Department of Intensive Care Unit, Lanzhou University First Affiliated Hospital, Lanzhou, China.
Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China.
BMJ Open. 2019 Oct 7;9(10):e031812. doi: 10.1136/bmjopen-2019-031812.
Soluble urokinase plasminogen activated receptor (suPAR) is a biomarker that may predict the occurrence of focal segmental glomerulosclerosis (FSGS); however, there is still controversy about whether suPAR can predict FSGS. In this study, we performed a systematic evaluation and meta-analysis to prove whether suPAR can predict FSGS, and to detect a threshold concentration of suPAR that can be used to diagnose FSGS. In addition, a threshold concentration of suPAR for the diagnosis of FSGS was proposed.
Systematic review and meta-analysis.
We systematically searched PubMed, Embase, Cochrane Library, Web of Science and China Biology Medicine databases for studies published from the inception dates to 1 December 2018. ELIGIBILITY CRITERIA: (1) Data involving the suPAR level were from blood samples; (2) FSGS was diagnosed by biopsy; and (3) randomised controlled trials, cohort studies, case-control studies and cross-sectional studies.
Initially, a total of 364 studies were searched, among which 29 studies were finally included. In addition, seven studies described the cut-off value of suPAR, which ranged from 2992.6 to 5500 pg/mL.
The results showed that the suPAR levels in the primary FSGS group were significantly higher when compared with that in the normal control group (p0.001; standard mean difference (SMD): 2.56; 95% CI 1.85 to 3.28), and significant differences were observed in the secondary FSGS and in the normal control group (p0.001; SMD: 1.68; 95% CI 1.37 to 1.98). A suPAR concentration of 3000 pg/mL may be the best threshold for the diagnosis of primary FSGS (sensitivity=0.72; specificity=0.88; area under the curve=0.85).
Our results suggested that suPAR might be a potential biomarker for predicting primary and secondary FSGS. In addition, our data showed that a suPAR concentration of 3000 pg/mL might be used as a threshold for the diagnosis of FSGS.
CRD42019120948.
可溶性尿激酶型纤溶酶原激活物受体（suPAR）是一种可能预测局灶节段性肾小球硬化（FSGS）发生的生物标志物；然而，关于 suPAR 是否能预测 FSGS 仍存在争议。本研究通过系统评价和荟萃分析来证明 suPAR 是否能预测 FSGS，并检测出用于诊断 FSGS 的 suPAR 临界浓度。此外，还提出了用于诊断 FSGS 的 suPAR 临界浓度。
系统评价和荟萃分析。
我们系统地检索了 PubMed、Embase、Cochrane 图书馆、Web of Science 和中国生物医学文献数据库，以获取截至 2018 年 12 月 1 日发表的研究数据。
（1）数据涉及血液样本中的 suPAR 水平；（2）FSGS 通过活检诊断；（3）随机对照试验、队列研究、病例对照研究和横断面研究。
最初共检索到 364 项研究，最终纳入 29 项研究。此外，有 7 项研究描述了 suPAR 的截止值，范围为 2992.6 至 5500 pg/ml。
结果显示，原发性 FSGS 组的 suPAR 水平明显高于正常对照组（p<0.001；标准均数差（SMD）：2.56；95%置信区间（CI）1.85 至 3.28），且在继发性 FSGS 与正常对照组之间也存在显著差异（p<0.001；SMD：1.68；95%CI 1.37 至 1.98）。suPAR 浓度 3000 pg/ml 可能是原发性 FSGS 诊断的最佳阈值（敏感性=0.72；特异性=0.88；曲线下面积=0.85）。
我们的研究结果表明，suPAR 可能是预测原发性和继发性 FSGS 的潜在生物标志物。此外，我们的数据表明，suPAR 浓度 3000 pg/ml 可能可作为 FSGS 的诊断阈值。
CRD42019120948。
