Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China.
Anhui Province Key Laboratory of Major Autoimmune Diseases, 81 Meishan Road, Hefei, Anhui, China.
Curr Pharm Des. 2019;25(10):1091-1098. doi: 10.2174/1381612825666190319124009.
Insulin-like growth factor-1 (IGF-1) levels have been investigated in rheumatoid arthritis (RA), however, produced inconsistent results. The purpose of this meta-analysis was to derive a more precise conclusion about serum/plasma IGF-1 levels in RA patients.
PubMed, Embase and the Cochrane Library databases were searched up to December 2018 in English, and the studies comparing serum/plasma IGF-1 levels between RA group and healthy control group were what we are interested in. The Newcastle-Ottawa Scale (NOS) was used to assess the methodological quality of the included studies. The heterogeneity test was performed by the Cochrane Q statistic and I2 -statistic. The publication bias was evaluated by the funnel plot and Egger's test. The standard mean difference (SMD) with 95% confidence interval (CI) was calculated by the fixed-effects or random-effects model.
A total of eleven articles with 334 cases and 261 controls were finally included. Compared with the healthy group, the RA group had lower circulating IGF-1 levels (pooled SMD= -0.936, 95% CI= -1.382 to -0.489, p<0.001). The subgroup analysis showed that RA patients from Asia (SMD= -0.645, 95% CI= -1.063 to -0.228, p= 0.002) and Europe (SMD= -1.131, 95% CI= -1.767 to -0.495, p<0.001) had lower circulating IGF-1 levels, no significant difference in plasma/serum IGF-1 levels was observed in RA patients from America. Sensitivity analysis indicated the stability and credibility of the overall effect sizes.
Patients with RA have lower circulating IGF-1 level than healthy controls, particularly for patients from Asia and Europe. Further studies are necessary to elucidate the role of IGF-1 in the pathological process of RA.
胰岛素样生长因子-1（IGF-1）水平在类风湿关节炎（RA）中已有研究，但结果不一致。本荟萃分析旨在更准确地得出 RA 患者血清/血浆 IGF-1 水平的结论。
检索了 2018 年 12 月前在英文数据库 PubMed、Embase 和 Cochrane Library 中的研究，对比较 RA 组和健康对照组血清/血浆 IGF-1 水平的研究感兴趣。采用 Newcastle-Ottawa 量表（NOS）评估纳入研究的方法学质量。采用 Cochrane Q 统计量和 I2 统计量进行异质性检验。采用漏斗图和 Egger 检验评估发表偏倚。采用固定效应模型或随机效应模型计算标准均数差（SMD）及其 95%置信区间（CI）。
共纳入 11 篇文章，包含 334 例 RA 患者和 261 例对照。与健康组相比，RA 组循环 IGF-1 水平较低（汇总 SMD=-0.936，95%CI=-1.382 至-0.489，p<0.001）。亚组分析显示，来自亚洲（SMD=-0.645，95%CI=-1.063 至-0.228，p=0.002）和欧洲（SMD=-1.131，95%CI=-1.767 至-0.495，p<0.001）的 RA 患者循环 IGF-1 水平较低，而来自美洲的 RA 患者血浆/血清 IGF-1 水平无显著差异。敏感性分析表明，总体效应大小稳定且可信。
RA 患者的循环 IGF-1 水平低于健康对照者，特别是来自亚洲和欧洲的患者。需要进一步研究以阐明 IGF-1 在 RA 病理过程中的作用。
