Prevalence of Hyperhomocysteinemia in China: An Updated Meta-Analysis.
Prevalence of Hyperhomocysteinemia in China: An Updated Meta-Analysis.
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中国高同型半胱氨酸血症的患病率：最新荟萃分析
DOI：
10.3390/biology10100959
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发表时间：
2021-09-26
期刊：
影响因子：
4.2
通讯作者：
Yang YD
中科院分区：
文献类型：
--
作者：
Zeng Y;Li FF;Yuan SQ;Tang HK;Zhou JH;He QY;Baker JS;Dong YH;Yang YD
高同型半胱氨酸血症（Hyperhomocysteinemia，HHcy）是指血清中同型半胱氨酸浓度超过15 μmol/L，在脑血管疾病的发病机制中起重要作用。中国高同型半胱氨酸血症的患病率已在先前的荟萃分析中概述。考虑到同型半胱氨酸在血管损伤过程中的关键作用，已经进行了更多的研究来通过营养补充剂如叶酸或其他治疗来预防高同型半胱氨酸血症。此外，研究表明，高同型半胱氨酸血症的患病率随时间推移而增加;因此，有必要提供对中国同型半胱氨酸状态的既往荟萃分析的更新。这是了解流行率、随时间变化的趋势及其决定因素所必需的。结果表明，高同型半胱氨酸血症的患病率在中国正在增加，特别是在老年人、男性以及中国北方、内陆地区和农村地区的居民中。我们进行了一项荟萃分析，以系统地评估中国高同型半胱氨酸血症（HHcy）的患病率，其随时间的变化及其决定因素。使用英文数据库（PubMed、Embase和Web of Science）和中文数据库（CNKI、CBM、VIP和万方）进行文献检索。时间范围为2014年1月至2021年3月。我们采用随机效应模型估计HHCy的合并阳性率和相应的95%置信区间（95%CI）。为了找到异质性的来源，我们进行了亚组分析和荟萃回归。共识别出29篇相关文章，涉及338，660名参与者，128，147例HHcy病例。中国人群HHcy患病率为37.2%（95%CI：32.6- 41.8%，I2 = 99.8%，p < 0.001）。随着时间的推移，HHcy患病率呈逐渐上升的趋势，2015-2016年期间有所增加（与2013-2014年相比，p < 0.001），但2015-2016年和2017-2018年之间保持稳定。亚组分析显示，55岁以上的老年人、男性以及中国北方、内陆和农村居民的患病率较高（每次比较，p < 0.001）。Meta回归分析显示，年龄和研究领域贡献了42.3%的研究间异质性。目前的荟萃分析提供了强有力的证据表明，中国的高同型半胱氨酸患病率正在增加，并且在不同年龄，性别和地理分布之间存在很大差异。因此，应重点关注高危人群，实施公共卫生政策和策略，预防和控制高同型半胱氨酸。
Hyperhomocysteinemia has been defined as an elevated serum concentration of homocysteine exceeding 15 μmol/L and has been proven to play an important role in the pathogenesis of cerebrovascular disease. The prevalence of hyperhomocysteinemia in China has been outlined in a previous meta-analysis. Considering the key role of homocysteine in the process of vascular injury, more studies have been conducted to prevent hyperhomocysteinemia by nutritional supplements such as folic acid or other treatments. Additionally, studies have shown that the prevalence of hyperhomocysteinemia increases over time; therefore, it was necessary to provide an update from the previous meta-analysis on homocysteine status in China. This was needed to understand the prevalence, the trend in changes over time, and its determinants. The results highlight that the prevalence of hyperhomocysteinemia is increasing in China, especially among the elderly, men, and residents in the north, inland areas, and rural areas of China. We conducted a meta-analysis to systematically assess the prevalence of hyperhomocysteinemia (HHcy) in China, its change over time, and its determinants. Literature searches were conducted using English databases (PubMed, Embase, and Web of Science) and Chinese databases (CNKI, CBM, VIP, and Wanfang). The time ranges were from Jan 2014 to Mar 2021 in China. We adopted the random effects model to estimate the pooled positive rates of HHcy and corresponding 95% confidence intervals (95% CI). To find the sources of heterogeneity, we performed subgroup analysis and meta-regression. A total of 29 related articles were identified involving 338,660 participants with 128,147 HHcy cases. The estimated prevalence of HHcy in China was 37.2% (95% CI: 32.6–41.8%, I2 = 99.8%, p for heterogeneity < 0.001). The trend of HHcy prevalence was gradually upward over time, with increases during 2015–2016 (comparison to 2013–2014, p < 0.001), but steady between 2015–2016 and 2017–2018. Subgroup analysis showed that the prevalence was higher in the elderly over 55 years old, males, and residents in the north, inland, and rural China (for each comparison, p < 0.001). Meta-regression analysis revealed that age and area of study contributed to 42.3% of the heterogeneity between studies. The current meta-analysis provides strong evidence that the prevalence of HHcy is increasing in China, and varies substantially across different ages, genders, and geographic distribution. Accordingly, high-risk population groups should be focused on, and public health policies and strategies should be carried out to prevent and control HHcy in China.
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