A Meta-Analysis Of Homocysteine As A Risk Factor For Pediatric Arterial Ischemic Stroke

Objective: To investigate the link of homocysteine(Hcy)with Pediatric Arterial Ischemic Stroke(PAIS).Method: The databases were searched from CNKI,Wanfang,Weipu,EBSCO,Pub Med and Cochrane library(Date: January 1995?February 2017).Presence of Hcy and PAIS were collected.The quality of literatures was evaluated according to the Cochrane systematic evaluation method.The odds ratio(OR)of high serum Hcy and the serum Hcy level in PAIS and the control group were selected as effective indicators.The results of the selected literatures were recorded,the inspection of heterogeneity,the OR of high serum Hcy and the serum Hcy level were analysis by using stata software,and the sources of heterogeneity were explored by single factor meta regression analysis.Result: According to the inclusion and exclusion criteria,seven literatures were screening into the Meta-analysis.1.There were five literatures were enrolled into the Meta-analysis with the OR of high serum Hcy.The results showed that a total of 694 patients were included in this analysis,192 cases of PAIS group and 502 cases of healthy children.Heterogeneity was examined,chi-square = 8.55,the degree of freedom is 4,I2 = 53.2%(P = 0.073).The merged OR was 4.473(CI: 2.13,9.38),and the Overall effect test Z = 3.96(P < 0.01)by using fixed effects model,which showed that statistical significance was existed.2.There were four literatures were enrolled into the Meta-analysis with the Serum Hcy levels.The results showed that a total of 4389 patients were included in this analysis,195 cases of PAIS group and 4230 cases of healthy children.Heterogeneity was examined,chi-square = 8.56,the degrees of freedom is 3,I2 = 65.0%(P = 0.036),heterogeneity was large.The merged SMD was 0.097(CI:-0.223,0.416),and the Overall effect test Z =0.059(P=0.552)by using random-effects model,which showed that there was no statistical significance.Conclusion: 1.Compared to the healthy children,high proportion of High serum Hcy levels could be seen in patients with PAIS,which suggested high blood serum Hcy levels may increase the risk of PAIS.2.Dispute was existed in the studies of whether serum level of Hcy is abnormal in PAIS,there is no adequate clinical evidence suggesting significant difference between patients of PAIS and healthy children.