高血压与胆石症风险的关联性研究

Association between hypertension and the risk of gallstone disease

目的通过开展一项全国多中心研究及一项系统综述和Meta分析,全面研究高血压与胆石症(GSD)患病风险的关联性。方法研究分为3个阶段:第1阶段,于2015—2020年在成都、天津、北京和重庆地区共4个中心招募参与健康检查的研究对象。使用多因素Logistic回归分析研究不同中心高血压与GSD患病风险的相关性;第2阶段,系统检索Embase、PubMed、万方、维普和中国知网数据库中2021年5月之前发表的相关研究文献,并通过Meta分析以进一步验证这种关联性;第3阶段,采用随机效应模型对多中心横断面研究结果与既往文献结果进行合并分析。结果横断面研究共招募633948例受试者,GSD的患病率为7.844%。多因素Logistic回归分析显示,高血压与GSD患病风险呈正相关(P<0.05)。亚组分析结果显示高血压与GSD的关联在性别、年龄和胆结石亚型中无明显差异。系统综述和Meta分析最终纳入了80篇文献,结果表明每升高10 mmHg的舒张压和收缩压,GSD风险分别增加1.022倍和1.014倍。结论高血压显著增加GSD的患病风险,本研究结果将为探讨GSD的病因学和识别高危人群提供基础。

Objective This article aims to investigate the association between hypertension and the risk of GSD by conducting a national multicenter study,a systematic review,and a meta-analysis.Methods The study was conducted in three stages.In the first stage,subjects were recruited for health examination in four hospitals in Chengdu,Tianjin,Beijing,and Chongqing,China,from 2015 to 2020,and the multivariate logistic regression analysis was used to investigate the association between hypertension and the risk of GSD in each center.In the second stage,Embase,PubMed,Wanfang Data,VIP,and CNKI databases were searched for related studies published up to May 2021,and a meta-analysis was conducted to further verify such association.In the third stage,the random effects model was used for pooled analysis of the results of the multicenter cross-sectional study and the findings of previous literature.Results A total of 633948 participants were enrolled in the cross-sectional study,and the prevalence rate of GSD was 7.844%.The multivariate logistic regression analysis showed that hypertension was positively associated with the risk of GSD(P<0.05).Subgroup analysis showed that there was no significant difference in the association between hypertension and GSD between individuals with different sexes,ages,and subtypes of GSD.A total of 80 articles were included in the systematic review and the meta-analysis,and the results showed that the risk of GSD was increased by 1.022 times for every 10 mmHg increase in diastolic pressure and 1.014 times for every 10 mmHg increase in systolic pressure.Conclusion Hypertension significantly increases the risk of GSD,and the findings of this study will provide a basis for the etiology of GSD and the identification of high-risk groups.