出生体重与慢性肾脏病关联性的系统评价和Meta分析
发布时间：2018-09-10 18:47
【摘要】：目的系统评价出生体重与慢性肾脏病风险的关联性。方法电子检索The Cochrane图书馆、MEDLINE、OVID数据库、Springer数据库、维普数据库、万方数据库和中国知网,检索时间为建库截止至2016年6月,纳入以BW为暴露因素、评估生后发生CKD或其相关结局变量的观察性研究,文献需对CKD或其他结局变量的诊断标准做出描述并能提取CKD或其相关结局变量的OR值及其95%CI,语种限定为中、英文;排除文献:研究对象生后12个月内肾功能衰竭和死亡、有宫内感染病史或患先天遗传性疾病,母孕期暴露因素有潜在毒性物质接触史,研究人群包括成人和儿童但无法单独提取儿童数据。由两位作者独立检索关于出生体重(BW)对CKD风险相关的观察性研究,病例对照和队列研究采用NOS量表、横断面研究采用AHRQ量表对文献进行偏倚风险评价,提取OR值和95%CI。应用Stata 12.0对文献进行Meta分析,均选用Der SimonianLaird随机效应模型分析。结果 10篇观察性研究纳入本文分析,其中病例对照4篇(3篇8分,1篇7分),队列研究4篇(3篇7分,1篇8分),横断面研究2篇(1篇7分,1篇8分)。慢性肾脏病风险低出生体重(LBW)较正常BW人群高约80%,OR=1.80,95%CI:1.37~2.35;其中蛋白尿、终末期肾脏病和低e GFR在LBW较正常BW人群的OR及其95%CI分别为2.58(1.49~4.46)、1.42(1.22~1.66)和1.87(1.19~2.94)。终末期肾脏病、低e GFR在高出生体重(HBW)中较正常BW人群的OR及其95%CI分别为1.19(0.94~1.49)和1.09(0.93~1.27),HBW与生后慢性肾脏病之间无明显关联;LBW人群作为慢性肾脏病的高危人群仅见于男性人群中,OR=1.83,95%CI:1.10~3.05)。Egger回归提示纳入文献不存在发表偏倚。结论男性LBW是CKD的高危因素,HBW与生后CKD的发生无明显关联。
[Abstract]:Objective to evaluate the relationship between birth weight and risk of chronic kidney disease. Methods The Cochrane library was searched with MEDLINE OVID database, Springer database, Weip database, Wanfang database and China knowledge network. The retrieval time was up to June 2016, and BW was included as the exposure factor. To evaluate the observational study of postnatal CKD or its related outcome variables, the literature should describe the diagnostic criteria of CKD or other outcome variables and extract the OR values of CKD or its related outcome variables and 95 CIs in Chinese and English. Excluded documents: the subjects had a history of intrauterine infection or congenital hereditary disease, and exposure factors during pregnancy had a history of exposure to potentially toxic substances, including renal failure and death within 12 months after birth. The study included adults and children but could not extract data on children alone. The two authors independently searched for an observational study on the relationship between birth weight (BW) and CKD risk, case control and cohort studies using NOS scale, cross-sectional study using AHRQ scale to evaluate the bias risk of literature, and extracting OR value and 95 CIs. Stata 12.0 was applied to the Meta analysis of the literature, and Der SimonianLaird random effect model was used to analyze the results. Results Ten observational studies were included in this study, including 4 case control papers (3 8 points, 1 7 points), 4 cohort studies (3 papers 7 points, 1 article 8 points) and 2 cross-sectional studies (1 paper, 7 points, 1 article, 8 points). The risk of chronic kidney disease in low birth weight (LBW) was about 80% higher than that in normal BW group, and the OR and 95%CI in LBW group were 1.42 (1.221.66) and 1.87 (1.192.94), respectively, of which proteinuria, end-stage kidney disease and low e GFR were 1.42 (1.221.66) and 1.87 (1.192.94) respectively. End stage kidney disease, The OR and 95%CI of low e GFR in (HBW) with high birth weight were 1.19 (0.94 卤1.49) and 1.09 (0.933 卤1.27) respectively. There was no significant correlation between OR and chronic renal disease. The high risk group of chronic kidney disease was only found in male population (1.8395CIW 1.103.05) .Egger regression was reported. There was no publication bias in the literature. Conclusion there is no significant correlation between male LBW and postnatal CKD.
【作者单位】： 中南大学湘雅二医院儿科;
【分类号】：R722.1
本文编号：2235302
[Abstract]:Objective to evaluate the relationship between birth weight and risk of chronic kidney disease. Methods The Cochrane library was searched with MEDLINE OVID database, Springer database, Weip database, Wanfang database and China knowledge network. The retrieval time was up to June 2016, and BW was included as the exposure factor. To evaluate the observational study of postnatal CKD or its related outcome variables, the literature should describe the diagnostic criteria of CKD or other outcome variables and extract the OR values of CKD or its related outcome variables and 95 CIs in Chinese and English. Excluded documents: the subjects had a history of intrauterine infection or congenital hereditary disease, and exposure factors during pregnancy had a history of exposure to potentially toxic substances, including renal failure and death within 12 months after birth. The study included adults and children but could not extract data on children alone. The two authors independently searched for an observational study on the relationship between birth weight (BW) and CKD risk, case control and cohort studies using NOS scale, cross-sectional study using AHRQ scale to evaluate the bias risk of literature, and extracting OR value and 95 CIs. Stata 12.0 was applied to the Meta analysis of the literature, and Der SimonianLaird random effect model was used to analyze the results. Results Ten observational studies were included in this study, including 4 case control papers (3 8 points, 1 7 points), 4 cohort studies (3 papers 7 points, 1 article 8 points) and 2 cross-sectional studies (1 paper, 7 points, 1 article, 8 points). The risk of chronic kidney disease in low birth weight (LBW) was about 80% higher than that in normal BW group, and the OR and 95%CI in LBW group were 1.42 (1.221.66) and 1.87 (1.192.94), respectively, of which proteinuria, end-stage kidney disease and low e GFR were 1.42 (1.221.66) and 1.87 (1.192.94) respectively. End stage kidney disease, The OR and 95%CI of low e GFR in (HBW) with high birth weight were 1.19 (0.94 卤1.49) and 1.09 (0.933 卤1.27) respectively. There was no significant correlation between OR and chronic renal disease. The high risk group of chronic kidney disease was only found in male population (1.8395CIW 1.103.05) .Egger regression was reported. There was no publication bias in the literature. Conclusion there is no significant correlation between male LBW and postnatal CKD.
【作者单位】： 中南大学湘雅二医院儿科;
【分类号】：R722.1
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