噪声暴露与高血压发病风险的剂量-反应meta分析

Meta-analysis of dose-response relationship of noise exposure and risk of hypertension

目的探讨噪声暴露与高血压发病风险的剂量-反应关系。方法计算机检索中国知网、万方数据知识服务平台、维普网、中国生物医学文献服务系统、Pub Med、EMBase、Web of Science、Cochrane Library中发表的噪声暴露与高血压发病的剂量-反应关系的研究,检索时限为建库至2022年8月。由2名研究者独立筛选文献、提取资料,并对文献进行质量评估,应用Stata 16.0软件进行meta分析。结果共纳入10篇文献,包括214775例研究对象。meta分析结果显示,噪声暴露会增加高血压的发病风险(RR=1.31,95%CI:1.19~1.45,P<0.001)。剂量-反应meta分析结果显示,噪声暴露与高血压之间存在非线性关系(P<0.05)。与50 d B(A)噪声暴露比较,40 d B(A)噪声暴露高血压发病风险降低3%(RR=0.97,95%CI:0.96~0.98,P<0.001);45 d B(A)噪声暴露高血压发病风险降低1%(RR=0.99,95%CI:0.99~0.99,P<0.001);55 d B(A)噪声暴露高血压发病风险增加3%(RR=1.03,95%CI:1.03~1.04,P<0.001);60 d B(A)噪声暴露高血压发病风险增加4%(RR=1.04,95%CI:1.03~1.05,P<0.001);65 d B(A)噪声暴露高血压发病风险增加5%(RR=1.05,95%CI:1.03~1.06,P<0.001);70 d B(A)噪声暴露高血压发病风险增加5%(RR=1.05,95%CI:1.02~1.08,P<0.001);75 d B(A)噪声暴露高血压发病风险增加5%(RR=1.05,95%CI:0.99~1.11,P<0.001);80 d B(A)噪声暴露高血压发病风险增加6%(RR=1.06,95%CI:0.98~1.15,P<0.001);85 d B(A)噪声暴露高血压发病风险增加9%(RR=1.09,95%CI:1.00~1.18,P<0.001);90 d B(A)噪声暴露高血压发病风险增加17%(RR=1.17,95%CI:1.09~1.26,P<0.001);95 d B(A)噪声暴露高血压发病风险增加31%(RR=1.31,95%CI:1.20~1.43,P<0.001)。漏斗图结果显示,本研究受发表偏倚影响较小,meta分析结果较可靠。结论噪声暴露与高血压发病风险存在关联,今后有待将大样本高质量文献纳入研究,以便为高血压的预防提供可靠的参考。

Objective To investigate the dose-response relationship between noise exposure and the risk of hypertension.Methods Literatures on the dose-response relationship between noise exposure and hypertension published in CNKI,Wanfang Data,VIP,Chinese Biomedical Literature Service System,PubMed,EMBase,Web of Science,Cochrane Library were searched by computer.The search period was from inception to August 2022.Two researchers independently screened literatures,extracted data,and evaluated literatures quality.Stata 16.0 software was used for meta-analysis.Results A total of ten literatures were included,including 214775 subjects.Meta-analysis showed that noise exposure increased the risk of hypertension(RR=1.31,95%CI:1.19-1.45,P<0.001).The results of dose-response meta-analysis showed that there was a nonlinear relationship between noise exposure and hypertension(P<0.05).Compared with 50 dB(A)noise exposure,40 dB(A)noise exposure reduced the risk of hypertension by 3%(RR=0.97,95%CI:0.96-0.98,P<0.001).45 dB(A)noise exposure reduced the risk of hypertension by 1%(RR=0.99,95%CI:0.99-0.99,P<0.001);55 dB(A)noise exposure increased the risk of hypertension by 3%(RR=1.03,95%CI:1.03-1.04,P<0.001);60 dB(A)noise exposure increased the risk of hypertension by 4%(RR=1.04,95%CI:1.03-1.05,P<0.001);65 dB(A)noise exposure increased the risk of hypertension by 5%(RR=1.05,95%CI:1.03-1.06,P<0.001);70 dB(A)noise exposure increased the risk of hypertension by 5%(RR=1.05,95%CI:1.02-1.08,P<0.001);75 dB(A)noise exposure increased the risk of hypertension by 5%(RR=1.05,95%CI:0.99-1.11,P<0.001);80 dB(A)noise exposure increased the risk of hypertension by 6%(RR=1.06,95%CI:0.98-1.15,P<0.001);85 dB(A)noise exposure increased the risk of hypertension by 9%(RR=1.09,95%CI:1.00-1.18,P<0.001);90 dB(A)noise exposure increased the risk of hypertension by 17%(RR=1.17,95%CI:1.09-1.26,P<0.001);95 dB(A)noise exposure increased the risk of hypertension by 31%(RR=1.31,95%CI:1.20-1.43,P<0.001).The results of funnel plot showed that this study was less affected by publication bias and the results of meta-analysis were more reliable.Conclusion Noise exposure is associated with the risk of hypertension,and a large sample of high-quality literature needs to be included in future studies in order to provide a reliable reference for the prevention of hypertension.