摘要
目的通过meta分析明确超重、一般性肥胖和中心性肥胖与复发性静脉血栓栓塞(VTE)的关系。方法系统检索PubMed、Embase、中国知网和万方数据库,筛选超重、一般性肥胖以及中心性肥胖与复发性VTE关联的观察性研究,包括前瞻性与回顾性研究。采用Stata 12.0软件对纳入数据进行统计分析,加权合并OR及其相应的95%CI。结果本研究共纳入14篇文献。与正常体重相比,超重与复发性VTE无显著关联(OR=1.11,95%CI 0.96~1.28,P=0.154),中心性肥胖与复发性VTE无显著关联(OR=1.26,95%CI 0.86~1.86,P=0.238),一般性肥胖与复发性VTE呈显著正相关(OR=1.49,95%CI 1.24~1.79,P<0.001)。亚组分析结果显示,一般性肥胖与复发性VTE风险在不同年龄、研究人群、样本量和研究设计亚组分析中均呈显著正相关。对9篇前瞻性研究结果汇总分析发现,一般性肥胖个体VTE复发风险增加了44%(OR=1.44,95%CI 1.02~2.04,P<0.001)。结论一般性肥胖与复发性VTE呈显著正相关,对于VTE合并肥胖患者,建议通过减轻体重,有针对性地调整抗凝药物治疗方案,从而预防VTE的复发。此外,由于目前中国关于体重指数和中心性肥胖与VTE复发的相关研究鲜见,未来尚需要在中国人群中开展大样本以及高质量的前瞻性研究进行验证。
Objective To explore the relationship of overweight,general obesity(GO)and central obesity(CO)with the risk of recurrent venous thromboembolism(VTE).Methods We systematically searched PubMed,Embase,CNKI and Wanfang database to collect observational studies on the relationship of overweight,GO and CO with recurrent VTE,including prospective and retrospective studies.The statistical analysis was conducted by Stata 12.0 software.The OR and corresponding 95%CI were pooled.Results A total of 14 studies were included.Compared with normal weight,overweight was not significantly related to the risk of recurrent VTE(OR=1.11,95%CI 0.96~1.28,P=0.154),CO was not significantly related to the risk of recurrent VTE(OR=1.26,95%CI 0.86~1.86,P=0.238),respectively,while GO was positively related to it(OR=1.49,95%CI 1.24~1.79,P<0.001).Furthermore,subgroup analysis results showed GO was positively related to recurrent VTE in subgroups of different age,study population,sample size and study design.Pooled results of 9 prospective studies showed GO increased the risk of recurrent VTE by 44%(OR=1.44,95%CI 1.02~2.04,P<0.001).Conclusion There was a significant positive relationship between GO and recurrent VTE.For patients with VTE complicated by obesity,the reduction of body weight and adjustment of anticoagulant plan should be recommended to prevent VTE recurrence.In addition,as few domestic study has explored the association of body mass index and CO with VTE recurrence,future large-sample and high-quality prospective studies in China should be conducted for validation.
作者
范婷泳
袁丽
FAN Tingyong;YUAN Li(West China School of Nursing,Sichuan University/The Center of Gerontology and Geriatrics,West China Hospital,Sichuan University,Chengdu 610041,Sichuan,China;Department of Endocrinology&Metabolism,West China Hospital,Sichuan University,Chengdu 610041,Sichuan,China)
出处
《心血管病学进展》
CAS
2022年第6期559-565,共7页
Advances in Cardiovascular Diseases
