0.46-1.76),evaluation tool for frailty Freid frailty phenotype(SMD=0.63,95%CI:0.06-1.20),Frail Scale(SMD=0.40,95%CI:0.32-0.48),and data types original data(SMD=0.84,95%CI:0.27-1.42),converted data(SMD=0.39,95%CI:0.26-0.53)were associated with an increased risk of frailty(P<0.05).Conclusion Current results suggest that high level of homocysteine may be a risk factor for frailty occurrence.However,due to the limitations of literatures’quantity and research methods,the results need to be further explored.