膳食镁摄入量与脑卒中及心血管死亡关系的meta分析
发布时间：2018-11-25 19:07
【摘要】：研究背景:镁作为人体内含量较多的微量元素之一,具有重要的生物学作用。人体内多种生理功能的维持,包括神经-肌肉的传导、心肌兴奋性、肌肉收缩、血压调节、骨骼完整、胰岛素分泌及葡萄糖代谢等,都有赖于镁的存在。尽管镁离子对维持机体的正常代谢及功能至关重要,然而,人群中膳食镁的摄入不足是一个普遍问题,研究显示,在70岁以上人群中,男性和女性的镁摄入不足分别高达81%和82%。动物研究显示镁缺乏与动脉粥样硬化的发生密切相关。流行病学研究显示,与血清镁水平正常的人群比较,镁缺乏人群的左室肥厚、心血管死亡及全因死亡均显著升高,提示镁的缺乏可能是导致心血管疾病发生的重要危险因素之一。近年来多项流行病学观察了膳食镁的摄入量与脑卒中及心血管死亡发生的关系,结果不完全一致:一些研究显示镁的摄入与脑卒中及心血管事件的发生呈负相关,而另外一些研究未观察到两者具有显著相关性。目前国内尚无meta分析观察膳食镁的摄入量与心血管死亡的关系。Meta分析是对具有相同研究目的且相互独立的多项研究结果进行系统的、综合定量分析的一种研究方法。Meta分析具有提高统计学检验效能、定量估计研究效应的平均水平、评价研究结果的不一致性、发现单个研究未阐明的问题等优点。因此,本论文通过汇总目前已发表的观察膳食镁与脑卒中及心血管死亡关系的队列研究,进行meta分析,以更准确地评价膳食中镁的摄入量与脑卒中及心血管死亡发病的关联。研究目的:1、通过汇总观察膳食镁的摄入量与脑卒中关系的队列研究,进行meta分析,以更准确地评价镁的摄入与脑卒中的关系。2、通过汇总观察膳食镁的摄入量与心血管死亡关系的队列研究,进行meta分析,以更准确地评价镁的摄入与心血管死亡的关系。研究方法:1、制定检索策略及文献纳入标准,全面检索Pub Med、Web of Science、Coch rane Library databases和CNKI、万方数据知识服务平台。仔细筛选所检索到的文献,尽可能地收集到符合既定纳入标准的相关研究。2、采用预先制定的表格提取纳入研究的一般资料,包括发表研究的第一作者、研究发表年代、研究进行的国家或地区、受试者的种族、样本量、随访时间、每日膳食镁平均摄入量、终点事件定义、混杂因素控制、相对危险度(RR)值或风险比值(HR)等。对纳入研究进行质量评价。3、汇总每项研究的RR或HR值,计算总的RR值及其95%可信区间,并进行异质性检验、发表偏倚检验和敏感性分析。采用meta回归探讨异质性来源。研究结果:1、与低水平的每日膳食镁的摄入人群比较,高水平镁摄入者的总的脑卒中的发生风险显著降低,即高水平镁的摄入与总脑卒中的发生呈显著负相关(RR:0.87,95%CI:0.81-0.94,p=0.001),独立于常见的脑卒中危险因素之外,如年龄、吸烟、高血压、糖尿病等。分别对缺血性脑卒中和出血性脑卒中进行亚组分析,结果显示,每日高水平镁的摄入量与缺血性脑卒中的发生呈显著独立负相关(RR:0.85,95%CI:0.77-0.94,p=0.001),而与出血性脑卒中的发生无显著相关(RR:0.94,95%CI:0.80-1.12,p=0.499)。异质性检验显示各项研究间无显著异质性。2、与低水平的每日膳食镁的摄入比较,高水平镁的摄入与心血管死亡的发生存在负相关趋势,但尚未达到统计学意义。异质性检验显示存在显著异质性(I2=74.6%,p=0.000)。3、Egger’s检验及Begg’s检验结果未发现存在发表偏倚证据。4、敏感性分析显示剔除任何一项研究未对总的结果产生明显影响。5、将研究的样本量、发表年龄、种族做为变量引入meta回归方程,未发现上述变量是异质性来源的重要因素。结论:1、每日膳食镁的摄入量与缺血性脑卒中的发生呈独立负相关,而与出血性脑卒无显著相关性。2、每日膳食镁的摄入量与心血管死亡存在负相关趋势,未达到统计学意义,两者的关系有待于进一步研究证实。
[Abstract]:Background: Magnesium, as one of the trace elements in human body, has important biological effects. The maintenance of various physiological functions in human body, including conduction of nerve-muscle, excitability of myocardium, muscle contraction, blood pressure regulation, complete bone, insulin secretion and glucose metabolism, depend on the presence of magnesium. Although magnesium ion is essential to the normal metabolism and function of the maintenance body, the lack of dietary magnesium in the population is a general problem, and the study shows that in the population of over 70 years, the magnesium intake of men and women is 81% and 82%, respectively. Animal studies show that the lack of magnesium is closely related to the occurrence of atherosclerosis. The epidemiological study shows that magnesium deficiency may be one of the most important risk factors leading to the occurrence of cardiovascular disease compared with those with normal serum magnesium levels, left ventricular hypertrophy, cardiovascular death and all-cause death in the magnesium deficiency population. In recent years, the relationship between the intake of dietary magnesium and the incidence of stroke and cardiovascular death has been observed in a number of epidemiological studies, and the results are not identical: some studies have shown that the intake of magnesium is negatively correlated with the occurrence of stroke and cardiovascular events, while others have not observed a significant correlation. At present, there is no meta-analysis in China to observe the relationship between the intake of dietary magnesium and the cardiovascular death. Meta-analysis is a kind of research method for systematic and comprehensive quantitative analysis of multiple research results with the same research purpose and independent of each other. Meta-analysis has the advantages of improving the statistical test efficiency, quantitatively estimating the average level of the study effect, evaluating the inconsistency of the research results, and finding out the problems that the single study has not set forth. Therefore, this paper makes a meta-analysis to more accurately evaluate the relationship between the intake of magnesium in the diet and the incidence of stroke and cardiovascular death by summarizing the currently published cohort study of the relationship between the dietary magnesium and the stroke and the cardiovascular death. Objective: To study the relationship between the intake of magnesium and the relationship between the intake of magnesium and the stroke, and to evaluate the relationship between the intake of magnesium and the stroke. The meta-analysis was performed to more accurately assess the relationship between magnesium intake and cardiovascular death. The research method: 1. The search strategy and the literature are included in the standard, and the comprehensive search of the pub Med, the Web of Science, the Cch rane Library databases and the CNKI and Wanfang data knowledge service platform. carefully screen the retrieved literature and, as much as possible, collect the relevant studies that meet the established criteria of incorporation. 2. Use a pre-established table to extract the general information included in the study, including the first author of the study, the study publication, the country or region in which the study was conducted, The subject's race, sample size, follow-up time, daily dietary magnesium average intake, endpoint event definition, confounding factor control, relative risk (RR) value, or risk ratio (HR), etc. The quality assessment was conducted for inclusion in the study. 3. The RR or HR values of each study were summarized, the total RR value and its 95% confidence interval were calculated, and the heterogeneity test, the bias test and the sensitivity analysis were made. The heterogeneous sources were discussed using meta-regression. The results of the study were as follows: 1. The risk of total stroke in the high-level magnesium intake was significantly lower than that of the low level of daily dietary magnesium (RR: 0.87, 95% CI: 0.81-0.94, p = 0.001). It is independent of the common risk factors of stroke, such as age, smoking, hypertension, diabetes, etc. The results showed that the daily high level of magnesium intake was negatively correlated with the occurrence of ischemic stroke (RR: 0.85, 95% CI: 0.77-0.94, p = 0.001), and no significant correlation with the occurrence of hemorrhagic stroke (RR: 0.94, 95% CI: 0.80-1.12, p = 0. 499). The heterogeneity test showed no significant heterogeneity among the studies. There was a negative correlation between the intake of high levels of magnesium and the occurrence of cardiovascular death in comparison with the low levels of daily dietary magnesium. There was a significant heterogeneity in the heterogeneity test (I2 = 74.6%, p = 0.000). 3, the Egger's test and the Beg's test results were not found to have published bias evidence. 4. The sensitivity analysis showed no significant impact on the overall results. 5. Sample size to be studied, age, Race as a variable introduced the meta-regression equation, and the above variables were not found to be an important factor in the source of heterogeneity. Conclusion: 1. The intake of daily dietary magnesium is negatively correlated with the occurrence of ischemic stroke, and there is no significant correlation with hemorrhagic cerebral stroke. The relationship between the two is to be further studied and confirmed.
【学位授予单位】：泰山医学院
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R54;R743.3
本文编号：2357119
[Abstract]:Background: Magnesium, as one of the trace elements in human body, has important biological effects. The maintenance of various physiological functions in human body, including conduction of nerve-muscle, excitability of myocardium, muscle contraction, blood pressure regulation, complete bone, insulin secretion and glucose metabolism, depend on the presence of magnesium. Although magnesium ion is essential to the normal metabolism and function of the maintenance body, the lack of dietary magnesium in the population is a general problem, and the study shows that in the population of over 70 years, the magnesium intake of men and women is 81% and 82%, respectively. Animal studies show that the lack of magnesium is closely related to the occurrence of atherosclerosis. The epidemiological study shows that magnesium deficiency may be one of the most important risk factors leading to the occurrence of cardiovascular disease compared with those with normal serum magnesium levels, left ventricular hypertrophy, cardiovascular death and all-cause death in the magnesium deficiency population. In recent years, the relationship between the intake of dietary magnesium and the incidence of stroke and cardiovascular death has been observed in a number of epidemiological studies, and the results are not identical: some studies have shown that the intake of magnesium is negatively correlated with the occurrence of stroke and cardiovascular events, while others have not observed a significant correlation. At present, there is no meta-analysis in China to observe the relationship between the intake of dietary magnesium and the cardiovascular death. Meta-analysis is a kind of research method for systematic and comprehensive quantitative analysis of multiple research results with the same research purpose and independent of each other. Meta-analysis has the advantages of improving the statistical test efficiency, quantitatively estimating the average level of the study effect, evaluating the inconsistency of the research results, and finding out the problems that the single study has not set forth. Therefore, this paper makes a meta-analysis to more accurately evaluate the relationship between the intake of magnesium in the diet and the incidence of stroke and cardiovascular death by summarizing the currently published cohort study of the relationship between the dietary magnesium and the stroke and the cardiovascular death. Objective: To study the relationship between the intake of magnesium and the relationship between the intake of magnesium and the stroke, and to evaluate the relationship between the intake of magnesium and the stroke. The meta-analysis was performed to more accurately assess the relationship between magnesium intake and cardiovascular death. The research method: 1. The search strategy and the literature are included in the standard, and the comprehensive search of the pub Med, the Web of Science, the Cch rane Library databases and the CNKI and Wanfang data knowledge service platform. carefully screen the retrieved literature and, as much as possible, collect the relevant studies that meet the established criteria of incorporation. 2. Use a pre-established table to extract the general information included in the study, including the first author of the study, the study publication, the country or region in which the study was conducted, The subject's race, sample size, follow-up time, daily dietary magnesium average intake, endpoint event definition, confounding factor control, relative risk (RR) value, or risk ratio (HR), etc. The quality assessment was conducted for inclusion in the study. 3. The RR or HR values of each study were summarized, the total RR value and its 95% confidence interval were calculated, and the heterogeneity test, the bias test and the sensitivity analysis were made. The heterogeneous sources were discussed using meta-regression. The results of the study were as follows: 1. The risk of total stroke in the high-level magnesium intake was significantly lower than that of the low level of daily dietary magnesium (RR: 0.87, 95% CI: 0.81-0.94, p = 0.001). It is independent of the common risk factors of stroke, such as age, smoking, hypertension, diabetes, etc. The results showed that the daily high level of magnesium intake was negatively correlated with the occurrence of ischemic stroke (RR: 0.85, 95% CI: 0.77-0.94, p = 0.001), and no significant correlation with the occurrence of hemorrhagic stroke (RR: 0.94, 95% CI: 0.80-1.12, p = 0. 499). The heterogeneity test showed no significant heterogeneity among the studies. There was a negative correlation between the intake of high levels of magnesium and the occurrence of cardiovascular death in comparison with the low levels of daily dietary magnesium. There was a significant heterogeneity in the heterogeneity test (I2 = 74.6%, p = 0.000). 3, the Egger's test and the Beg's test results were not found to have published bias evidence. 4. The sensitivity analysis showed no significant impact on the overall results. 5. Sample size to be studied, age, Race as a variable introduced the meta-regression equation, and the above variables were not found to be an important factor in the source of heterogeneity. Conclusion: 1. The intake of daily dietary magnesium is negatively correlated with the occurrence of ischemic stroke, and there is no significant correlation with hemorrhagic cerebral stroke. The relationship between the two is to be further studied and confirmed.
【学位授予单位】：泰山医学院
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R54;R743.3
【参考文献】
相关期刊论文 前1条
1 ;Tea consumption and risk of stroke:a dose-response meta-analysis of prospective studies[J];Journal of Zhejiang University-Science B(Biomedicine & Biotechnology);2012年08期
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