Diabetes mellitus and the risk of aneurysmal subarachnoid haemorrhage: A systematic review and meta-analysis of current evidence.
Objective This systematic review aimed to define the relationship between diabetes mellitus (DM) and the risk of aneurysmal subarachnoid haemorrhage (aSAH). Methods Studies associated with DM and aSAH published until March 2016 were retrieved from Pubmed, Embase, Web of Science, and Cochrane Library databases. A random-effects model was used to calculate the relative risks (RRs) with 95% confidence intervals (CIs). Results Eighteen observational studies were retrieved. The overall RRs for DM and aSAH were RRs = 0.59 (0.44, 0.79), with moderate heterogeneity ( I2= 55.7%, Pheterogeneity= 0.000). Subgroup analysis by study quality revealed a reduced association between DM and aSAH risk in high quality studies only (RRs = 0.40, 95% CI: 0.29, 0.56; I2= 0.0%, Pheterogeneity= 0.549), therefore study quality may be a source of heterogeneity. Conclusion A potential decreased risk of aSAH in DM patients was found in high quality studies. Further studies are required to confirm this causal relationship and to investigate the biological mechanisms.
1 Department of Neurosurgery & Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, China.
Xi-Yang
XY
Yao
2 Department of Neurosurgery, Suzhou Xiangcheng People's Hospital, Suzhou, China.
Cai-Qi
CQ
Jiang
3 Department of Neurosurgery, The People's Hospital of Rugao, Jiangsu Rugao, China.
Gen-Lai
GL
Jia
1 Department of Neurosurgery & Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, China.
Gang
G
Chen
D000328:Adult; D016022:Case-Control Studies; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis* / Q000503:physiopathology; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D064887:Observational Studies as Topic; D065840:Protective Factors; D012306:Risk; D013345:Subarachnoid Hemorrhage / Q000175:diagnosis* / Q000503:physiopathology
Diabetes; intracranial aneurysm; meta-analysis; subarachnoid hemorrhage; systematic review