Association between serum amyloid A levels and coronary heart disease: a systematic review and meta analysis of 26 studies
Association between serum amyloid A levels and coronary heart disease: a systematic review and meta analysis of 26 studies
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血清淀粉样蛋白 A 水平与冠心病之间的关联：26 项研究的系统回顾和荟萃分析
DOI：
10.1007/s00011-020-01325-1
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发表时间：
--
影响因子：
6.7
通讯作者：
Chen Keyang （陈可洋）
中科院分区：
文献类型：
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作者：
Zhou Jielin;Lu Yao;Wang Sufang;Chen Keyang （陈可洋）
背景与目的血清淀粉样蛋白A(SAA)与冠心病(CHD)的关系尚不一致，且SAA水平与某些因素在冠心病发病中的相关性尚未得到全面的评价。本研究通过检索Cochrane图书馆、PubMed、Embase、Science Direct等数据库，系统检索Cochrane图书馆、PubMed、Embase和Science Direct数据库，探讨冠心病患者血清SAA水平与冠心病的关系，以及SAA水平与CRP、纤维蛋白原、白介素6(IL-6)、高密度脂蛋白胆固醇(HDLC)水平的相关性。采用随机效应模型计算合并标化平均差(SMD)、相关系数(R)和95%可信区间(CI)。结果共纳入26项研究，涉及冠心病病例6466例，受试者16184人。与对照组相比，病例组血清SAA水平显著升高( = 为0.38，95%CI为0.21，0.56)。亚组分析显示，病例组与对照组SAA水平差异与年龄、性别、学习类型有关。此外，Meta回归模型表明，不同的大陆、性别和出版年份分别可以解释52.05%、50.17%、28.07%的异质性来源。分层分析进一步发现，随着CHD的加重，SAA浓度逐渐升高。相关分析显示，冠心病患者血清SAA水平与C反应蛋白(r= 0.45，95%CI 0.19，0.71)、纤维蛋白原(r= 0.41，95%CI 0.35，0.47)、IL-6(r=HDL0.48，95%CI 0.41，0.54)呈正相关，与 -C水平呈负相关(r= −=0.28，95%CI−=0.38，−=0.18)。尤其是年龄超过55岁的受试者，来自欧洲和亚洲的受试者，或病例对照研究。此外，我们还发现SAA浓度随着CHD严重程度的增加而增加。重要的是，我们的研究表明，高水平的SAA可能通过增加CRP、纤维蛋白原、IL-6水平或降低HDLC水平而在CHD中发挥作用。
Background and aimsThe relationship between serum amyloid A (SAA) and coronary heart disease (CHD) remains inconsistent, and the correlation of SAA levels and some factors have not been thoroughly evaluated in CHD. The present study assessed the associations of SAA levels and CHD, and the correlation of SAA levels and CRP, fibrinogen, interleukin-6 (IL-6), and HDL-C levels in CHD patient.MethodsWe systematically searched databases of Cochrane Library, PubMed, Embase, and ScienceDirect from their inception to 2018. Pooled standardized mean difference (SMD), correlation coefficient (r), and 95% confidence intervals (CI) were computed using random-effect model.ResultA total of 26 studies were identified for analysis, involving a total of 6466 CHD cases and 16,184 participants. Compared with the control group, the case group had markedly higher SAA levels (SMD = 0.38, 95% CI 0.21, 0.56). Subgroup analysis manifested that SAA level difference between case group and control group were associated with age, continent, and study type. Moreover, meta-regression model suggested that different continent, sex, and publication year can explain the origin of 52.05%, 50.17%, 28.07% heterogeneity, respectively. By stratified analyses, we further found that the concentration of SAA increased gradually with the aggravation of CHD. Additionally, the meta-analysis of correlation showed that SAA levels were positively related with CRP (r= 0.45, 95% CI 0.19, 0.71), fibrinogen (r= 0.41, 95% CI 0.35, 0.47), and IL-6 (r= 0.48, 95% CI 0.41, 0.54) levels, but negatively linked with HDL-C levels (r= − 0.28, 95% CI − 0.38, − 0.18) in CHD patients.ConclusionHigh levels of SAA are significantly associated with increased risk of CHD, especially for participants aged more than 55 years, subjects from Europe and Asia, or case–control study. Furthermore, we find that SAA concentrations increased with the severity of CHD. Importantly, our study suggests that high levels of SAA might play a role in CHD by increasing CRP, fibrinogen, IL-6 levels, or attenuating HDL-C levels.