血清同型半胱氨酸水平与男性勃起功能障碍相关性的系统评价和Meta分析

The correlation between serum homocysteine levels and male erectile dysfunction: a systematic reviewand Meta analysis

目的 通过系统评价的方法探索血清同型半胱氨酸(Hcy)水平与男性勃起功能障碍(ED)的相关性。方法 检索EMbase、PubMed、Cochrane Library、CNKI、CBM、万方和维普数据库,搜集关于血清Hcy水平与男性ED相关性的临床研究。由2位研究员独立进行文献筛选、资料提取和纳入研究偏倚风险评估。采用ReMan 5.4软件和Stata 12软件进行Meta分析。结果 共纳入16项研究,包括3 474例研究对象,ED组1 648例,健康对照组1 826例。Meta分析结果显示,与健康对照组相比,ED患者的血清Hcy水平更高[SMD 1.23(95%CI 0.74~1.72,P<0.000 1)]。根据血清Hcy的检测方法不同进行亚组分析,结果如下:荧光偏振免疫分析法亚组与高效液相色谱法亚组,ED患者的血清Hcy水平未显著高于健康对照组[SMD 0.95(95%CI 0.03~1.92,P<0.000 1)、SMD 0.82(95%CI 0.38~1.25,P<0.000 1)]。酶循环法亚组、酶联免疫吸附试验测定法亚组与其他检测方法亚组,ED患者的血清Hcy显著高于健康对照组[SMD 1.01(95%CI 0.20~2.22,P<0.000 1)、SMD 1.52(95%CI 0.59~3.63,P<0.000 1)、SMD 2.17(95%CI 0.49~3.84,P<0.000 1)]。结论 ED患者血清Hcy水平明显更高。但纳入研究的质量有限,还需开展更多高质量研究予以验证。

Objective To evaluate the correlation between serum homocysteine levels and male erectile dysfunction by systematic review.Methods EMbase,PubMed,Cochrane Library,CNKI,CBM,Wanfang and VIP databases to collect clinical studies on the correlation between serum homocysteine(Hey)levels and male erectile dysfunction(ED).Two researchers independently performed literature screening,data extraction,and risk of bias assessment of included studies.Meta-analysis was performed using ReMan 5.4 software and Stata 12 software.Results A total of 16 studies were included,including 3,474 subjects,1,648 in the ED group and 1,826 in the healthy control group.Meta-analysis results showed that compared with healthy controls,ED patients had higher serum Hey levels[SMD 1.23(95%CI0.74-1.72,P<0.000,1)].Subgroup analysis was carried out according to different detection methods of serum Hey,and the analysis results were in the subgroup of fluorescence polarization immunassay and high performance liquid chromatography,the serum Hey level of ED patients was not sigifcantly higher than that of healthy control group[SMD 0.95(95%CI 0.03-1.92,P<0.00,1),SMD 0.82(95%CI 0.38-1.25,P<0.000,1)].The serum Hey of ED patents was significantly higher than that of healthy controls[SMD 1.01(95%CI 0.20-2.22,P<0.000,1),SMD 1.52(95%CI 0.59-3.63,P<0.000,1),SMD 2.17(95%CI 0.49-3.84,P<0.000,1)].Conclusions The seum Hey level is sigificantly higher in ED patients.However,the quality limiations of the included studies need to be venifed by more high-quality studies.