Association of 6-thioguanine nucleotide levels and inflammatory bowel disease activity: A meta-analysis
Association of 6-thioguanine nucleotide levels and inflammatory bowel disease activity: A meta-analysis
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DOI：
10.1053/j.gastro.2006.01.046
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发表时间：
2006-04-01
期刊：
影响因子：
29.4
通讯作者：
Lewis, JD
中科院分区：
文献类型：
--
作者：
Osterman, MT;Kundu, R;Lewis, JD
背景和目标：已经提出6-硫鸟嘌呤核苷酸（6-TGN）水平与用硫唑嘌呤或6-巯基嘌呤（6-MP）治疗的患者中的炎性肠病（IBD）活动相关。以前的研究，大多数样本量小，得出了相互矛盾的结论。我们的目的是汇集现有数据，以提供更精确的估计6-TGN水平和IBD活动之间的关联。方法：计算机检索Medline和PubMed（1966 ~ 2004年11月），并对所选文献的参考文献列表进行回顾性分析。使用固定和随机效应模型来检验活动性疾病患者与缓解患者的平均/中位数6-TGN水平是否不同，以及6-TGN水平高于230 - 260 pmol/8 × 10（8）红细胞阈值是否与临床缓解相关。当研究报告多个6-TGN阈值时，我们使用较低值的数据。结果：我们确定了55篇文章，其中12篇包含足够的数据。缓解期患者的平均/中位数6-TGN水平高于活动性IBD患者（合并差异，66 pmol/8 × 10（8）红细胞; 95%置信区间，18-113; P = 0.006），但具有显著异质性。排除1个离群值研究消除了这种异质性。6-TGN水平高于阈值的患者（62%）比低于阈值的患者（36%）更有可能缓解（合并比值比，3.3; 95%置信区间，1.7-6.3; P
Background & Aims: 6-Thioguanine nucleotide (6-TGN) levels have been proposed to correlate with inflammatory bowel disease (IBD) activity among patients treated with azathioprine or 6-mercaptopurine (6-MP). Previous studies, most with small sample sizes, yielded conflicting conclusions. Our aim was to pool the available data to provide a more precise estimate of the association between 6-TGN levels and IBD activity. Methods: We searched Medline and PubMed (from :1966 to November 2004) and reviewed the reference lists of selected articles. Fixed and random-effects models were used to test whether mean/median 6-TGN levels differed among patients with active disease vs remission and whether 6-TGN levels above a threshold of 230 -260 pmol/8 x 10(8) red blood cells were associated with clinical remission. When studies reported multiple 6-TGN threshold values, we used the data for the lower value. Results: We identified 55 articles, 12 of which contained data sufficient for inclusion. The mean/median 6-TGN levels were higher among patients in remission than in those with active IBD) (pooled difference, 66 pmol/8 X 10(8) red blood cells; 95% confidence interval, 18-113; P =.006), but with significant heterogeneity. Excluding the 1 outlier study eliminated this heterogeneity. Patients with 6-TGN levels above the threshold value were more likely to be in remission (62%) than those below the threshold value (36%) (pooled odds ratio, 3.3; 95% confidence interval, 1.7-6.3; P