Association between bilirubin levels and risk of stroke: a systematic review and meta-analysis
Objective To evaluate the association between bilirubin levels and stroke risk.Design Systematic review and meta-analysis, reported in accordance with Meta-analysis Of Observational Studies in Epidemiology guidelines.Data sources The PubMed, Embase, Cochrane Central Register of Controlled Trials and...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-05-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/13/5/e064433.full |
| _version_ | 1797829606091259904 |
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| author | Min Li Zhenyu Tang Gege Wang Luyao Qiao Siqi Zhou Jun Min |
| author_facet | Min Li Zhenyu Tang Gege Wang Luyao Qiao Siqi Zhou Jun Min |
| author_sort | Min Li |
| collection | DOAJ |
| description | Objective To evaluate the association between bilirubin levels and stroke risk.Design Systematic review and meta-analysis, reported in accordance with Meta-analysis Of Observational Studies in Epidemiology guidelines.Data sources The PubMed, Embase, Cochrane Central Register of Controlled Trials and China National Knowledge Infrastructure Databases were searched from inception up to 27 February 2022.Eligibility criteria Cohort studies assessing the dose–response relationship between bilirubin levels and risk of stroke were eligible for inclusion. There were no language restrictions.Data extraction and synthesis All data from eligible studies were collected and assessed by two independent investigators. We generated pooled relative risks (RRs) with 95% CIs. We used a restricted cubic spline model for the dose–response analyses. Subsequent subgroup analyses were conducted according to stroke outcomes, follow-up duration, geographical area and size of the cohort.Results Nine articles including results from 11 cohort studies with 7835 cases of stroke and 263 596 participants met the inclusion criteria. The summarised RR of stroke comparing the highest and lowest bilirubin level was 0.85 (95% CI 0.72 to 0.99). The dose–response analysis indicated that a 15 µmol/L increment of bilirubin level was associated with an 18% lower risk of stroke (RR=0.82, 95% CI 0.67 to 0.99). For ischaemic stroke, the RR was 0.76 (95% CI 0.58 to 0.99). Significant publication bias was not detected.Conclusions Elevated bilirubin levels were associated with a decreased risk of stroke among adults.PROSPERO registration number CRD42017071497. |
| first_indexed | 2024-04-09T13:22:58Z |
| format | Article |
| id | doaj.art-4026a38ee49e4214ad4f3ca73683ef9d |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-04-09T13:22:58Z |
| publishDate | 2023-05-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-4026a38ee49e4214ad4f3ca73683ef9d2023-05-11T00:00:05ZengBMJ Publishing GroupBMJ Open2044-60552023-05-0113510.1136/bmjopen-2022-064433Association between bilirubin levels and risk of stroke: a systematic review and meta-analysisMin Li0Zhenyu Tang1Gege Wang2Luyao Qiao3Siqi Zhou4Jun Min5Department of Radiation Oncology, Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital, Shanghai, Shanghai, ChinaDepartment of Neurology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, People`s Republic of ChinaDepartment of Neurology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, ChinaDepartment of Neurology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, ChinaDepartment of Neurology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, ChinaDepartment of Neurology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, ChinaObjective To evaluate the association between bilirubin levels and stroke risk.Design Systematic review and meta-analysis, reported in accordance with Meta-analysis Of Observational Studies in Epidemiology guidelines.Data sources The PubMed, Embase, Cochrane Central Register of Controlled Trials and China National Knowledge Infrastructure Databases were searched from inception up to 27 February 2022.Eligibility criteria Cohort studies assessing the dose–response relationship between bilirubin levels and risk of stroke were eligible for inclusion. There were no language restrictions.Data extraction and synthesis All data from eligible studies were collected and assessed by two independent investigators. We generated pooled relative risks (RRs) with 95% CIs. We used a restricted cubic spline model for the dose–response analyses. Subsequent subgroup analyses were conducted according to stroke outcomes, follow-up duration, geographical area and size of the cohort.Results Nine articles including results from 11 cohort studies with 7835 cases of stroke and 263 596 participants met the inclusion criteria. The summarised RR of stroke comparing the highest and lowest bilirubin level was 0.85 (95% CI 0.72 to 0.99). The dose–response analysis indicated that a 15 µmol/L increment of bilirubin level was associated with an 18% lower risk of stroke (RR=0.82, 95% CI 0.67 to 0.99). For ischaemic stroke, the RR was 0.76 (95% CI 0.58 to 0.99). Significant publication bias was not detected.Conclusions Elevated bilirubin levels were associated with a decreased risk of stroke among adults.PROSPERO registration number CRD42017071497.https://bmjopen.bmj.com/content/13/5/e064433.full |
| spellingShingle | Min Li Zhenyu Tang Gege Wang Luyao Qiao Siqi Zhou Jun Min Association between bilirubin levels and risk of stroke: a systematic review and meta-analysis BMJ Open |
| title | Association between bilirubin levels and risk of stroke: a systematic review and meta-analysis |
| title_full | Association between bilirubin levels and risk of stroke: a systematic review and meta-analysis |
| title_fullStr | Association between bilirubin levels and risk of stroke: a systematic review and meta-analysis |
| title_full_unstemmed | Association between bilirubin levels and risk of stroke: a systematic review and meta-analysis |
| title_short | Association between bilirubin levels and risk of stroke: a systematic review and meta-analysis |
| title_sort | association between bilirubin levels and risk of stroke a systematic review and meta analysis |
| url | https://bmjopen.bmj.com/content/13/5/e064433.full |
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