血清可溶性尿激酶型纤溶酶原激活物受体与局灶节段性肾小球硬化症：系统评价和荟萃分析。
Serum soluble urokinase type plasminogen activated receptor and focal segmental glomerulosclerosis: a systematic review and meta-analysis.
机构信息
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.
出版信息
BMJ Open. 2019 Oct 7;9(10):e031812. doi: 10.1136/bmjopen-2019-031812.
OBJECTIVES
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.
DESIGN
Systematic review and meta-analysis.
DATA SOURCES
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.
DATA EXTRACTION AND SYNTHESIS
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.
RESULTS
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).
CONCLUSION
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.
TRIAL REGISTRATION NUMBER
CRD42019120948.
目的
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。
设计
系统评价和荟萃分析。
数据来源
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。
纳入标准
（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。
数据提取和综合
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
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）。
结论
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。
试验注册号
CRD42019120948。
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