循环视黄醇结合蛋白 4 水平与非酒精性脂肪性肝病：系统评价和荟萃分析。

Circulating retinol binding protein 4 levels in nonalcoholic fatty liver disease: a systematic review and meta-analysis.

机构信息

Department of Clinical Laboratory, Affiliated Yancheng Hospital, School of Medicine, Southeast University, No. 75 Juchang Road, Tinghu, Yancheng, Jiangsu, 224001, People's Republic of China.

出版信息

Lipids Health Dis. 2017 Sep 20;16(1):180. doi: 10.1186/s12944-017-0566-7.

DOI:10.1186/s12944-017-0566-7

PMID:28931435

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5607593/

Abstract

BACKGROUND

Retinol binding protein 4 (RBP4) is implicated in obesity, insulin resistance and type 2 diabetes mellitus that are closely associated with nonalcoholic fatty liver disease (NAFLD). However, recent investigations regarding circulating RBP4 levels in NAFLD are conflicting. This meta-analysis is to determine whether NAFLD, non-alcoholic steatohepatitis (NASH) and simple steatosis (SS) patients have altered RBP4 levels.

METHODS

We performed a systematic search in PubMed, EMBASE and The Cochrane Library up until 18 March 2017, and 12 studies comprising a total of 4247 participants (2271 NAFLD patients and 1976 controls) were included in the meta-analysis.

RESULTS

There were no significant differences of circulating RBP4 levels in the following comparisons: (1) NAFLD patients vs controls (standardized mean differences [SMD]: 0.08; 95% CI: -0.21, 0.38); (2) NASH patients vs controls (SMD: -0.49; 95% CI: -1.09, 0.12); (3) SS patients vs controls (SMD: -0.72; 95% CI: -1.64, 0.20) and (4) NASH vs SS patients (SMD: -0.04; 95% CI: -0.32, 0.24). The results remained essentially unchanged in the comparisons between NAFLD patients and controls after excluding single individual study or bariatric studies (n = 2). No significant publication bias was detected. However, there was significant heterogeneity among studies and the subgroup and meta-regression analyses did not find the potential sources.

CONCLUSIONS

Circulating RBP4 levels may not be associated with NAFLD. Further prospective cohort studies are required to confirm these findings.

摘要

背景

视黄醇结合蛋白 4（RBP4）与肥胖、胰岛素抵抗和 2 型糖尿病密切相关，这些疾病都与非酒精性脂肪性肝病（NAFLD）密切相关。然而，最近关于 NAFLD 患者循环 RBP4 水平的研究结果存在争议。本荟萃分析旨在确定非酒精性脂肪肝（NAFLD）、非酒精性脂肪性肝炎（NASH）和单纯性脂肪变性（SS）患者的 RBP4 水平是否发生改变。

方法

我们在 PubMed、EMBASE 和 The Cochrane Library 进行了系统检索，检索截至 2017 年 3 月 18 日，共纳入 12 项研究，总计 4247 名参与者（2271 名 NAFLD 患者和 1976 名对照者）纳入荟萃分析。

结果

在以下比较中，循环 RBP4 水平没有显著差异：（1）NAFLD 患者与对照组（标准化均数差 [SMD]：0.08；95%CI：-0.21，0.38）；（2）NASH 患者与对照组（SMD：-0.49；95%CI：-1.09，0.12）；（3）SS 患者与对照组（SMD：-0.72；95%CI：-1.64，0.20）；（4）NASH 与 SS 患者（SMD：-0.04；95%CI：-0.32，0.24）。在排除单项研究或减重研究（n=2）后，NAFLD 患者与对照组之间的比较结果基本不变。未发现明显的发表偏倚。然而，研究之间存在显著的异质性，亚组和荟萃回归分析未发现潜在的来源。