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脂联素作为代谢综合征检测生物标志物的荟萃分析

Meta-Analysis of Adiponectin as a Biomarker for the Detection of Metabolic Syndrome.

作者信息

Liu Zhengtao, Liang Shuheng, Que Shuping, Zhou Lin, Zheng Shusen, Mardinoglu Adil

机构信息

Key Laboratory of Combined Multi-Organ Transplantation, Ministry of Public Health and Key Laboratory of Organ Transplantation of Zhejiang Province, Hangzhou, China.

Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.

出版信息

Front Physiol. 2018 Sep 19;9:1238. doi: 10.3389/fphys.2018.01238. eCollection 2018.

Abstract

Previous studies revealed the potential significance of circulating adiponectin levels with respect to the diagnosis and prediction of metabolic syndrome, but uncertainty has been noted across different cohorts. Systematic evaluation was performed for diagnostic accuracy and predictivity of adiponectin variation for metabolic syndrome in enrolled studies including 1,248 and 6,020 subjects, respectively. Adiponectin can identify metabolic syndrome with moderate accuracy (area under the curve = 0.81, 95% CI: 0.77-0.84). Heterogeneity analysis revealed that an increasing index of insulin resistance was independently associated with improving the performance of adiponectin upon metabolic syndrome diagnosis (ratio of diagnostic odds ratio = 3.89, 95% CI: 1.13-13.9). In addition, reductions in adiponectin were associated with increasing metabolic syndrome incidence in a linear dose-response manner. The risk of hypoadiponectinemia with metabolic syndrome was especially increased in men ( < 0.05). Further Mendelian randomization analysis identified that the amplified risk could be attributed to increased susceptibility (up to 7%) to insulin resistance compared with women. In conclusion, adiponectin measurement might have potential benefits in the detection of metabolic syndrome. Factors that affect insulin resistance should be considered for adjustment in future assessments.

摘要

先前的研究揭示了循环脂联素水平在代谢综合征诊断和预测方面的潜在意义,但不同队列研究结果存在不确定性。分别对纳入1248名和6020名受试者的研究中脂联素变化对代谢综合征的诊断准确性和预测性进行了系统评价。脂联素能够以中等准确性识别代谢综合征(曲线下面积=0.81,95%CI:0.77-0.84)。异质性分析显示,胰岛素抵抗指数增加与脂联素在代谢综合征诊断中的性能改善独立相关(诊断比值比之比=3.89,95%CI:1.13-13.9)。此外,脂联素降低与代谢综合征发病率呈线性剂量反应关系增加。男性发生代谢综合征伴低脂联素血症的风险尤其增加(<0.05)。进一步的孟德尔随机化分析表明,与女性相比,风险增加可归因于胰岛素抵抗易感性增加(高达7%)。总之,测量脂联素在代谢综合征检测中可能具有潜在益处。未来评估中应考虑影响胰岛素抵抗的因素进行调整。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/08ab/6176651/1cdb93bacc1f/fphys-09-01238-g0001.jpg

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