Department of Nephrology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, 300112, Tianjin, People's Republic of China.
Department of Nephrology, First Central Hospital of Tianjin, 300192, Tianjin, People's Republic of China.
Int Urol Nephrol. 2019 Jun;51(6):1005-1011. doi: 10.1007/s11255-019-02123-3. Epub 2019 Apr 8.
Galectin-3 as a β-galactoside-binding lectin, which has served important functions in numerous biological activities including cell growth, apoptosis, pre-mRNA splicing, differentiation, transformation, angiogenesis, inflammation, fibrosis, and host defense, may be used in prediction of clinical outcomes in CKD patients. However, the given results remain debatable and inconclusive. Hence, we performed a comprehensive meta-analysis to clarify the predictive value of galectin-3 in patients with CKD, especially ESRD patients going on dialysis.
PubMed and Embase electronic databases were searched to identify eligible studies reporting the association between galectin-3 and adverse outcomes in CKD patients. We searched the literatures published October 2018 or earlier. We used both fix-effects and random-effects models to calculate the overall effect estimate. An I > 50% indicates at least moderate statistical heterogeneity. A sensitivity analysis and subgroup analysis were performed to find the origin of heterogeneity.
We ultimately enrolled five studies with a total of 5226 patients in this meta-analysis. The result showed that high galectin-3 levels were associated with increased risk of all-cause mortality and cardiovascular (CV) events in CKD patients. For every 1% increased in galectin-3, the risk of all-cause mortality increased by 37.9% (HR 1.379, 95% CI 1.090-1.744). Much more, the risk of CV events in CKD patients was also significantly increased (HR 1.054, 95% CI 1.007-1.102) with no statistical heterogeneity among the studies (I = 0.0%, p = 0.623). However, there was no statistical difference between the risk of all-cause mortality and galectin-3 in HD patients (HR 1.171, 95% CI 0.963-1.425).
Our meta-analysis suggests that high levels of galectin-3 may increase the risk of all-cause mortality and CV events in CKD patients, however, probably not a sensitive biomarker for outcomes in HD patients. Further studies were warranted to validate our findings.
半乳糖凝集素-3 是一种 β-半乳糖苷结合凝集素，在细胞生长、凋亡、前体 mRNA 剪接、分化、转化、血管生成、炎症、纤维化和宿主防御等众多生物学活性中发挥重要作用，可用于预测 CKD 患者的临床结局。然而，这些结果仍存在争议，尚无定论。因此，我们进行了一项综合荟萃分析，以阐明半乳糖凝集素-3 在 CKD 患者，尤其是接受透析的终末期肾病患者中的预测价值。
检索 PubMed 和 Embase 电子数据库，以确定报告半乳糖凝集素-3 与 CKD 患者不良结局之间关联的合格研究。我们检索了 2018 年 10 月或更早发表的文献。我们使用固定效应和随机效应模型来计算总体效应估计。I ＞50% 表示至少存在中度统计学异质性。进行敏感性分析和亚组分析以确定异质性的来源。
我们最终纳入了这项荟萃分析中的五项研究，共 5226 例患者。结果表明，半乳糖凝集素-3 水平升高与 CKD 患者全因死亡率和心血管（CV）事件风险增加相关。半乳糖凝集素-3 每增加 1%，全因死亡率的风险增加 37.9%（HR 1.379，95% CI 1.090-1.744）。此外，CKD 患者的 CV 事件风险也显著增加（HR 1.054，95% CI 1.007-1.102），但研究之间无统计学异质性（I = 0.0%，p = 0.623）。然而，在 HD 患者中，全因死亡率与半乳糖凝集素-3 之间无统计学差异（HR 1.171，95% CI 0.963-1.425）。
本荟萃分析表明，半乳糖凝集素-3 水平升高可能增加 CKD 患者全因死亡率和 CV 事件风险，但可能不是 HD 患者结局的敏感生物标志物。需要进一步的研究来验证我们的发现。
