血尿酸与阿尔茨海默病关系的Meta分析

Association between Serum Uric Acid Levels and Alzheimer’s Disease: A Meta Analysis

摘要: 目的：系统评价血尿酸在阿尔茨海默病患者和一般人群之间的差异，探讨血尿酸与阿尔茨海默病之间的关系。方法：计算机检索PubMed、EMbase、The Cochrane Library、CNKI、CBM、维普、万方数据库，并辅以参考文献追溯和手工检索方法，查找有关血尿酸水平与阿尔茨海默病的病例–对照研究的文献，检索时限均为建库时间至2017年8月。由两位评价员按照纳入与排除标准独立筛选文献、提取资料和质量评价后，采用stata12.0软件进行统计量的合并分析。结果：最终纳入24个研究，共计1378例阿尔茨海默病患者。Meta分析结果为SMD = −0.27，95% CI (−1.16, −1.28)，P < 0.001，说明病例组的血尿酸水平低于对照组，病例组与对照组之间血尿酸的差异有统计学意义。亚组分析显示各个研究的异质性可能来源于尿酸的测定方法。敏感性分析显示各个研究之间的结果较稳定，Meta分析的结果较稳健。经Begger’s和Egger’s检验，P > 0.1，提示无发表偏倚。结论：阿尔茨海默病患者的血尿酸水平较一般人群低，提示血尿酸水平较高患阿尔茨海默病的风险相对较低，血尿酸较高是阿尔茨海默病的保护因素。

Abstract: Objective: To systematically evaluate the difference of serum uric acid between patients with Alz-heimer’s disease and the general population and to explore the relationship between serum uric acid and Alzheimer’s disease. Methods: We searched PubMed, EMbase, The Cochrane Library, CNKI, CBM, VIP, Wanfang database, traced back to reference documentation and used manual retrieval method, in order to find out case-control study on the level of serum uric acid and Alzheimer’s disease. Retrieval time limitation is from inception to August 2017. Two reviewers screened articles, extracted data and evaluated quality independently according to inclusion and exclusion criteria. The analysis of statistical data was performed using stata12.0 software. Results: 24 studies were included, with a total of 1378 patients with Alzheimer’s disease. The results of Meta analysis were SMD = −0.27, 95%CI (−1.16, −1.28), P < 0.001, indicating that the level of serum uric acid in the case group was lower than that in the control group, and the difference of serum uric acid between the case group and the control group was statistically significant. Subgroup analysis showed that heterogeneity in each study may be due to the measuring method of serum uric acid. Sensitivity analysis showed that the results of each study were stable, and the results of Meta analysis were robust. Results of Begger’s and Egger’s test were both P > 0.1, suggesting no publication bias. Conclusion: The level of serum uric acid in patients with Alzheimer’s disease is lower than that of the general population, suggesting that the high level of serum uric acid reduce the risk of Alz-heimer’s disease relatively.