{"title":"循环同型半胱氨酸水平bbb10µmol/L对心血管疾病一级预防的干预:系统评价和剂量-反应荟萃分析","authors":"Zihui Huang, Jiupeng Zou, Zhen Li, Mengchu Li, Ruikun He, Jing Zeng, Zhijun Yang, Huabin Li, Xiaoting Lu, Huilian Zhu","doi":"10.1111/jebm.70080","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Several studies suggested that the risk of cardiovascular disease (CVD) had increased before individuals developed hyperhomocysteinemia. This study aimed to investigate the dose-response relationship between circulating homocysteine (Hcy) levels and the risk of CVD.</p><p><strong>Methods: </strong>Observational studies examining the relationship between circulating Hcy levels and CVD risks were included. Searches were conducted on English databases (PubMed, Embase, and Web of Science) and Chinese databases (CNKI, WanFang, VIP, and SinoMed) in May 2025. Combined relative risks (RRs) or odds ratios (ORs) were calculated using random-effects models. The dose-response relationship between circulating Hcy levels and CVD risks was assessed using restricted cubic spline analysis. The risk of bias was assessed using the Newcastle-Ottawa Scale for cohort and case-control studies, and the Agency for Healthcare Research and Quality criteria for cross-sectional studies. Publication bias was assessed using funnel plots and the trim-and-fill method.</p><p><strong>Results: </strong>A total of 117 original studies (35 cohort studies, 60 case-control studies, and 22 cross-sectional studies) were included, involving 504,469 participants with 43,089 CVD cases. Elevated circulating Hcy levels were significantly associated with increased CVD risks in all study types (RRs/ORs: 1.61-2.14). A non-linear dose-response relationship was observed between circulating Hcy levels and CVD risks (all p < 0.001), with thresholds at 10.4 µmol/L for cohort studies, and 10.0 µmol/L for both case-control studies and cross-sectional studies.</p><p><strong>Conclusions: </strong>In this meta-analysis, increased Hcy levels were linked to higher CVD risks. Circulating Hcy level >10 µmol/L may implement nutritional intervention in primary prevention of CVD.</p>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":" ","pages":"e70080"},"PeriodicalIF":3.5000,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Intervention at Circulating Homocysteine Levels >10 µmol/L for Primary Prevention of Cardiovascular Diseases: A Systematic Review and Dose-Response Meta-Analysis.\",\"authors\":\"Zihui Huang, Jiupeng Zou, Zhen Li, Mengchu Li, Ruikun He, Jing Zeng, Zhijun Yang, Huabin Li, Xiaoting Lu, Huilian Zhu\",\"doi\":\"10.1111/jebm.70080\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Several studies suggested that the risk of cardiovascular disease (CVD) had increased before individuals developed hyperhomocysteinemia. This study aimed to investigate the dose-response relationship between circulating homocysteine (Hcy) levels and the risk of CVD.</p><p><strong>Methods: </strong>Observational studies examining the relationship between circulating Hcy levels and CVD risks were included. Searches were conducted on English databases (PubMed, Embase, and Web of Science) and Chinese databases (CNKI, WanFang, VIP, and SinoMed) in May 2025. Combined relative risks (RRs) or odds ratios (ORs) were calculated using random-effects models. The dose-response relationship between circulating Hcy levels and CVD risks was assessed using restricted cubic spline analysis. The risk of bias was assessed using the Newcastle-Ottawa Scale for cohort and case-control studies, and the Agency for Healthcare Research and Quality criteria for cross-sectional studies. Publication bias was assessed using funnel plots and the trim-and-fill method.</p><p><strong>Results: </strong>A total of 117 original studies (35 cohort studies, 60 case-control studies, and 22 cross-sectional studies) were included, involving 504,469 participants with 43,089 CVD cases. Elevated circulating Hcy levels were significantly associated with increased CVD risks in all study types (RRs/ORs: 1.61-2.14). A non-linear dose-response relationship was observed between circulating Hcy levels and CVD risks (all p < 0.001), with thresholds at 10.4 µmol/L for cohort studies, and 10.0 µmol/L for both case-control studies and cross-sectional studies.</p><p><strong>Conclusions: </strong>In this meta-analysis, increased Hcy levels were linked to higher CVD risks. Circulating Hcy level >10 µmol/L may implement nutritional intervention in primary prevention of CVD.</p>\",\"PeriodicalId\":16090,\"journal\":{\"name\":\"Journal of Evidence‐Based Medicine\",\"volume\":\" \",\"pages\":\"e70080\"},\"PeriodicalIF\":3.5000,\"publicationDate\":\"2025-09-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Evidence‐Based Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1111/jebm.70080\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Evidence‐Based Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/jebm.70080","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
摘要
目的:几项研究表明,在个体发生高同型半胱氨酸血症之前,心血管疾病(CVD)的风险已经增加。本研究旨在探讨循环同型半胱氨酸(Hcy)水平与心血管疾病风险之间的剂量-反应关系。方法:研究循环Hcy水平与心血管疾病风险之间关系的观察性研究。检索于2025年5月在英文数据库(PubMed、Embase、Web of Science)和中文数据库(CNKI、万方、维普、中国医学信息网)进行。使用随机效应模型计算综合相对风险(rr)或优势比(ORs)。循环Hcy水平与CVD风险之间的剂量-反应关系采用限制性三次样条分析进行评估。队列研究和病例对照研究采用纽卡斯尔-渥太华量表评估偏倚风险,横断面研究采用卫生保健研究和质量机构标准评估偏倚风险。采用漏斗图和修剪填充法评估发表偏倚。结果:共纳入117项原始研究(35项队列研究、60项病例对照研究和22项横断面研究),涉及504,469名参与者和43,089例CVD病例。在所有研究类型中,循环Hcy水平升高与CVD风险增加显著相关(rr / or: 1.61-2.14)。循环Hcy水平与CVD风险之间存在非线性剂量-反应关系(均p < 0.001),队列研究的阈值为10.4µmol/L,病例对照研究和横断面研究的阈值均为10.0µmol/L。结论:在这项荟萃分析中,Hcy水平升高与CVD风险升高有关。循环Hcy水平bbb10µmol/L可用于心血管疾病一级预防的营养干预。
Intervention at Circulating Homocysteine Levels >10 µmol/L for Primary Prevention of Cardiovascular Diseases: A Systematic Review and Dose-Response Meta-Analysis.
Objective: Several studies suggested that the risk of cardiovascular disease (CVD) had increased before individuals developed hyperhomocysteinemia. This study aimed to investigate the dose-response relationship between circulating homocysteine (Hcy) levels and the risk of CVD.
Methods: Observational studies examining the relationship between circulating Hcy levels and CVD risks were included. Searches were conducted on English databases (PubMed, Embase, and Web of Science) and Chinese databases (CNKI, WanFang, VIP, and SinoMed) in May 2025. Combined relative risks (RRs) or odds ratios (ORs) were calculated using random-effects models. The dose-response relationship between circulating Hcy levels and CVD risks was assessed using restricted cubic spline analysis. The risk of bias was assessed using the Newcastle-Ottawa Scale for cohort and case-control studies, and the Agency for Healthcare Research and Quality criteria for cross-sectional studies. Publication bias was assessed using funnel plots and the trim-and-fill method.
Results: A total of 117 original studies (35 cohort studies, 60 case-control studies, and 22 cross-sectional studies) were included, involving 504,469 participants with 43,089 CVD cases. Elevated circulating Hcy levels were significantly associated with increased CVD risks in all study types (RRs/ORs: 1.61-2.14). A non-linear dose-response relationship was observed between circulating Hcy levels and CVD risks (all p < 0.001), with thresholds at 10.4 µmol/L for cohort studies, and 10.0 µmol/L for both case-control studies and cross-sectional studies.
Conclusions: In this meta-analysis, increased Hcy levels were linked to higher CVD risks. Circulating Hcy level >10 µmol/L may implement nutritional intervention in primary prevention of CVD.
期刊介绍:
The Journal of Evidence-Based Medicine (EMB) is an esteemed international healthcare and medical decision-making journal, dedicated to publishing groundbreaking research outcomes in evidence-based decision-making, research, practice, and education. Serving as the official English-language journal of the Cochrane China Centre and West China Hospital of Sichuan University, we eagerly welcome editorials, commentaries, and systematic reviews encompassing various topics such as clinical trials, policy, drug and patient safety, education, and knowledge translation.