Body mass index and the risk of abdominal aortic aneurysm presence and postoperative mortality: a systematic review and dose-response meta-analysis
Body mass index and the risk of abdominal aortic aneurysm presence and postoperative mortality: a systematic review and dose-response meta-analysis
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DOI：
10.1097/js9.0000000000001125
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发表时间：
2024-04-01
影响因子：
15.3
通讯作者：
Han，Yanshuo
中科院分区：
文献类型：
--
作者：
Wu，Yihao;Zhang，Hao;Han，Yanshuo
背景：关于BMI与腹主动脉瘤（AAA）的关系的临床数据不一致，特别是对于肥胖和超重患者。本研究的目的是确定是否肥胖与AAA的存在，并调查BMI和AAA的存在和术后mortality.Materials和方法的风险之间的定量关系：PubMed，Web of Science和Embase数据库被用来搜索相关的研究更新到2023年12月。采用基于随机效应模型的常规Meta分析估计合并相对危险度（RR）和95%CI。使用稳健误差荟萃回归（REMR）模型进行剂量反应荟萃分析，以量化BMI与AAA结局变量之间的相关性。根据研究对象的特点进行亚组分析、敏感性分析和发表偏倚分析。荟萃分析显示，肥胖患者中AAA的患病率较高，RR为1.07。剂量反应荟萃分析显示BMI与AAA存在风险之间存在非线性关系。一个“U”形曲线反映了AAA患者的BMI和术后死亡率的风险之间的相关性也被发现，这表明“最安全”的BMI区间（28.55，31.05）与最小的RR.Conclusions：肥胖是积极的，但非线性相关的AAA存在的风险增加。BMI与AAA术后死亡率呈“U”形曲线相关，超重和肥胖患者的RR最低。这些发现为AAA发病率提供了预防策略，并为改善接受AAA手术修复的患者的预后提供了指导。
Background:The clinical data regarding the relationships between BMI and abdominal aortic aneurysm (AAA) are inconsistent, especially for the obese and overweight patients. The aims of this study were to determine whether obesity is associated with the presence of AAA and to investigate the quantitative relationship between BMI and the risk of AAA presence and postoperative mortality.Materials and methods:PubMed, Web of Science, and Embase databases were used to search for pertinent studies updated to December 2023. The pooled relative risk (RR) with 95% CI was estimated by conventional meta-analysis based on random effects model. Dose-response meta-analyses using robust-error meta-regression (REMR) model were conducted to quantify the associations between BMI and AAA outcome variables. Subgroup analysis, sensitivity analysis, and publication bias analysis were performed according to the characteristics of participants.Results:Eighteen studies were included in our study. The meta-analysis showed a higher prevalence of AAA with a RR of 1.07 in patients with obesity. The dose-response meta-analysis revealed a nonlinear relationship between BMI and the risk of AAA presence. A ‘U’shape curve reflecting the correlation between BMI and the risk of postoperative mortality in AAA patients was also uncovered, suggesting the ‘safest’BMI interval (28.55, 31.05) with the minimal RR.Conclusions:Obesity is positively but nonlinearly correlated with the increased risk of AAA presence. BMI is related to AAA postoperative mortality in a ‘U’shaped curve, with the lowest RR observed among patients suffering from overweight and obesity. These findings offer a preventive strategy for AAA morbidity and provide guidance for improving the prognosis in patients undergone AAA surgical repair.