血浆同型半胱氨酸水平升高与心血管疾病及各种死亡风险因子的meta分析_英文_.docx

78Peng et al. / J Zhejiang Univ-Sci B (Biomed Biotechnol) 2015 16(1):78-86Journal of Zhejiang University-SCIENCE B (Biomedicine Biotechnology) ISSN 1673-1581 (Print); ISSN 1862-1783 (Online)/jzus%3B/jzus; / E-mail: mailto:jzus@jzus@Elevated homocysteine levels and risk of cardiovascular andall-cause mortality: a meta-analysis of prospective studiesHui-yong PENG, Chang-feng MAN, Juan XU, Yu FAN??(Cancer Institute, the Affiliated People’s Hospital, Jiangsu University, Zhenjiang 212002, China)?E-mail: mailto:jszjfanyu@163.comjszjfanyu@163.comReceived June 30, 2014; Revision accepted Nov. 6, 2014; Crosschecked Dec. 20, 2014Abstract: Objective: To investigate whether elevated homocysteine levels were a predictor of subsequent coronary heart disease (CHD) mortality, cardiovascular mortality or all-cause mortality in the general population by a meta- analysis. Methods: In a systematic search conducted in the databases of PubMed and Embase prior to October 2013, we identified relevant prospective observational studies evaluating the association between baseline homocysteine levels and CHD mortality, cardiovascular or all-cause mortality in the general population. Pooled adjust risk ratio (RR) and corresponding 95% confidence interval (CI) were calculated separately for categorical risk estimates and con- tinuous risk estimates. Results: Twelve studies with 23 623 subjects were included in the meta-analysis. Comparing the highest to lowest homocysteine level categories, CHD mortality increased by 66% (RR 1.66; 95% CI 1.12–2.47; P=0.012), cardiovascular mortality increased by 68% (RR 1.68; 95% CI 1.04–2.70; P=0.033), and all-cause mortality increased by 93% (RR 1.93; 95% CI 1.54–2.43; P0.001). Moreover, for each 5 μmol/L homocysteine increment, the pooled RR was 1.52 (95% CI 1.26–1.84; P0.001) for CHD mortality, 1.32 (95% CI 1.08–1.61; P=0.006) for cardio- vascular mortality, and 1.27 (95% CI 1.03–1.55; P=0.023) for all-cause mortality. Conclusions: Elevated homocysteine