循环microRNA-126与冠状动脉疾病关系的荟萃分析。
完整摘要 · 中文译文
背景：冠状动脉疾病（CAD）是全球发病和死亡的主要原因。循环微小RNA-126（miR-126）已被认为与血管生物学相关，但其与CAD关联的证据仍不一致。既往研究受限于样本量小和方法学差异。本系统综述和荟萃分析旨在量化CAD患者与健康对照者之间循环miR-126水平的差异，并探讨异质性的潜在来源。 方法：检索策略根据PICO框架制定，并适配数据库特定的受控词汇（如MeSH）。对七个数据库（PubMed、Embase、Web of Science、Cochrane Library、CNKI、万方和维普）从建库至2024年12月31日进行了全面文献检索。随后于2025年1月1日至2026年3月15日进行了补充检索。纳入报告CAD患者和对照者循环miR-126水平的合格研究。使用方法学质量采用纽卡斯尔-渥太华量表（NOS）评估。使用随机效应模型计算标准化均数差（SMD）及其95%置信区间（CI）。进行亚组和敏感性分析以探讨方法学和临床异质性来源，并评估发表偏倚。 结果：共纳入19项研究。其中，11项提供了完整的CAD versus对照总体数据并纳入主要荟萃分析，而12项提供了亚组水平数据并被 纳入亚组分析或描述性亚组证据。与对照组相比，冠心病（CAD）患者的循环 miR-126 水平显著降低（SMD = -2.51；95% CI：-3.44 至 -1.58），并存在显著异质性（I² = 97.8%）。亚组分析表明，异质性主要由方法学差异驱动，尤其是测量量表和标准化方法。敏感性分析证实了结果的稳健性，在所有分析中方向和统计学显著性均保持一致。 结论：与健康对照相比，CAD 患者的循环 miR-126 持续降低。尽管效应量在各研究间存在差异，但这种关联似乎稳健且具有生物学合理性。未来需要采用标准化测量方案的大规模多中心研究来验证这些发现并探索其潜在临床意义。 PROSPERO 注册号：CRD4202563309。
完整摘要 · 英文原文
BACKGROUND: Coronary artery disease (CAD) is a leading cause of morbidity and mortality worldwide. Circulating microRNA-126 (miR-126) has been implicated in vascular biology, yet evidence regarding its association with CAD remains inconsistent. Previous studies were limited by small sample sizes and methodological variability. This systematic review and meta-analysis aimed to quantify differences in circulating miR-126 levels between CAD patients and healthy controls and to explore potential sources of heterogeneity. METHODS: The search strategy was developed according to the PICO framework and adapted to database-specific controlled vocabulary (e.g.,MeSH).A comprehensive literature search was conducted across seven databases (PubMed, Embase, Web of Science, Cochrane Library, CNKI, Wanfang, and VIP) from database inception to December 31, 2024. A supplementary search was subsequently conducted from January 1, 2025, to March 15, 2026. Eligible studies reporting circulating miR-126 levels in CAD patients and controls were included. Methodological quality was assessed using the Newcastle-Ottawa Scale (NOS). Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated using random-effects models. Subgroup and sensitivity analyses were conducted to investigate methodological and clinical sources of heterogeneity, and publication bias was evaluated. RESULTS: A total of 19 studies were included. Of these, 11 provided complete overall CAD-versus-control data and were included in the primary meta-analysis, while 12 contributed subgroup-level data and were included in subgroup analyses or descriptive subgroup evidence. Circulating miR-126 levels were significantly lower in CAD patients compared with controls (SMD = - 2.51; 95% CI: -3.44 to - 1.58), with substantial heterogeneity (I² = 97.8%). Subgroup analyses indicated that heterogeneity was primarily driven by methodological differences, particularly measurement scale and normalization methods. Sensitivity analyses confirmed the robustness of the findings, with consistent direction and statistical significance across all analyses. CONCLUSION: Circulating miR-126 is consistently reduced in CAD patients compared with healthy controls. While the magnitude of effect varies across studies, this association appears robust and biologically plausible. Future large-scale, multicenter studies using standardized measurement protocols are warranted to validate these findings and explore their potential clinical relevance. PROSPERO REGISTRATION: CRD4202563309.