筋萎縮性側索硬化症の予後バイオマーカーとしての血清尿酸値の有用性 : メタアナリシスからのエビデンス
Haji, Shotaro Tokushima University Tokushima University Educator and Researcher Directory
Sako, Wataru Tokushima University KAKEN Search Researchers
Murakami, Nagahisa Tokushima University
Osaki, Yusuke Tokushima University Tokushima University Educator and Researcher Directory
Furukawa, Takahiro Tokushima University|Shinko Hospital
Izumi, Yuishin Tokushima University Tokushima University Educator and Researcher Directory KAKEN Search Researchers
Kaji, Ryuji Tokushima University|National Hospital Organization Utano Hospital Tokushima University Educator and Researcher Directory KAKEN Search Researchers
Amyotrophic lateral sclerosis
Thesis or Dissertation
Objective: To determine the value of uric acid (UA) as a prognostic biomarker for amyotrophic lateral sclerosis (ALS) using a meta-analysis of hazard ratio-based studies.
Methods: We included data from Tokushima University (47 patients with ALS) and three previous studies (1835 patients with ALS) with a hazard ratio (HR) identified by a systematic computational search. A total of four studies and 1882 patients were enrolled in the pooled analysis. We pooled HRs of death or tracheostomy, which were estimated by a Cox proportional hazard model, using a random-effects model. Heterogeneity was assessed by Q statistic, and a p value < 0.1 was considered significant heterogeneity. Furthermore, sensitivity analysis was performed to assess the effect of each single study and the robustness of the summary effect. We evaluated publication bias by visual assessment of the funnel plot and Egger’s test, and adjusted the bias using a trim-and-fill method.
Results: This meta-analysis revealed that UA could be a prognostic factor for ALS (all, HR = 0.87, p < 0.001; men, HR = 0.83, p < 0.001; women, HR = 0.76, p < 0.001). The included studies were homogeneous (all, p = 0.43; men, p = 0.9; women, p = 0.49). Sensitivity analysis confirmed the robustness of these summary effects. Publication bias was detected, which was adjusted for by a trim-and-fill method. The adjusted results showed significant summary effects (all, HR = 0.88, p = 0.002; men, HR = 0.83, p < 0.001; women, HR = 0.77, p < 0.001).
Conclusion: The present meta-analysis suggests that the serum UA level could be a prognostic biomarker in patients with ALS. Sensitivity analyses and the trim-and-fill method supported the robustness of these results.
Clinical Neurology and Neurosurgery
|DOI (Published Version)|
|URL ( Publisher's Version )|
k3566_abstract_review.pdf 237 KB
k3566_fulltext.pdf 3.67 MB
|MEXT report number||
Doctor of Medical Science