膳食鎂攝入量與腦卒中及心血管死亡關(guān)系的meta分析
發(fā)布時(shí)間：2018-11-25 19:07
【摘要】：研究背景:鎂作為人體內(nèi)含量較多的微量元素之一,具有重要的生物學(xué)作用。人體內(nèi)多種生理功能的維持,包括神經(jīng)-肌肉的傳導(dǎo)、心肌興奮性、肌肉收縮、血壓調(diào)節(jié)、骨骼完整、胰島素分泌及葡萄糖代謝等,都有賴于鎂的存在。盡管鎂離子對(duì)維持機(jī)體的正常代謝及功能至關(guān)重要,然而,人群中膳食鎂的攝入不足是一個(gè)普遍問(wèn)題,研究顯示,在70歲以上人群中,男性和女性的鎂攝入不足分別高達(dá)81%和82%。動(dòng)物研究顯示鎂缺乏與動(dòng)脈粥樣硬化的發(fā)生密切相關(guān)。流行病學(xué)研究顯示,與血清鎂水平正常的人群比較,鎂缺乏人群的左室肥厚、心血管死亡及全因死亡均顯著升高,提示鎂的缺乏可能是導(dǎo)致心血管疾病發(fā)生的重要危險(xiǎn)因素之一。近年來(lái)多項(xiàng)流行病學(xué)觀察了膳食鎂的攝入量與腦卒中及心血管死亡發(fā)生的關(guān)系,結(jié)果不完全一致:一些研究顯示鎂的攝入與腦卒中及心血管事件的發(fā)生呈負(fù)相關(guān),而另外一些研究未觀察到兩者具有顯著相關(guān)性。目前國(guó)內(nèi)尚無(wú)meta分析觀察膳食鎂的攝入量與心血管死亡的關(guān)系。Meta分析是對(duì)具有相同研究目的且相互獨(dú)立的多項(xiàng)研究結(jié)果進(jìn)行系統(tǒng)的、綜合定量分析的一種研究方法。Meta分析具有提高統(tǒng)計(jì)學(xué)檢驗(yàn)效能、定量估計(jì)研究效應(yīng)的平均水平、評(píng)價(jià)研究結(jié)果的不一致性、發(fā)現(xiàn)單個(gè)研究未闡明的問(wèn)題等優(yōu)點(diǎn)。因此,本論文通過(guò)匯總目前已發(fā)表的觀察膳食鎂與腦卒中及心血管死亡關(guān)系的隊(duì)列研究,進(jìn)行meta分析,以更準(zhǔn)確地評(píng)價(jià)膳食中鎂的攝入量與腦卒中及心血管死亡發(fā)病的關(guān)聯(lián)。研究目的:1、通過(guò)匯總觀察膳食鎂的攝入量與腦卒中關(guān)系的隊(duì)列研究,進(jìn)行meta分析,以更準(zhǔn)確地評(píng)價(jià)鎂的攝入與腦卒中的關(guān)系。2、通過(guò)匯總觀察膳食鎂的攝入量與心血管死亡關(guān)系的隊(duì)列研究,進(jìn)行meta分析,以更準(zhǔn)確地評(píng)價(jià)鎂的攝入與心血管死亡的關(guān)系。研究方法:1、制定檢索策略及文獻(xiàn)納入標(biāo)準(zhǔn),全面檢索Pub Med、Web of Science、Coch rane Library databases和CNKI、萬(wàn)方數(shù)據(jù)知識(shí)服務(wù)平臺(tái)。仔細(xì)篩選所檢索到的文獻(xiàn),盡可能地收集到符合既定納入標(biāo)準(zhǔn)的相關(guān)研究。2、采用預(yù)先制定的表格提取納入研究的一般資料,包括發(fā)表研究的第一作者、研究發(fā)表年代、研究進(jìn)行的國(guó)家或地區(qū)、受試者的種族、樣本量、隨訪時(shí)間、每日膳食鎂平均攝入量、終點(diǎn)事件定義、混雜因素控制、相對(duì)危險(xiǎn)度(RR)值或風(fēng)險(xiǎn)比值(HR)等。對(duì)納入研究進(jìn)行質(zhì)量評(píng)價(jià)。3、匯總每項(xiàng)研究的RR或HR值,計(jì)算總的RR值及其95%可信區(qū)間,并進(jìn)行異質(zhì)性檢驗(yàn)、發(fā)表偏倚檢驗(yàn)和敏感性分析。采用meta回歸探討異質(zhì)性來(lái)源。研究結(jié)果:1、與低水平的每日膳食鎂的攝入人群比較,高水平鎂攝入者的總的腦卒中的發(fā)生風(fēng)險(xiǎn)顯著降低,即高水平鎂的攝入與總腦卒中的發(fā)生呈顯著負(fù)相關(guān)(RR:0.87,95%CI:0.81-0.94,p=0.001),獨(dú)立于常見(jiàn)的腦卒中危險(xiǎn)因素之外,如年齡、吸煙、高血壓、糖尿病等。分別對(duì)缺血性腦卒中和出血性腦卒中進(jìn)行亞組分析,結(jié)果顯示,每日高水平鎂的攝入量與缺血性腦卒中的發(fā)生呈顯著獨(dú)立負(fù)相關(guān)(RR:0.85,95%CI:0.77-0.94,p=0.001),而與出血性腦卒中的發(fā)生無(wú)顯著相關(guān)(RR:0.94,95%CI:0.80-1.12,p=0.499)。異質(zhì)性檢驗(yàn)顯示各項(xiàng)研究間無(wú)顯著異質(zhì)性。2、與低水平的每日膳食鎂的攝入比較,高水平鎂的攝入與心血管死亡的發(fā)生存在負(fù)相關(guān)趨勢(shì),但尚未達(dá)到統(tǒng)計(jì)學(xué)意義。異質(zhì)性檢驗(yàn)顯示存在顯著異質(zhì)性(I2=74.6%,p=0.000)。3、Egger’s檢驗(yàn)及Begg’s檢驗(yàn)結(jié)果未發(fā)現(xiàn)存在發(fā)表偏倚證據(jù)。4、敏感性分析顯示剔除任何一項(xiàng)研究未對(duì)總的結(jié)果產(chǎn)生明顯影響。5、將研究的樣本量、發(fā)表年齡、種族做為變量引入meta回歸方程,未發(fā)現(xiàn)上述變量是異質(zhì)性來(lái)源的重要因素。結(jié)論:1、每日膳食鎂的攝入量與缺血性腦卒中的發(fā)生呈獨(dú)立負(fù)相關(guān),而與出血性腦卒無(wú)顯著相關(guān)性。2、每日膳食鎂的攝入量與心血管死亡存在負(fù)相關(guān)趨勢(shì),未達(dá)到統(tǒng)計(jì)學(xué)意義,兩者的關(guān)系有待于進(jìn)一步研究證實(shí)。
[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.
【學(xué)位授予單位】：泰山醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R54;R743.3
本文編號(hào)：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.
【學(xué)位授予單位】：泰山醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R54;R743.3
【參考文獻(xiàn)】
相關(guān)期刊論文 前1條
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
，本文編號(hào)：2357119
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