Intensive Care Unit, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Province, PR China.
Significance for "*" refer to co-first author.
J Intensive Care Med. 2020 Oct;35(10):1013-1025. doi: 10.1177/0885066618807124. Epub 2018 Oct 30.
Tissue inhibitor of metalloproteinase 2 (TIMP-2) and insulin-like growth factor binding protein 7 (IGFBP7) are recent promising markers for identification of cardiac surgery-associated acute kidney injury (CSA-AKI). The aim of this study was systematically and quantitatively to evaluate the accuracy of urinary TIMP-2 and IGFBP7 for the diagnosis of CSA-AKI.
Three databases including PubMed, ISI web of knowledge, and Embase were systematically searched from inception to March 2018. Two investigators conducted the processes of literature search study selection, data extraction, and quality evaluation independently. Meta-DiSc and STATA were used for all statistical analyses.
A total of 8 studies comprising 552 patients were included in this meta-analysis. Pooled sensitivity and specificity with corresponding 95% confidence intervals (CIs) were 0.79 (95% CI, 0.71-0.86, = 74.2%) and 0.76 (95% CI, 0.72-0.80, = 80.8%), respectively. Pooled positive likelihood ratio (LR), negative LR, and diagnostic odds ratio were 3.49 (95% CI, 2.44-5.00, = 61.5%), 0.31(95% CI, 0.19-0.51, = 51.8%), and 14.89 (95% CI, 7.31-30.32, = 27.9%), respectively. The area under curve estimated by summary receiver operating characteristic was 0.868 (standard error [SE] 0.032) with a Q* value of 0.799 (SE 0.032). Sensitivity analysis demonstrated that one study notably affected the stability of pooled results. One of the subgroups investigated-AKI threshold-could account for partial heterogeneity.
Urinary TIMP-2 and IGFBP7 is a helpful biomarker for early diagnosis of CSA-AKI. And, the potential of this biomarker with a broader spectrum of clinical settings may be the focus of future studies.
组织金属蛋白酶抑制剂 2（TIMP-2）和胰岛素样生长因子结合蛋白 7（IGFBP7）是最近用于鉴定心脏手术相关急性肾损伤（CSA-AKI）的有前途的标志物。本研究的目的是系统地定量评估尿 TIMP-2 和 IGFBP7 对 CSA-AKI 的诊断准确性。
从开始到 2018 年 3 月，我们系统地检索了包括 PubMed、ISI web of knowledge 和 Embase 在内的三个数据库。两名研究者独立进行文献搜索、研究选择、数据提取和质量评估。所有统计分析均使用 Meta-DiSc 和 STATA。
共有 8 项研究（共 552 例患者）纳入了本荟萃分析。合并的敏感性和特异性及其相应的 95%置信区间（CI）分别为 0.79（95%CI，0.71-0.86， = 74.2%）和 0.76（95%CI，0.72-0.80， = 80.8%）。合并阳性似然比（LR）、阴性 LR 和诊断比值比分别为 3.49（95%CI，2.44-5.00， = 61.5%）、0.31（95%CI，0.19-0.51， = 51.8%）和 14.89（95%CI，7.31-30.32， = 27.9%）。汇总受试者工作特征曲线下面积估计值为 0.868（标准误 [SE] 0.032），Q* 值为 0.799（SE 0.032）。敏感性分析表明，有一项研究显著影响了合并结果的稳定性。一个亚组研究（AKI 阈值）可以部分解释异质性。
尿 TIMP-2 和 IGFBP7 是 CSA-AKI 早期诊断的有用生物标志物。并且，该生物标志物在更广泛的临床环境中的潜力可能是未来研究的重点。
