Center for Research and Development, Angeles University Foundation, Angeles City, Philippines.
Department of Medical Technology, College of Allied Medical Professions, Angeles University Foundation, Angeles City, Philippines.
PLoS One. 2018 Dec 17;13(12):e0208905. doi: 10.1371/journal.pone.0208905. eCollection 2018.
Managing nephropathy associated with diabetes mellitus warrant investigation of relevant biomarkers in predicting this condition. Adiponectin (ADP) may hold promise as a biomarker for diabetic nephropathy (DN). In this study, we examine associations of ADP with DN by meta-analyzing relevant literature. We also examined the predictive potential of ADP and estimate progression of DN.
Multi-database literature searches and serial omissions of articles yielded 13 studies for inclusion in the meta-analysis. We compared ADP levels between controls/ normoalbuminuria and cases with micro- and macroalbuminuria (MI and MA, respectively) as well as MI versus MA using standardized mean differences (SMD). Associations of ADP with DN were indicated with the P-value considered significant at ≤ 0.05. Subgrouping was based on diabetes type (1 and 2). Predictive potential of ADP was explored with AUC (area under the curve) derived from Receiver Operating Characteristic curve analysis.
At high P-values of <10-5, overall and subgroup outcomes indicated ADP associations with DN (up to SMD = 1.89-2.26, respectively). However, heterogeneity of the initial SMD effects (up to I2 = 99%) warranted examination of their sources which with the Galbraith plot method, either eliminated or reduced their heterogeneity, signifying combinability of the studies. This feature along with consistency of significant associations, robust outcomes and significant AUC values provide good evidence of the associative and predictive roles of ADP in DN.
管理与糖尿病相关的肾病需要研究相关的生物标志物来预测这种情况。脂联素（ADP）可能是糖尿病肾病（DN）的生物标志物。在这项研究中，我们通过荟萃分析相关文献来检查 ADP 与 DN 的相关性。我们还检查了 ADP 的预测潜力，并估计了 DN 的进展。
多数据库文献检索和文章的连续遗漏产生了 13 项研究，纳入荟萃分析。我们比较了对照组/正常白蛋白尿和微量白蛋白尿（MI）和大量白蛋白尿（MA）病例之间的 ADP 水平，以及 MI 与 MA 之间的 ADP 水平，使用标准化均数差值（SMD）。当 P 值≤0.05 时，认为 ADP 与 DN 之间存在关联具有统计学意义。亚组分析基于糖尿病类型（1 型和 2 型）。通过接收者操作特征曲线分析得出的 AUC（曲线下面积）来探索 ADP 的预测潜力。
在高 P 值<10-5 的情况下，总体和亚组结果表明 ADP 与 DN 相关（最高 SMD 值为 1.89-2.26）。然而，初始 SMD 效应的异质性（高达 I2 = 99%）需要检查其来源，通过 Galbraith 绘图法，要么消除了它们的异质性，要么降低了它们的异质性，表明这些研究具有可组合性。这一特征以及一致的显著关联、稳健的结果和显著的 AUC 值，为 ADP 在 DN 中的关联和预测作用提供了很好的证据。
