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ID 116650
タイトル別表記
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
著者
土師, 正太郎 徳島大学大学院医科学教育部(医学専攻)
Murakami, Nagahisa Tokushima University
古川, 貴大 Tokushima University|Shinko Hospital
梶, 龍兒 Tokushima University|National Hospital Organization Utano Hospital 徳島大学 教育研究者総覧 KAKEN研究者をさがす
キーワード
Amyotrophic lateral sclerosis
Uric acid
Hazard ratio
Meta-analysis
Survival
資料タイプ
学位論文
抄録
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.
掲載誌名
Clinical Neurology and Neurosurgery
ISSN
03038467
cat書誌ID
AA1152339X
出版者
Elsevier
203
開始ページ
106566
発行日
2021-02-19
備考
内容要旨・審査要旨・論文本文の公開
本論文は,著者Shotaro Hajiの学位論文として提出され,学位審査・授与の対象となっている。
EDB ID
出版社版DOI
出版社版URL
フルテキストファイル
言語
eng
著者版フラグ
博士論文全文を含む
文科省報告番号
甲第3566号
学位記番号
甲医第1517号
学位授与年月日
2021-12-23
学位名
博士(医学)
学位授与機関
徳島大学
部局
病院
医学系