Department of Central Laboratory, the First Affiliated Hospital, Xi'an Medical University, Xi'an, Shaanxi, 710077, PR China.
Clinical Medicine (three-year program) of Postgrade 2016, Xi'an Medical University, Xi'an, Shaanxi, 710021, PR China.
Endocrine. 2019 Aug;65(2):227-237. doi: 10.1007/s12020-019-01982-1. Epub 2019 Jun 26.
The prevalence of non-alcoholic fatty liver disease (NAFLD) is rapidly increasing worldwide. A number of researchers have studied the relationship between Insulin-like growth factor-1(IGF-1) and NAFLD. However, the results are controversial. This meta-analysis, aimed to systemically evaluate the correlation between IGF-1 and NAFLD.
We searched for four online databases: PubMed, Web of Science, Embase and CNKI up to Feb 2018. We then applied a random-effects model to evaluate the overall effect sizes by calculating Standard mean difference (SMD) and its 95% confidence intervals (CIs).
Twelve articles were included in this meta-analysis. The pooled analysis showed that the level of IGF-1 in the control group was significantly higher than that in the NAFLD group. (SMD: 1.00, 95% CI: 0.54-1.46, P < 0.00001). However, significant heterogeneity was discovered among the included studies (P < 0.00001, I = 96%). Then a series of subgroup analyses were performed. Compared to the nonalcoholic steatohepatitis (NASH) group, the level of IGF-1 was significantly higher in the Non- or probable-NASH group (SMD: 1.42, 95% CI: 0.25-2.58, P = 0.02). The level of IGF-1 in patients with increased insulin resistance (SMD: 0.49; 95% CI: 0.36-0.63; P < 0.00001) and high Body Mass Index (SMD: 0.50; 95% CI: 0.22-0.79; P < 0.05) were significantly lower than healthy control. In addition, the same conclusion were found in studies carried out in Asia and Europe (Asia: SMD: 0.69, 95% CI: -0.29-1.66, P = 0.17; Europe: SMD: 0.89, 95% CI: 0.41-1.38, P < 0.05).
The level of IGF-1 is down-regulated in NAFLD patients compared to healthy controls, suggesting that IGF-1 might be used as a potential biomarker and therapeutic target for NAFLD.
非酒精性脂肪性肝病（NAFLD）的患病率在全球范围内迅速上升。许多研究人员已经研究了胰岛素样生长因子-1（IGF-1）与 NAFLD 之间的关系。然而，结果存在争议。本荟萃分析旨在系统评估 IGF-1 与 NAFLD 之间的相关性。
我们在 PubMed、Web of Science、Embase 和中国知网（CNKI）四个在线数据库中进行了搜索，截至 2018 年 2 月。然后，我们通过计算标准均数差（SMD）及其 95%置信区间（CI），应用随机效应模型评估总效应大小。
本荟萃分析共纳入 12 篇文章。汇总分析显示，对照组 IGF-1 水平明显高于 NAFLD 组。（SMD：1.00，95%CI：0.54-1.46，P<0.00001）。然而，纳入的研究存在显著异质性（P<0.00001，I=96%）。然后进行了一系列亚组分析。与非酒精性脂肪性肝炎（NASH）组相比，非或可能 NASH 组 IGF-1 水平显著升高（SMD：1.42，95%CI：0.25-2.58，P=0.02）。胰岛素抵抗增加的患者 IGF-1 水平（SMD：0.49；95%CI：0.36-0.63；P<0.00001）和高体重指数（SMD：0.50；95%CI：0.22-0.79；P<0.05）显著低于健康对照组。此外，在亚洲和欧洲进行的研究中也得出了相同的结论（亚洲：SMD：0.69，95%CI：-0.29-1.66，P=0.17；欧洲：SMD：0.89，95%CI：0.41-1.38，P<0.05）。
与健康对照组相比，NAFLD 患者的 IGF-1 水平下调，提示 IGF-1 可能作为 NAFLD 的潜在生物标志物和治疗靶点。
