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Meta-Analysis
. 2018 Feb 7;8(1):2568.
doi: 10.1038/s41598-018-21019-3.

Plasma homocysteine concentrations and risk of intracerebral hemorrhage: a systematic review and meta-analysis

Zhike Zhou  1 , Yifan Liang  2 , Huiling Qu  3 , Mei Zhao  4 , Feng Guo  5 , Chuansheng Zhao  6 , Weiyu Teng  7
Affiliations
Meta-Analysis

Plasma homocysteine concentrations and risk of intracerebral hemorrhage: a systematic review and meta-analysis

Zhike Zhou et al. Sci Rep. .

Abstract

Intracerebral hemorrhage (ICH) has the highest mortality rate in all strokes. However, controversy still exists concerning the association between plasma homocysteine (Hcy) and ICH. A systematic review and meta-analysis was conducted using Pubmed, Embase, and Web of Science up to April 18, 2017. Standard mean difference (SMD) for mean differences of plasma Hcy levels with 95% confidence intervals (CI) was calculated. Seven studies including 667 ICH patients and 1821 ischemic stroke patients were identified for meta-analysis. Our results showed that Hcy levels in ICH patients were significantly higher than those in healthy controls (SMD = 0.59, 95% CI = 0.51-0.68, P < 0.001); no statistic differences were found in the comparisons of Hcy levels between ICH and ischemic stroke (SMD = -0.03, 95% CI = -0.13-0.06, P > 0.05); further subgroup analysis of ethnicity (Asians: SMD = 0.57, 95% CI = 0.48-0.66, P < 0.001; Caucasians: SMD = 0.77, 95% CI = 0.51-1.02, P < 0.001) and sample size (small samples: SMD = 0.55, 95% CI = 0.30-0.80, P < 0.001; large samples size: SMD = 0.60, 95% CI = 0.51-0.69, P < 0.001) in relation to Hcy levels between ICH and healthy controls did not change these results. In conclusion, Hcy level may be an aggravating factor in atherosclerosis, which is positively associated with high risk of ICH. Race-specific differences between Asians and Caucasians have no impact on the risk of ICH.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Flow chart of study selection in the meta-analysis.
Figure 2
Figure 2
Forest plots for the comparisons of plasma Hcy levels between intracerebral hemorrhage (ICH) patients and healthy controls (A); Forest plots for the comparisons of plasma Hcy levels between intracerebral hemorrhage (ICH) patients and ischemic stroke patients (B). CI: confidence interval.
Figure 3
Figure 3
Forest plots of the subgroup analyses on ethnicity (A) and sample size (B) in relation to plasma Hcy levels between intracerebral hemorrhage (ICH) patients and healthy controls. CI: confidence interval.
Figure 4
Figure 4
Forest plot in the sensitivity analysis of the present meta-analysis (individual names for each study have been omitted). CI: confidence interval.
Figure 5
Figure 5
Funnel plot to detect risk of publication bias in the meta-analysis. SMD: standard mean difference.
See this image and copyright information in PMC

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References

    1. Ikram MA, Wieberdink RG, Koudstaal PJ. International epidemiology of intracerebral hemorrhage. Curr Atheroscler Rep. 2012;14:300–6. doi: 10.1007/s11883-012-0252-1. - DOI - PMC - PubMed
    1. Thabet AM, Kottapally M, Hemphill JC. Management of intracerebral hemorrhage. Handb Clin Neurol. 2017;140:177–94. doi: 10.1016/B978-0-444-63600-3.00011-8. - DOI - PubMed
    1. Cai X, Rosand J. The Evaluation and Management of Adult Intracerebral Hemorrhage. Semin Neurol. 2015;35:638–45. doi: 10.1055/s-0035-1564687. - DOI - PubMed
    1. Zheng H, Chen C, Zhang J, Hu Z. Mechanism and Therapy of Brain Edema after Intracerebral Hemorrhage. Cerebrovasc Dis. 2016;42:155–69. doi: 10.1159/000445170. - DOI - PubMed
    1. Provencio JJ, Da Silva IR, Manno EM. Intracerebral hemorrhage: new challenges and steps forward. Neurosurg Clin N Am. 2013;24:349–59. doi: 10.1016/j.nec.2013.03.002. - DOI - PubMed

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