Sun Qiang, Zhang Zhenhai, Zhang Hong, Liu Xiaorong
Beijing Children's Hospital affiliated to Capital Medical University, Nephrology Department, Beijing Key Laboratory of Pediatric Chronic Kidney Disease and Blood Purification, Beijing, 100045, China.
The Affiliated Bayi Brain Hospital, The Military General Hospital of Beijing PLA, Beijing, 100053, China.
PLoS One. 2016 Nov 21;11(11):e0166700. doi: 10.1371/journal.pone.0166700. eCollection 2016.
Galactose-deficient IgA1 was evaluated in patients with IgA nephropathy(IgAN) and controls in order to determine the predictive value of galactose-deficient IgA1 in cases of IgA nephropathy.
PubMed, EMBASE, Cochrane central register of controlled trials, CNKI, CBM disc, and VIP database were searched to identify eligible studies that evaluated a difference in aberrant IgA1 glycosylation in IgAN patients compared with controls. A meta-analysis was conducted to evaluate the impact of galactose-deficient IgA1(Gd-IgA1) levels in different groups.
A total of 22 studies (n = 1657) met inclusion criteria. The mean Newcastle-Ottawa Scale (NOS) score was 7.2 and ranged from 6 to 8. The standard mean difference(SMD) in the meta-analysis of 20 studies of the level of Gd-IgA1 in the serum and/or supernatant of cultured cells was higher in the IgAN group compared with healthy controls as well as in those with other renal diseases (SMD = 1.76, 95% CI = 1.18-2.34, P<0.00001; SMD = 1.05, 95% CI = 0.05-2.04, P = 0.04). The data synthesis suggested that IgAN patients had similar levels of serum Gd-IgA1, with no significant differences, compared with first-degree relatives and Henoch-Schonlein purpura nephritis (HSPN) patients (MD = 0.04, 95% CI = 0.00-0.08, P = 0.05; MD = -46.03, 95% CI = -217.70-125.64, P = 0.60). In addition, the combined MD of 5 studies indicated that there were no significant differences in Gd-IgA1 levels among patients with varying severities of IgAN (MD = 0.02, 95% CI = -0.02-0.05, P = 0.28).
The pooled evidence suggests that the level of Gd-IgA1 in the serum or supernatant of cultured cells from peripheral blood or tonsils may be a useful biomarker for predicting IgA nephropathy, though the level of Gd-IgA1 was not significantly associated with disease severity.
对IgA肾病(IgAN)患者及对照者的半乳糖缺陷型IgA1进行评估,以确定半乳糖缺陷型IgA1在IgA肾病病例中的预测价值。
检索PubMed、EMBASE、Cochrane对照试验中央注册库、中国知网、中国生物医学文献数据库和维普数据库,以识别评估IgAN患者与对照者异常IgA1糖基化差异的合格研究。进行荟萃分析以评估不同组中半乳糖缺陷型IgA1(Gd-IgA1)水平的影响。
共有22项研究(n = 1657)符合纳入标准。纽卡斯尔-渥太华量表(NOS)平均评分为7.2分,范围为6至8分。在对20项关于血清和/或培养细胞上清液中Gd-IgA1水平的研究进行的荟萃分析中,IgAN组的标准平均差(SMD)高于健康对照者以及其他肾脏疾病患者(SMD = 1.76,95%CI = 1.18 - 2.34,P < 0.00001;SMD = 1.05,95%CI = 0.05 - 2.04,P = 0.04)。数据综合分析表明,与一级亲属和过敏性紫癜性肾炎(HSPN)患者相比,IgAN患者的血清Gd-IgA1水平相似,无显著差异(MD = 0.04,95%CI = 0.00 - 0.08,P = 0.05;MD = -46.03,95%CI = -217.70 - 125.64,P = 0.60)。此外,5项研究的合并MD表明,不同严重程度的IgAN患者之间Gd-IgA1水平无显著差异(MD = 0.02,95%CI = -0.02 - 0.05,P = 0.28)。
汇总证据表明,外周血或扁桃体培养细胞的血清或上清液中Gd-IgA1水平可能是预测IgA肾病的有用生物标志物,尽管Gd-IgA1水平与疾病严重程度无显著相关性。