Meta Analysis Of The Risk Factors Of Stroke In Chinese Youth And Middle-aged Adults

Objection To provide for decision-making on stroke prevention , through investigating the correlation and evaluate the correlation degree between stroke and the following factors including hypertension,hyperlipidemia,family history of stroke,past history of cadiopathy,family history of hypertension,diabetes,over weight,alcohol drinking,smoking, oral contraceptive use,polymorphism of MTHFR gene in Chinese youth and middle-aged adults using meta-analysis method.Method After collecting 21 epidemiology literatures domestic from January 1994 to June 2007 that reported on correlations between stroke in Chinese youth and middle-aged adults and the following factors including hypertension,hyperlipidemia,family history of stroke,past history of cadiopathy,family history of hypertension,diabetes,over weight,alcohol drinking,smoking,oral contraceptive use,polymorphism of MTHFR gene ,Meta-analysis and cumulative Meta analysis are processed using Review Manager 4.2 program, selecting fixed or random model based on the heterogeneity test. Sensitivity analysis is done to the different results; the publication bias is evaluated by funnel plots and fail-safe number.Results Totally, 21 epidemiological studies were analyzed synthetically by Meta-analysis. The cumulative cases and controls were 4743 and 17901, respectively. The pooled odds ratio (OR) values and 95% CI were as follows: hypertension 7.12(5.16-9.03),hyperlipidemia 4.67(2.72-8.03),family history of stroke 4.23(2.22-8.06),past history of cadiopathy 4.19(1.56-11.27 ),family history of hypertension 3.85(2.13-6.97),diabetes 2.78(1.88-4.11),over weight 2.65(2.23-3.16),alcohol drinking 2.03(1.57-2.62),smoking1.74 (1.33-2.27),respectively (P <0. 05 for all).oral contraceptive use 2.30(0.59-8.97),polymorphism of MTHFR gene 1.05(0.49-2.24),respectively (P>0.05 for all).The cumulative meta-analysis results showed significant including difference in each point between stroke and all the factors, point estimate of OR and 95% confidence interval (95%CI) go stable as the increasing of sample size.Sensitivity analysis is carried out to different factors. Sensitivity analysis results are similar to the original results, which prove that the conclusion of this research work is stable and reliable.The funnel plots for all risk factors are all symmetrical by the fail-safe number are more than showing that the publication bias is under control.Conclusion1. The main factors influencing the incidence of stroke in Chinese youth and middle-aged adults currently are hypertension,hyperlipidemia,family history of stroke,past history of cadiopathy,family history of hypertension,diabetes,over weight,alcohol drinking,smoking.2. Using OR as effect guideline and under the Wynder stander, there are moderate correlation between stroke in Chinese young and middle-aged adults and the following factors: hypertension,hyperlipidemia,family history of stroke,past history of cadiopathy,family history of hypertension,diabetes,over weight,alcohol drinking ;and there are weak correlation between stroke in Chinese young and middle-aged adults and smoking.3. Cumulative meta-analysis outcomes showed the dynamic changing of the correlation between the risk factors and stroke in Chinese young and middle-aged adults, suggesting a stable relationship.4. The sensitivity analysis and publication bias estimation show that the outcomes of this research work is stable and reliable which can authentically reflect the epidemiology research status on risk factors to stroke in Chinese young and middle-aged adults in the latest decade.