同型半胱氨酸与脑白质病变关系的Meta分析

Meta-Analysis of the Relationship between Homocysteine and White Matter Lesions

摘要: 目的：系统评价血浆同型半胱氨酸水平与脑白质病变的关系。方法：计算机检索PubMed、Embase、Cochrane、CNKI和万方数据库自建库至2023年10月有关同型半胱氨酸与脑白质病变的文献。由2名研究者按照纳入和排除标准进行文献筛选、资料提取和质量评价后，采用Revman5.4和stata16软件进行数据分析。结果：共纳入10篇病例对照研究。纳入的10篇文献的纽卡斯尔–渥太华量表(NOS)评分均 ≥ 6分，表明质量可靠。meta分析结果显示，血浆同型半胱氨酸水平与脑白质病变相关(轻度vs.对照组：MD = 1.23, 95% CI: 0.91~1.55；中度vs.对照组：MD = 3.44, 95% CI: 2.65~4.22；重度组vs.对照组：MD = 6.46, 95% CI: 4.69~8.24)。且血浆同型半胱氨酸水平与脑白质病变严重程度呈显著正相关(中度vs.轻度：MD = 2.01, 95% CI: 1.62~2.40；重度vs.轻度：MD = 5.00, 95% CI: 3.34~6.65；重度vs.中度：MD = 2.99, 95% CI: 1.48~4.49)。结论：血浆同型半胱氨酸水平越高，脑白质病变程度越严重。

Abstract: Objective: To systematically evaluate the relationship between homocysteine level and the severity of white matter lesions. Methods: PubMed, Embase, Cochrane, CNKI and Wanfang database were searched by computer from the establishment of the database to October 2023 to find literatures on homocysteine and white matter lesions. After literature selection, data extraction and quality evaluation according to the inclusion and exclusion criteria by two researchers, Revman 5.4 and stata 16 software were used to analyze the data. Results: A total of 10 case-control studies were included. The Newcastle-Ottawa Scale (NOS) scores of the 10 included studies were all above 6 points, indicating that the quality was reliable. Meta-analysis results showed that homocysteine level was correlated with white matter lesions (mild vs. control group: MD = 1.23, 95% CI: 0.91~1.55; moderate vs. control group: MD = 3.44, 95% CI: 2.65~4.22; severe vs. control group: MD = 6.46, 95% CI: 4.69~8.24). There was a significant positive correlation between homocysteine level and severity of white matter lesions (moderate vs. mild: MD = 2.01, 95% CI: 1.62~2.40; severe vs. mild: MD = 5.00, 95% CI: 3.34~6.65; severe vs. moderate: MD = 2.99, 95% CI: 1.48~4.49). Conclusions: The higher the level of homocysteine, the higher the severity of white matter lesions.