Table 1.
Associations between OSA and multiple heath outcomes
| Outcomes | Publication | Number of studies | Number of participants | Number of cases | Type of metric | Relative risk (95% CI) | P value* | P value # | I2 (%) | P value※ | Whether exist publication bias | ||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Cardiovascular disorders | |||||||||||||||||||||||||||
| Aortic dissection | Xiushi Zhou (2018) | 1 cohort study, 2 case–control studies | 55,911 | 16,019 | OR | 1.60 (1.01–2.53) | 0.04 | 0.44 | 0 | 0.58 | No | ||||||||||||||||
| Cardiovascular disease(CVD) | Xia Wang (2013) | 11 cohort studies | 25,594 | 2628 | RR | 1.79 (1.47–2.18) | < 0.001 | 0.131 | 31.5 | 0.028 | Yes | ||||||||||||||||
| Stroke | Min Li (2014) | 10 cohort studies | 18,609 | 678 | RR | 2.10 (1.50–2.93) | < 0.001 | 0.04 | 47.5 | 0.288& | No | ||||||||||||||||
| Ischemic heart disease(IHD) | Wuxiang Xie (2014) | 6 cohort studies | 1083 | 625 | RR | 1.83 (1.15–2.93) | 0.011 | 0.111 | 44.2 | 0.006 | Yes | ||||||||||||||||
| Coronary heart disease(CHD) | Chengjuan Xie (2017) | 6 cohort studies | 18,022 | 15,562 | RR | 1.63 (1.18–2.26) | 0.003 | 0.061& | 52.7& | 0.145& | No | ||||||||||||||||
| Major adverse cardiac events (MACEs) | Chengjuan Xie (2017) | 9 cohort studies | 18,022 | 15,562 | RR | 2.04 (1.56–2.66) | < 0.001 | 0.021 | 55.7 | 0.132 | No | ||||||||||||||||
| Atrial fibrillation | Irini Youssef (2018) | 4 cross-sectional studies, 5 cohort studies | 19,837 | 12,255 | OR | 2.12 (1.84–2.43) | < 0.001 | 0.004 | 64.42 | 0.097& | Yes | ||||||||||||||||
| Resistant hypertension | Haifeng Hou (2018) | 6 case -control studies | 1465 | 925 | OR | 2.84 (1.70–3.98) | < 0.001 | 0.816 | 0 | 0.187& | No | ||||||||||||||||
| Essential hypertension | Haifeng Hou (2018) | 2 case–control studies, 5 cohort studies | 7102 | 4513 | OR | 1.80 (1.54–2.06) | < 0.001 | 0.221 | 26 | 0.0526& | Yes | ||||||||||||||||
| Atrial fibrillation recurrence after catheter ablation | Chee Yuan Ng (2011) | 6 observational studies | 3995 | 958 | RR | 1.25 (1.08–1.45) | 0.003 | 0.008 | 49 | 0.879& | No | ||||||||||||||||
| major adverse cardiovascular event (MACE) after PCI | Xiao Wang (2018) | 9 observational studies | 2755 | 1581 | RR | 1.96 (1.36–2.81) | < 0.001 | 0.02 | 54 | 0.002 | Yes | ||||||||||||||||
| Stroke after PCI | Xiao Wang (2018) | 6 observational studies | 2110 | 1254 | RR | 1.55 (0.90–2.67) | 0.11 | 0.62 | 0 | 0.149& | No | ||||||||||||||||
| Myocardial infarction (MI) after PCI | Hua Qu (2018) | 6 observational studies | 2342 | 1112 | OR | 1.59 (1.14–2.23) | 0.007 | 0.32 | 15 | 0.655& | No | ||||||||||||||||
| Coronary revascularization after PCI | Hua Qu (2018) | 7 observational studies | 2415 | 1163 | OR | 1.57 (1.23–2.01) | < 0.001 | 0.7 | 0 | 0.483& | No | ||||||||||||||||
| Re-admission for heart failure after PCI | Hua Qu (2018) | 4 observational studies | 1774 | 793 | OR | 1.71 (0.99–2.96) | 0.06 | 0.86 | 0 | 0.254& | No | ||||||||||||||||
| Left ventricular hypertrophy (LVH) | Cesare Cuspidi (2020) | 9 observational studies | 3244 | 1802 | OR | 1.70 (1.44–2.00) | < 0.001 | < 0.001 | 60 | 0.0876& | Yes | ||||||||||||||||
| Left ventricular diastolic diameter (LVEDD) | LeiYu (2019) | 13 observational studies | 882 | 563 | WMD | 1.24 (0.68, 1.80) | < 0.001 | 0.658 | 0 | 0.431 | No | ||||||||||||||||
| Left ventricular systolic diameter (LVESD) | LeiYu (2019) | 11 observational studies | 630 | 396 | WMD | 1.14 (0.47, 1.81) | 0.001 | 0.696 | 0 | 0.722 | No | ||||||||||||||||
| Left ventricular mass(LVM) | LeiYu (2019) | 6 observational studies | 432 | 304 | WMD | 35.34 (20.67, 50.00) | < 0.001 | < 0.001 | 79.1 | 0.914 | No | ||||||||||||||||
| Leftventricular ejection fraction (LVEF) | LeiYu (2019) | 15 observational studies | 1104 | 710 | WMD | − 3.01 (− 1.90, − 0.79) | 0.001 | < 0.001 | 64.7 | 0.048 | Yes | ||||||||||||||||
| Left atrial diameter (LAD) | LeiYu (2019) | 7 observational studies | 468 | 311 | WMD | 2.13 (1.48, 2.77) | < 0.001 | 0.408 | 2.2 | 0.072 | Yes | ||||||||||||||||
| Left atrial diameter volume index (LAVI) | LeiYu (2019) | 3 observational studies | 228 | 159 | WMD | 3.96 (3.32, 4.61) | < 0.001 | 0.445 | 0 | 0.735 | No | ||||||||||||||||
| Right ventricular internal diameter (RVID) | Abdirashit Maripov (2017) | 16 observational studies | 1498 | 902 | WMD | 2.49 (1.62, 3.37) | < 0.001 | < 0.001 | 96.8 | 0.001 | Yes | ||||||||||||||||
| Right ventricular free wall thickness (RVWT) | Abdirashit Maripov (2017) | 9 observational studies | 976 | 579 | WMD | 0.82 (0.51, 1.13) | < 0.001 | < 0.001 | 95.6 | 0.671 | No | ||||||||||||||||
| Right ventricular myocardial performance index(RV MPI) | Abdirashit Maripov (2017) | 14 observational studies | 1298 | 864 | WMD | 0.08 (0.06, 0.10) | < 0.001 | < 0.001 | 84.1 | 0.15 | No | ||||||||||||||||
| Tricuspid annular systolic velocity (RV S′) | Abdirashit Maripov (2017) | 14 observational studies | 1030 | 639 | WMD | − 0.95 (− 0.32, − 1.59) | 0.003 | < 0.001 | 88.4 | 0.347 | No | ||||||||||||||||
| Tricuspid annular plane systolic excursion (TAPSE) | Abdirashit Maripov (2017) | 11 observational studies | 1033 | 655 | WMD | − 1.76 (− 0.78, − 2.73) | < 0.001 | < 0.001 | 89.3 | 0.462 | No | ||||||||||||||||
| Right ventricular fractional area change (RA FAC) | Abdirashit Maripov (2017) | 6 observational studies | 661 | 422 | WMD | − 3.16 (− 0.73, − 5.60) | 0.011 | < 0.001 | 80.2 | 0.006 | Yes | ||||||||||||||||
| Epicardial adipose tissue (EAT) thickness | Guang Song (2020) | 9 observational studies | 1178 | 898 | WMD | 0.95 (0.73, 1.16) | < 0.001 | < 0.001 | 64.7 | 0.549 | No | ||||||||||||||||
| Coronary flow reserve (CFR) | Rui-Heng Zhang (2020) | 1 case–control study, 4 cross-sectional studies | 1336 | 829 | WMD | ’ − 0.78 (− 0.32, − 1.25) | < 0.001 | < 0.001 | 84.4 | 0.49 | No | ||||||||||||||||
| Systolic blood pressure (SBP) | De-Lei Kong (2016) | 2 cross-sectional studies, 3 cohort studies, 1 case–control studies | 1046 | 534 | SMD | 0.56 (0.40, 0.71) | < 0.001 | 0.132 | 41.03 | NA | NA | ||||||||||||||||
| Cerebral and cerebrovascular disease | |||||||||||||||||||||||||||
| Cerebral white matter changes | Bo-Lin Ho (2018) | 10 observational studies | 1582 | 818 | OR | 2.06 (1.52–2.80) | < 0.001 | 0.025 | 48.5 | 0.338 | No | ||||||||||||||||
| Cerebrovascular (CV) disease | Zesheng Wu (2018) | 15 cohort studies | 3,120,368 | 3,117,496 | HR | 1.94 (1.31–2.89) | 0.001 | < 0.001 | 90.3 | > 0.05 | No | ||||||||||||||||
| White matter hyperintensities (WMH) | Yuhong Huang (2019) | 11 cross-sectional studies, 2 case–control studies | 4412 | 2065 | OR | 2.23 (1.53–3.25) | < 0.001 | < 0.001 | 80.3 | < 0.01 | Yes | ||||||||||||||||
| Silent brain infarction (SBI) | Yuhong Huang (2019) | 9 cross-sectional studies, 2 case–control studies, 1 cohort study | 3353 | 1893 | OR | 1.54 (1.06–2.23) | 0.023 | 0.018 | 52 | 0.605 | No | ||||||||||||||||
| Cerebral microbleeds (CMBs) | Yuhong Huang (2019) | 3 cross-sectional studies | 342 | 271 | OR | 2.17 (0.61–7.73) | 0.234 | < 0.01 | 60.2 | NA | Unclear | ||||||||||||||||
| Perivascular spaces (PVS) | Yuhong Huang (2019) | 2 cross-sectional studies | 267 | 152 | OR | 1.56 (0.28–8.57) | 0.623 | < 0.01 | 69.5 | NA | NA | ||||||||||||||||
| Asymptomatic lacunar infarction (ALI) | AnthipaChokesuwattanaskul (2019) | 6 cross-sectional studies, 1 cohort study | 1756 | 713 | OR | 1.78 (1.06–3.01) | 0.03 | 0.128& | 41 | 0.43 | No | ||||||||||||||||
| Mortality | |||||||||||||||||||||||||||
| All-cause mortality | Lei Pan (2016) | 12 cohort studies | 34,382 | 18,139 | HR | 1.26 (1.09–1.43) | 0.001 | < 0.001 | 70.4 | 0.003 | Yes | ||||||||||||||||
| Cardiovascular mortality | Xiahui Ge (2013) | 4 cohort studies | 5228 | 239 | RR | 2.21 (1.61–3.04) | < 0.001 | 0.418 | 0 | 0.448 | No | ||||||||||||||||
| All-cause death after PCI | Xiao Wang (2018) | 4 cohort studies | 1919 | 1154 | RR | 1.70 (1.05–2.77) | 0.03 | 0.71 | 0 | 0.176& | No | ||||||||||||||||
| Cardiac death after PCI | Hua Qu (2018) | 7 cohort studies | 2465 | 1187 | OR | 2.05 (1.15–3.65) | 0.01 | 0.96 | 0 | 0.828& | No | ||||||||||||||||
| Cancer mortality | Xiaobin Zhang (2017) | 3 cohort studies | 7346 | 179 | HR | 1.38 (0.79–2.41) | 0.257 | 0.004 | 66.1 | 0.205 | No | ||||||||||||||||
| Postoperative complications | |||||||||||||||||||||||||||
| Postoperative respiratory failure | Faizi Hai BA (2013) | 12 cohort studies | 5611 | 2390 | OR | 2.42 (1.53–3.84) | < 0.001 | 0.39 | 5 | 0.28 | No | ||||||||||||||||
| Postoperative cardiac events | Faizi Hai BA (2013) | 11 cohort studies | 3781 | 2109 | OR | 1.63 (1.16–2.29) | 0.005 | 0.7 | 0 | 0.187& | No | ||||||||||||||||
| Postoperative desaturation | R. Kaw (2012) | 11 cohort studies | 3645 | 1764 | OR | 2.27 (1.20–4.26) | 0.01 | < 0.001 | 68 | 0.04& | Yes | ||||||||||||||||
| Postoperative ICU transfer | R. Kaw (2012) | 9 cohort studies | 5743 | 2062 | OR | 2.81 (1.46–5.43) | 0.002 | 0.02 | 57 | 0.033& | Yes | ||||||||||||||||
| Postoperative composite endpoints of postoperative cardiac or cerebrovascular complications | Ka Ting Ng (2020) | 12 observational studies | 2,003,694 | 126,027 | OR | 1.44 (1.17–1.78) | < 0.001 | NA | 89 | NA | Unclear | ||||||||||||||||
| Postoperative myocardial infarction | Ka Ting Ng (2020) | 8 observational studies | 714,650 | NA | OR | 1.37 (1.19–1.59) | < 0.001 | NA | 36 | NA | Unclear | ||||||||||||||||
| Postoperative congestive cardiac failure | Ka Ting Ng (2020) | 3 observational studies | 2104 | NA | OR | 3.16 (1.02–9.81) | 0.05 | NA | 0 | NA | Unclear | ||||||||||||||||
| Postoperative atrial fibrillation | Ka Ting Ng (2020) | 6 observational studies | 1,463,449 | NA | OR | 1.50 (1.30–1.73) | < 0.001 | NA | 87 | NA | Unclear | ||||||||||||||||
| Postoperative cerebrovascular accident | Ka Ting Ng (2020) | 5 observational studies | 1,641,495 | NA | OR | 1.09 (0.75–1.60) | 0.65 | NA | 61 | NA | Unclear | ||||||||||||||||
| Postoperative composite endpoints of pulmonary complications | Ka Ting Ng (2020) | 8 observational studies | 1,983,748 | NA | OR | 2.52 (1.92–3.31) | < 0.001 | NA | 96 | NA | Unclear | ||||||||||||||||
| Postoperative pneumonia | Ka Ting Ng (2020) | 10 observational studies | 2,675,205 | NA | OR | 1.66 (1.17–2.35) | 0.004 | NA | 96 | NA | Unclear | ||||||||||||||||
| Postoperative reintubation | Ka Ting Ng (2020) | 9 observational studies | 2,061,268 | NA | OR | 2.29 (0.90–5.82) | 0.08 | NA | 99 | NA | Unclear | ||||||||||||||||
| Postoperative in-hospital mortality | Ka Ting Ng (2020) | 6 observational studies | 2,497,794 | NA | OR | 0.86 (0.42–1.76) | 0.68 | NA | 94 | NA | Unclear | ||||||||||||||||
| Postoperative 30-day mortality | Ka Ting Ng (2020) | 6 observational studies | 616,754 | NA | OR | 1.27 (1.03–1.57) | 0.02 | NA | 0 | NA | Unclear | ||||||||||||||||
| Postoperative acute kidney injury | Ka Ting Ng (2020) | 5 observational studies | 1,724,932 | NA | OR | 2.41 (1.93–3.02) | < 0.001 | NA | 92 | NA | Unclear | ||||||||||||||||
| Postoperative delirium | Ka Ting Ng (2020) | 6 observational studies | 2346 | NA | OR | 2.45 (1.50–4.01) | < 0.001 | NA | 2 | NA | Unclear | ||||||||||||||||
| Postoperative venoembolism | Ka Ting Ng (2020) | 10 observational studies | 2,100,013 | NA | OR | 1.63 (1.17–2.27) | 0.004 | NA | 94 | NA | Unclear | ||||||||||||||||
| Postoperative surgical site infection | Ka Ting Ng (2020) | 5 observational studies | 2962 | NA | OR | 1.30 (0.93–1.83) | 0.13 | NA | 0 | NA | Unclear | ||||||||||||||||
| Postoperative bleeding | Ka Ting Ng (2020) | 3 observational studies | 18,712 | NA | OR | 1.10 (0.40–3.01) | 0.85 | NA | 63 | NA | Unclear | ||||||||||||||||
| Postoperative length of hospital stay | Ka Ting Ng (2020) | 15 observational studies | 1,569,278 | NA | MD | 0.09 (0.00–0.17) | 0.04 | NA | 96 | NA | Unclear | ||||||||||||||||
| Pregnancy-related disorders | |||||||||||||||||||||||||||
| Gestational diabetes mellitus (GDM) | Xinge Zhang (2020 | 6 cohort studies | 2,522,547 | 139,559 | RR | 1.60 (1.21–2.12) | 0.004 | 0.003 | 69.2 | 0.4829 | No | ||||||||||||||||
| C-section | Lina Liu (2019) | 6 observational studies | NA | NA | OR | 1.42 (1.12–1.79) | < 0.001 | < 0.001 | 86.5 | NA | Unclear | ||||||||||||||||
| Pregnancy-related prolonged hospital stay | Lina Liu (2019) | 3 observational studies | NA | NA | OR | 1.94 (0.88–4.28) | 0.1 | < 0.001 | 98.6 | NA | Unclear | ||||||||||||||||
| Pregnancy-related wound complication | Lina Liu (2019) | 3 observational studies | NA | NA | OR | 1.87 (1.56–2.24) | < 0.001 | 0.883 | 0 | NA | Unclear | ||||||||||||||||
| Pregnancy-related pulmonary edema | Lina Liu (2019) | 3 observational studies | NA | NA | OR | 6.35 (4.25–9.50) | < 0.001 | 0.294 | 18.2 | NA | Unclear | ||||||||||||||||
| Small for gestational age | Lina Liu (2019) | 4 observational studies | NA | NA | OR | 1.26 (0.80–2.01) | 0.321 | 0.01 | 73.8 | NA | Unclear | ||||||||||||||||
| Stillbirth | Lina Liu (2019) | 3 observational studies | NA | NA | OR | 1.12 (0.85–1.49) | 0.413 | 0.572 | 0 | NA | Unclear | ||||||||||||||||
| Poor fetal growth | Lina Liu (2019) | 4 observational studies | NA | NA | OR | 1.15 (0.98–1.34) | 0.091 | 0.266 | 24.3 | NA | Unclear | ||||||||||||||||
| Gestational hypertension | Liwen Li (2018) | 4 cross-sectional studies, 7 cohort studies | 56,731,077 | 19,047 | OR | 1.80 (1.28–2.52) | 0.001 | 0.72 | 0 | 0.649& | No | ||||||||||||||||
| Preeclampsia | Liwen Li (2018) | 2 cross-sectional studies, 7 cohort studies | 56,097,993 | 19,776 | OR | 2.63 (1.87–3.70) | < 0.001 | < 0.01 | 78 | 0.797& | No | ||||||||||||||||
| Preterm birth | Liwen Li (2018) | 2 cross-sectional studies, 3 cohort studies | 56,746,100 | 18,337 | OR | 1.75 (1.21–2.55) | 0.003 | < 0.01 | 90 | 0.931& | No | ||||||||||||||||
| Birth weight | Liwen Li (2018) | 4 cohort studies | 4311 | 1387 | WMD | − 47.46 (− 242.09, 147.16) | 0.281 | < 0.01 | 93 | NA | No$ | ||||||||||||||||
| Neonatal intensive care unit (NICU) admission | Ting Xu (2014) | 4 cohort studies | 757 | 177 | RR | 2.65 (1.86–3.76) | < 0.001 | 0.235 | 29.6 | 0.063& | Yes | ||||||||||||||||
| Ophthalmic disorders | |||||||||||||||||||||||||||
| Diabetic retinopathy (DR) | Zhenliu Zhu (2017) | 6 case -control studies | 1092 | 608 | OR | 2.01 (1.49–2.72) | < 0.001 | 0.062 | 52.4 | 0.112& | No | ||||||||||||||||
| Keratoconus | Marco Pellegrini (2020) | 4 case–control studies, 1 cohort study | 33,844 | 16,922 | OR | 1.84 (1.16–2.91) | 0.009 | 0.003 | 74.6 | 0.07 | Yes | ||||||||||||||||
| Glaucoma | Xinhua Wu (2015) | 12 observational studies | 36,909 | 11,765 | OR | 1.65 (1.44–1.88) | < 0.001 | 0.06 | 43 | 0.335 | No | ||||||||||||||||
| Floppy eyelid syndrome (FES) | Leh-Kiong Huon (2016) | 7 cross-sectional studies | 902 | 337 | OR | 4.70 (2.98–7.41) | < 0.001 | 0.129& | 39.3& | 0.379& | No | ||||||||||||||||
| Nonarteritic anterior ischemic optic neuropathy (NAION) | Yong Wu (2015) | 4 cohort studies, 1 case–control study | 5916 | 164 | OR | 6.18 (2.00–19.11) | 0.002 | 0.002 | 77 | 0.35 | No | ||||||||||||||||
| Central serous chorioretinopathy (CSCR) | Chris Y.Wu (2018) | 6 case–control studies | 7238 | 1479 | OR | 1.56 (1.16–2.10) | 0.003 | 0.237 | 26.3 | 0.281 | No | ||||||||||||||||
| retinal nerve fiber layer (RNFL) thickness | Cheng-Lin Sun (2016) | 8 case–control studies | 1237 | 763 | WMD | − 2.92 (− 4.61, − 1.24) | 0.001 | 0.017 | 59.1 | 0.929 | No | ||||||||||||||||
| Choroidal thickness | Chris Y.Wu (2018) | 9 case–control studies | 778 | 514 | WMD | 25.52 (− 78.79, − 27.76) | 0.824 | 0.001 | 98.6 | 0.137 | No | ||||||||||||||||
| Digestive disorders | |||||||||||||||||||||||||||
| Gastroesophageal reflux disease | Zeng-Hong Wu (2019) | 1 case–control study, 6 cross-sectional studies | 2699 | 1452 | OR | 1.75 (1.18–2.59) | 0.006 | 0.04 | 54 | 0.052 | Yes | ||||||||||||||||
| Steatosis | Shanshan Jin (2018) | 3 cohort studies, 1 cross-sectional study | 1635 | 1375 | OR | 3.19 (2.34–4.34) | < 0.001 | 0.677 | 0 | 0.89 | No | ||||||||||||||||
| Lobular inflammation | Shanshan Jin (2018) | 3 cohort studies | 350 | 205 | OR | 2.85 (1.8–-4.49) | < 0.001 | 0.994 | 0 | 0.469 | No | ||||||||||||||||
| Ballooning degeneration | Shanshan Jin (2018) | 3 cohort studies | 350 | 205 | OR | 2.29 (1.36–3.84) | 0.002 | 0.774 | 0 | 0.888 | No | ||||||||||||||||
| NAFLD activity score(NAS) | Shanshan Jin (2018) | 3 cohort studies | 350 | 205 | OR | 1.63 (0.68–3.86) | 0.271 | 0.259 | 25.9 | 0.839 | No | ||||||||||||||||
| NAFLD defined by liver histology | G. Musso (2013) | 8 cross-sectional studies | 994 | 537 | OR | 2.01 (1.36–2.97) | < 0.001 | 0.4 | 4 | 0.303& | No | ||||||||||||||||
| NAFLD defined by radiology | G. Musso (2013) | 6 cross-sectional studies | 561 | 269 | OR | 2.99 (1.79–4.99) | < 0.001 | 0.33 | 13 | 0.433& | No | ||||||||||||||||
| NAFLD defined by AST elevation | G. Musso (2013) | 11 cross-sectional studies | 746 | 368 | OR | 2.36 (1.46–3.82) | < 0.001 | 0.99 | 0 | 0.65& | No | ||||||||||||||||
| NAFLD defined by ALT elevation | G. Musso (2013) | 14 cross-sectional studies | 1833 | 938 | OR | 2.60 (1.88–3.61) | < 0.001 | 0.74 | 0 | 0.179& | No | ||||||||||||||||
| Nonalcoholic steatohepatitis(NASH) | G. Musso (2013) | 10 cross-sectional studies | 1114 | 589 | OR | 2.37 (1.59–3.51) | < 0.001 | 0.81 | 0 | 0.404& | No | ||||||||||||||||
| Fibrosis | G. Musso (2013) | 10 cross-sectional studies | 1114 | 589 | OR | 2.16 (1.45–3.20) | < 0.001 | 0.67 | 0 | 0.778& | No | ||||||||||||||||
| Alanine transaminase (ALT) | Shanshan Jin (2018) | 7 cohort studies, 1 cross-sectional study | 2059 | 1684 | SMD | 0.21 (0.11, 0.31) | < 0.001 | 0.672 | 0 | 0.468 | No | ||||||||||||||||
| Aspartate transaminase (AST) | Shanshan Jin (2018) | 7 cohort studies, 1 cross-sectional study | 2059 | 1684 | SMD | 0.07 (− 0.03, 0.17) | 0.152 | 0.918 | 0 | < 0.05 | Yes | ||||||||||||||||
| Endocrine and metabolic system disorders | |||||||||||||||||||||||||||
| Type 2 diabetes (T2DM) | Ranran Qie (2020) | 16 cohort studies | 338,912 | 19,355 | RR | 1.40 (1.32–1.48) | < 0.001 | 0.045 | 40.8 | 0.221& | No | ||||||||||||||||
| Metabolic syndrome (MS) | Shaoyong Xu (2015) | 15 cross-sectional studies | 4161 | 2457 | OR | 2.87 (2.41–3.42) | < 0.001 | 0.23 | 20 | 0.232 | No | ||||||||||||||||
| Fasting blood glucose (FBG) | De-Lei Kong (2016) | 3 cross-sectional studies, 5 cohort studies, 2 case–control studies | 2053 | 1296 | SMD | 0.35 (0.18, 0.53) | < 0.001 | 0.008 | 59.69 | NA | No$ | ||||||||||||||||
| Total cholesterol (TC) | Rashid Nadeem (2014) | 63 observational studies | 18,111 | NA | SMD | 0.267 (0.146, 0.389) | 0.001 | NA | NA | NA | No$ | ||||||||||||||||
| Low-density lipoprotein (LDL) | Rashid Nadeem (2014) | 50 observational studies | 13,894 | NA | SMD | 0.296 (0.156, 0.436) | 0.001 | NA | NA | NA | No$ | ||||||||||||||||
| High-density lipoprotein (HDL) | Rashid Nadeem (2014) | 64 observational studies | 18,116 | NA | SMD | − 0.433 (− 0.604, − 0.262) | < 0.001 | NA | NA | NA | No$ | ||||||||||||||||
| Triglyceride (TG) | Rashid Nadeem (2014) | 62 observational studies | 17,831 | NA | SMD | 0.603 (0.431, 0.775) | < 0.001 | NA | NA | NA | No$ | ||||||||||||||||
| Adiponectin | Mi Lu (2019) | 20 case–control studies | 1356 | 878 | SMD | ′ − 0.71 (− 0.92, − 0.49) | < 0.001 | < 0.01 | 73 | 0.09 | Yes | ||||||||||||||||
| Oxidized low-density lipoprotein (Ox-LDL) | Reza Fadaei (2020) | 8 case -control studies | 623 | 391 | SMD | 0.95 (0.24, 1.67) | 0.009 | < 0.001 | 94.1 | < 0.161 | No | ||||||||||||||||
| Fibrinogen | Fang Lu (2019) | 25 observational studies | 3792 | 1480 | WMD | 0.38 (0.29, 0.47) | < 0.001 | < 0.001 | 80.3 | 0.208 | No | ||||||||||||||||
| Homocysteine | Kun Li (2017) | 10 observational studies | 773 | 457 | MD | 2.40 (0.60, 4.20) | 0.009 | < 0.001 | 96 | 0.947 | No | ||||||||||||||||
| Advanced glycation end products (AGEs) | Xingyu Wu (2018) | 5 cross-sectional studies | 670 | 323 | SMD | 0.98 (0.69, 1.27) | < 0.001 | 0.08 | 51 | NA | No$ | ||||||||||||||||
| Plasma renin activity(PRA) | Ze-Ning Jin (2016) | 5 case–control studies | 300 | 180 | MD | 0.17 (− 0.22, 0.55) | 0.4 | < 0.001 | 82 | NA | Unclear | ||||||||||||||||
| Plasma renin concentration(PRC) | Ze-Ning Jin (2016) | 5 case–control studies | 170 | 101 | MD | 0.95 (− 0.58, 2.48) | 0.23 | 0.001 | 78 | NA | Unclear | ||||||||||||||||
| Angiotensin II(AngII) | Ze-Ning Jin (2016) | 7 case–control studies | 384 | 207 | MD | 3.39 (2.00, 4.79) | < 0.001 | < 0.001 | 95 | 0.167 | No | ||||||||||||||||
| Aldosterone | Ze-Ning Jin (2016) | 9 case–control studies | 474 | 265 | MD | 0.95 (− 0.16, 2.07) | 0.09 | < 0.001 | 78 | 0.622 | No | ||||||||||||||||
| Serum vitamin D | Xiaoyan Li (2020) | 6 case–control studies, 21 cross-sectional studies, 2 cohort studies | 6298 | 4209 | SMD | ′ − 0.84(− 1.14, − 0.54) | < 0.001 | < 0.001 | 95 | NA | No$ | ||||||||||||||||
| Urological disorders | |||||||||||||||||||||||||||
| Diabetic kidney disease (DKD) | Wen Bun Leong (2016) | 7 cross-sectional studies | 1877 | 1159 | OR | 1.59 (1.16–2.18) | 0.004 | 0.224& | 26.8 | 0.684& | No | ||||||||||||||||
| Microalbuminuria | Tongtong Liu (2020) | 4 cross-sectional studies | 667 | 415 | RR | 2.32 (1.48–3.62) | < 0.001 | 0.578 | 0 | 0.55 | No | ||||||||||||||||
| Chronic kidney disease (CKD) | Der-Wei Hwu (2017) | 2 cohort studies, 16 cross-sectional studies | 7090 | 3720 | OR | 1.77 (1.37–2.29) | < 0.001 | < 0.001& | 87.2& | 0.011& | Yes | ||||||||||||||||
| Serum uric acid level | Tingting Shi (2019) | 14 observational studies | 5219 | 2656 | WMD | 50.25 (36.16,64.33) | < 0.001 | < 0.001 | 91.2 | 0.001 | Yes | ||||||||||||||||
| Serum cystatin C | Tongtong Liu (2020) | 7 cross-sectional studies | 1412 | 274 | SMD | 0.53 (0.42,0.64) | < 0.001 | 0.16 | 33.7 | 0.111 | No | ||||||||||||||||
| Estimated glomerular filtration rate (eGFR) | Tongtong Liu (2020) | 13 cross-sectional studies | 3344 | 657 | SMD | − 0.19 (− 0.27, − 0.12) | 0.001 | 0.057 | 33.1 | 0.516 | No | ||||||||||||||||
| Albumin/creatinine ratio(ACR) | Tongtong Liu (2020) | 3 cross-sectional studies | 740 | 88 | WMD | 0.71 (0.58, 0.84) | < 0.001 | 0.003 | 69.2 | 0.574 | No | ||||||||||||||||
| Other outcomes | |||||||||||||||||||||||||||
| Diabetic neuropathy | Xiandong Gu (2018) | 11 case -control studies | 1842 | 840 | OR | 1.84 (1.18–2.87) | 0.007 | < 0.01 | 68.6 | 0.13 | No | ||||||||||||||||
| Psoriasis | Tzong-Yun Ger (2020) | 3 cohort studies | 5,544,674 | 42,656 | RR | 2.52 (1.89–3.36) | < 0.001 | 0.95 | 0 | 0.545 | No | ||||||||||||||||
| Nocturia | Jiatong Zhou (2019) | 3 cohort studies, 8 case–control studies, 2 cross-sectional studies | 9924 | 406 | RR | 1.41 (1.26–1.59) | < 0.001 | 0.001 | 63.3 | 0.076 | Yes | ||||||||||||||||
| Allergic rhinitis | Yuan Cao (2018) | 1 cross-sectional study, 2 case–control studies, 1 cohort study | 1283 | 371 | OR | 1.73 (0.94–3.20) | 0.078 | 0.023 | 64.8 | 0.977 | No | ||||||||||||||||
| Parkinson’s disease | A-Ping Sun (2020) | 4 cohort studies, 1 case–control study | 83,449 | 26,070 | HR | 1.59 (1.36–1.85) | < 0.001 | 0.17 | 40 | 0.186 | No | ||||||||||||||||
| Erectile dysfunction | Luhao Liu (2015) | 1 cohort study, 3 case–control studies, 1 cross-sectional study | 834 | 532 | RR | 1.82 (1.12–2.97) | 0.016 | 0.002 | 76.5 | 0.077 | Yes | ||||||||||||||||
| Female sexual dysfunction | Luhao Liu (2015) | 2 case–control studies, 2 cohort studies | 438 | 149 | RR | 2.0 (1.29–3.08) | 0.002 | 0.194 | 36.4 | 0.327 | No | ||||||||||||||||
| Sexual dysfunction | Luhao Liu (2015) | 3 cohort studies, 5 case–control studies, 1 cross-sectional study | 1272 | 681 | RR | 1.87 (1.35–2.58) | < 0.001 | 0.001 | 70.1 | 0.692 | No | ||||||||||||||||
| Osteoporosis | Sikarin Upala (2016) | 2 cohort studies, 2 cross-sectional studies | 113,922 | 3141 | OR | 1.13 (0.60–2.14) | 0.703 | < 0.001 | 89.1 | 0.608& | No | ||||||||||||||||
| Gout | Tingting Shi (2019) | 3 cohort studies | 154,455 | 30,109 | HR | 1.25 (0.91–1.70) | 0.162 | < 0.001 | 91 | 0.876 | No | ||||||||||||||||
| Cancer incidence | Ghanshyam Palamaner Subash Shantha (2015) | 5 cohort studies | 112,226 | 904 | RR | 1.40 (1.01–1.95) | 0.04 | 0.04 | 60 | 0.069 | Yes | ||||||||||||||||
| Depression | Cass Edwards (2020) | 5 cohort studies | 45,056 | 10,983 | RR | 2.18 (1.47–2.88) | < 0.001 | 0.005 | 72.8 | 0.667& | No | ||||||||||||||||
| Crash risk | Stephen Tregear (2009) | 10 observational studies | 10,846 | 2214 | RR | 2.43 (1.21–4.89) | 0.013 | < 0.001 | 89 | 0.838& | No | ||||||||||||||||
| Work accidents | Sergio Garbarino (2016) | 7 cross-sectional studies | 8819 | 2738 | OR | 2.18 (1.53–3.10) | < 0.001 | 0.02 | 61 | 0.61 | No | ||||||||||||||||
| Carotid intima-media thickness (CIMT) | Min Zhou (2016) | 10 case–control studies, 8 case-sectional studies | 1896 | 1247 | SMD | 0.88 (0.65, 1.12) | < 0.001 | < 0.001 | 81 | 0.94 | No | ||||||||||||||||
*p value of significance level
#p value of Q test
※p value for Egger’s test
$The publication bias was assessed using funnel plot
&The result was reanalyzed