Association between homocysteine level and the risk of diabetic retinopathy: a systematic review and meta-analysis
Abstract Background Previous studies have demonstrated that elevated homocysteine (Hcy) level represents an independent risk factor for macrovascular disease. However, the relationship between hyperhomocysteinemia and the progression of diabetic retinopathy in patients remains controversial. Hence,...
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doaj-ad1a5fbe91aa445e9f74e1766ac550912020-11-25T02:03:06ZengBMCDiabetology & Metabolic Syndrome1758-59962018-08-011011810.1186/s13098-018-0362-1Association between homocysteine level and the risk of diabetic retinopathy: a systematic review and meta-analysisXunwen Lei0Guifeng Zeng1Yuemei Zhang2Qiang Li3Jinzhi Zhang4Zhenggang Bai5Kehu Yang6The First Clinical Medical College of Lanzhou UniversityGansu Health Vocational CollegeThe First Clinical Medical College of Lanzhou UniversityThe First Clinical Medical College of Lanzhou UniversityThe First Clinical Medical College of Lanzhou UniversitySchool of Public Affairs, Nanjing University of Science and TechnologyEvidence-Based Medicine Center, School of Basic Medical Sciences of Lanzhou UniversityAbstract Background Previous studies have demonstrated that elevated homocysteine (Hcy) level represents an independent risk factor for macrovascular disease. However, the relationship between hyperhomocysteinemia and the progression of diabetic retinopathy in patients remains controversial. Hence, the purpose of this systematic review and meta-analysis was to explore any potential association between Hcy and the risk of diabetic retinopathy. Methods PubMed, Embase, and the Cochrane Library databases were searched to screen studies that fulfilled the inclusion criteria from date of database inception to November 2017. The summary odds ratio (OR) with 95% confidence intervals (CIs) was used to calculate the pooled effect estimate for the relationship between Hcy and diabetic retinopathy risk. Sensitivity, subgroup analyses, and publication bias were also assessed. Results Eleven studies involving a total of 2184 diabetic patients were included in the meta-analysis. The summary OR suggested that increased Hcy level in diabetic patients was associated with an increased risk of diabetic retinopathy (OR 1.62; 95% CI 1.29–2.03; p < 0.001). Although significant heterogeneity was detected among the included studies, the findings of sensitivity analysis remained statistically significant. Subgroup analyses found a significant association between Hcy and diabetic retinopathy in most subsets, but no significant association was found if the sample size was < 100, participants had type 1 diabetes mellitus, and the study quality was low. Conclusions The findings of this study suggested that elevated Hcy level was associated with an increased risk of diabetic retinopathy, especially in type 2 diabetic patients. This finding may help diabetic patients to achieve effective management strategy to prevent the progression of diabetic retinopathy.http://link.springer.com/article/10.1186/s13098-018-0362-1Elevated homocysteineDiabetic retinopathySystematic reviewMeta-analysis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Xunwen Lei Guifeng Zeng Yuemei Zhang Qiang Li Jinzhi Zhang Zhenggang Bai Kehu Yang |
spellingShingle |
Xunwen Lei Guifeng Zeng Yuemei Zhang Qiang Li Jinzhi Zhang Zhenggang Bai Kehu Yang Association between homocysteine level and the risk of diabetic retinopathy: a systematic review and meta-analysis Diabetology & Metabolic Syndrome Elevated homocysteine Diabetic retinopathy Systematic review Meta-analysis |
author_facet |
Xunwen Lei Guifeng Zeng Yuemei Zhang Qiang Li Jinzhi Zhang Zhenggang Bai Kehu Yang |
author_sort |
Xunwen Lei |
title |
Association between homocysteine level and the risk of diabetic retinopathy: a systematic review and meta-analysis |
title_short |
Association between homocysteine level and the risk of diabetic retinopathy: a systematic review and meta-analysis |
title_full |
Association between homocysteine level and the risk of diabetic retinopathy: a systematic review and meta-analysis |
title_fullStr |
Association between homocysteine level and the risk of diabetic retinopathy: a systematic review and meta-analysis |
title_full_unstemmed |
Association between homocysteine level and the risk of diabetic retinopathy: a systematic review and meta-analysis |
title_sort |
association between homocysteine level and the risk of diabetic retinopathy: a systematic review and meta-analysis |
publisher |
BMC |
series |
Diabetology & Metabolic Syndrome |
issn |
1758-5996 |
publishDate |
2018-08-01 |
description |
Abstract Background Previous studies have demonstrated that elevated homocysteine (Hcy) level represents an independent risk factor for macrovascular disease. However, the relationship between hyperhomocysteinemia and the progression of diabetic retinopathy in patients remains controversial. Hence, the purpose of this systematic review and meta-analysis was to explore any potential association between Hcy and the risk of diabetic retinopathy. Methods PubMed, Embase, and the Cochrane Library databases were searched to screen studies that fulfilled the inclusion criteria from date of database inception to November 2017. The summary odds ratio (OR) with 95% confidence intervals (CIs) was used to calculate the pooled effect estimate for the relationship between Hcy and diabetic retinopathy risk. Sensitivity, subgroup analyses, and publication bias were also assessed. Results Eleven studies involving a total of 2184 diabetic patients were included in the meta-analysis. The summary OR suggested that increased Hcy level in diabetic patients was associated with an increased risk of diabetic retinopathy (OR 1.62; 95% CI 1.29–2.03; p < 0.001). Although significant heterogeneity was detected among the included studies, the findings of sensitivity analysis remained statistically significant. Subgroup analyses found a significant association between Hcy and diabetic retinopathy in most subsets, but no significant association was found if the sample size was < 100, participants had type 1 diabetes mellitus, and the study quality was low. Conclusions The findings of this study suggested that elevated Hcy level was associated with an increased risk of diabetic retinopathy, especially in type 2 diabetic patients. This finding may help diabetic patients to achieve effective management strategy to prevent the progression of diabetic retinopathy. |
topic |
Elevated homocysteine Diabetic retinopathy Systematic review Meta-analysis |
url |
http://link.springer.com/article/10.1186/s13098-018-0362-1 |
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