fcmedicineФундаментальная и клиническая медицинаFundamental and Clinical Medicine2500-07642542-0941КемГМУ10.23946/2500-0764-2023-8-4-101-114fcmedicine-799Research ArticleОБЗОРНЫЕ СТАТЬИREVIEW ARTICLESФакторы риска болезни Альцгеймера. Систематический обзор и мета-анализRisk factors for the alzheimer's disease. Systematic review and meta-analysishttps://orcid.org/0000-0003-4282-9119ХасановаГ. Р.KhasanovaG. R.

Хасанова Гульшат Рашатовна - доктор медицинских наук, профессор, заведующий кафедрой эпидемиологии и доказательной медицины.

420012, Казань, ул. Бутлерова, д. 49

Gulshat R. Khasanova - MD, DSc, Professor, Head of the Department of Epidemiology and Evidence-Based Medicine of the Kazan State Medical University.

49, Butlerov Street, Kazan, 420012

https://orcid.org/0000-0003-1732-6974МузаффароваМ. Ш.MuzaffarovaM. Sh.

Музаффарова Миляуша Шамилевна - специалист-эксперт отдела эпидемиологического надзора.

420111, Казань, ул. Большая Красная, д. 30

Milyausha Sh. Muzaffarova - MD, specialist-expert of the Epidemiological Surveillance Department of the Federal Service for Supervision of Consumer Rights Protection and Human Welfare in the Republic of Tatarstan (Tatarstan).

30 B. Krasnaya Street, 420111, Kazan

Shamilevnamed@mail.ruФГБОУ ВО «Казанский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияKazan State Medical UniversityRussian FederationУправление Федеральной службы по надзору в сфере защиты прав потребителей и благополучия человека по Республике Татарстан (Татарстан)РоссияThe office of the Federal service for supervision of consumer rights protection and human welfare (Rospotrebnadzor) in the Republic of TatarstanRussian Federation20230201202484101114Copyright © Хасанова Г.Р., Музаффарова М.Ш., 20242024Хасанова Г.Р., Музаффарова М.Ш.Khasanova G.R., Muzaffarova M.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://fcm.kemsmu.ru/jour/article/view/799

«Старение» населения актуализировало исследования в области эпидемиологии хронических заболеваний, в т.ч. болезни Альцгеймера (БА) - наиболее распространенной в популяции причины деменции.

Цель

Цель. Оценка роли потенциальных факторов риска БА путем проведения систематического обзора и мета-анализа.

Материалы и методы

Материалы и методы. С использованием электронных баз данных PubMed, Scopus, E-library проведен поиск статей на русском и английском языках», опубликованных с 1995 по 2022 гг. В соответствии с клиническим вопросом по формуле PECO отбирали работы, в которых авторы исследовали роль различных факторов риска в группах с БА и без нее. Исследование выполнено в соответствии с международными рекомендациями по написанию систематических обзоров и мета-анализов «PRISMA». Качество исследований анализировали по шкале Ньюкасл-Оттава для статей типа когортных и «случай-контроль». Степень гетерогенности оценивали с использованием критерия «хи-квадрат» и коэффициента I2. Публикационное смещение анализировали с помощью построения воронкообразной диаграммы. Использовали программное обеспечение Review Manager 5.3 и Microsoft Office Excel 2010.

Результаты

Результаты. Изначально из баз данных было извлечено 3197 статей; после скрининга и анализа на приемлемость в мета-анализ были включены 17 исследований (11 исследований - типа «случай-контроль» и 6 - когортных). В совокупности эти публикации включали данные 134 732 респондентов с подтвержденным диагнозом БА и 1 058 143 респондентов - без БА (контрольная группа). По результатам проведенного мета-анализа значимыми факторами риска явились: наследственность (отношение шансов (ОШ) 1,82; 95% доверительный интервал (95% ДИ) 1,66-1,99), артериальная гипертензия (ОШ 1,65; 95% ДИ 1,29-2,13), гиперхолестеринемия (ОШ 1,25; 95% ДИ 1,13-1,38), ожирение (ОШ 1,13; 95% ДИ 1,09-1,17), наличие сахарного диабета 2-го типа (ОШ 1,36; 95%; ДИ 1,15-1,62), низкий уровень образования (ОШ 1,61; 95% ДИ 1,18-2,18), депрессия (ОШ 1,35; 95% ДИ 1,03-1,76). Не выявлена связь с употреблением алкоголя, курением, наличием в анамнезе перенесенного инфаркта миокарда и/или ишемической болезни сердца, наличием в анамнезе перенесенного острого нарушения мозгового кровообращения, бессонницей, женским полом, черепно-мозговыми травмами.

Заключение

Заключение. Проведенный мета-анализ позволил получить подтверждение роли различных потенциальных факторов риска БА; при этом многие из них являются модифицируемыми и связаны с метаболическими нарушениями, на фоне которых, возможно, и происходит процесс накопления и отложения в клетках нервной системы бета-амилоида, что играет решающую роль в патогенезе заболевания. Продолжение исследований данного вопроса могло бы способствовать разработке прогностических шкал и персонифицированных рекомендаций профилактики этого неизлечимого на данный момент заболевания.

The “aging” of the population increased the importance of researches in the field of the epidemiology of chronic diseases, including Alzheimer's disease (AD) -the most common cause of dementia in the population.

Aim

Aim. The role of potential risk factors for AD through a systematic review and meta-analysis. The “aging” of the population has updated research in the field of the epidemiology of chronic diseases, incl. Alzheimer's disease (AD) is the most common cause of dementia in the population. The aim of the study was to assess the role of potential risk factors for AD through a systematic review and meta-analysis.

Materials and Methods

Materials and Methods. Using the electronic databases PubMed, Scopus, E-library, a search was made for articles in Russian and English, published from 1995 to 2022. In accordance with the clinical question, using the PECO formula, papers were selected in which the authors investigated the role of various risk factors in groups with and without AD. The study was carried out in accordance with the international guidelines for writing systematic reviews and meta-analyses "PRISMA". Study quality was analyzed using the Newcastle-Ottawa scale for cohort and case-control studies. The degree of heterogeneity was assessed using the chi-square test and the I2 coefficient. Publication bias was analyzed using a funnel plot. We used the software Review Manager 5.3 and Microsoft Office Excel 2010.

Results

Results. Initially, 3197 articles were retrieved from the databases; After screening and eligibility analysis, 17 studies were included in the me-ta-analysis (11 case-control studies and 6 cohort studies). Totally, these publications included data from 134,732 people with a confirmed diagnosis of AD and 1,058,143 respondents without AD (control group). According to the results of the meta-analysis, significant risk factors were: heredity (odds ratio (OR) 1.82; 95% confidence interval (95% CI) 1.66-1.99), arterial hypertension (OR 1.65; 95% CI 1.29-2.13), hypercholesterolemia (OR 1.25; 95% CI 1.13-1.38), obesity (OR 1.13; 95% CI 1.09-1.17), presence of diabetes mellitus 2 type (OR 1.36; 95%; CI 1.15-1.62), low level of education (OR 1.61; 95% CI 1.18-2.18), depression (OR 1.35; 95% CI 1.03-1.76). There was no relationship with alcohol consumption, smoking, a history of myocardial infarction and / or coronary heart disease, a history of acute cerebrovascular accident, insomnia, female gender, traumatic brain injury.

Conclusion

Conclusion. The conducted meta-analysis allowed to obtain confirmation of the role of various potential risk factors for AD; at the same time, many of them are modifiable and are associated with metabolic disorders, which can probably be involved into the process of accumulation and deposition of beta-amyloid in the cells of the nervous system. Continued research on this issue could contribute to the development of prognostic scales and personalized recommendations for the prevention of this currently incurable disease.

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The authors declare that there are no conflicts of interest present.