Proteomics Research Center, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Clinical Biochemistry, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
J Matern Fetal Neonatal Med. 2022 Jul;35(13):2606-2618. doi: 10.1080/14767058.2020.1789581. Epub 2020 Jul 7.
Pre-eclampsia (PE) is a serious pregnancy status characterized by high blood pressure. Although visfatin is usually associated with PE. Observational studies evaluating the relationship between circulating visfatin and pre-eclampsia have reported inconsistent results. We conducted this systematic review and meta-analysis to summarize published data on the association between visfatin and pre-eclampsia.
Electronic databases PubMed, ISI web of science, EMBASE, Scopus and the Cochrane library were comprehensively searched for selection of eligible studies until January 5, 2020. A random-effects model and the generic inverse variance method were used for quantitative data synthesis. The assessment of study quality was performed using the e Newcastle-Ottawa scale and the Agency for Healthcare Research and Quality. Sensitivity analyses and prespecified subgroup were conducted to evaluate potential heterogeneity. Random-effects meta-regression was conducted to assess the impact of potential confounders on the estimated effect sizes. The protocol for this study was registered in PROSPERO (No. CRD42018105861) in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).
Thirteen studies comprising a total of 536 subjects were included in this meta-analysis. We observed that the pre-eclampsia risk is associated with a statistically significant elevation of visfatin level [SMD (1.33 µg/l) (95% CI 0.37, 2.2) = .007]. No significant publication bias was observed in the meta-analysis. Subgroup and sensitivity analyses indicated that the pooled effects size were affected by systolic blood pressure [SMD (1.82 µg/l) 95% CI (0.94, 2.7), < .05], gestational age [SMD (2.01 µg/l) 95% CI (0.57, 3.4), = .006], body mass index [SMD (1.6 µg/l) 95% CI (0.37, 3), < .05] and pregnancy trimesters[SMD (2.3 µg/l) 95% CI (0.95, 3.7), = .001]. Random-effects meta-regression showed a significant association of visfatin level with potential confounders including systolic blood pressure, gestational age and birth weight at delivery of pre-eclampsia patients.
Collectively, our data revealed that the increase of visfatin level can be associated with the risk of pre-eclampsia. However, further studies on pre-eclampsia populations are warranted for corroboration of our findings.
子痫前期（PE）是一种以高血压为特征的严重妊娠状态。尽管内脏脂肪素通常与 PE 有关。评估循环内脏脂肪素与子痫前期之间关系的观察性研究报告结果不一致。我们进行了这项系统评价和荟萃分析，以总结关于内脏脂肪素与子痫前期之间关系的已发表数据。
全面检索电子数据库 PubMed、ISI 网络科学、EMBASE、Scopus 和 Cochrane 图书馆，以选择合格的研究，直到 2020 年 1 月 5 日。使用随机效应模型和通用逆方差法进行定量数据合并。使用 Newcastle-Ottawa 量表和医疗保健研究与质量 Agency 评估研究质量。进行敏感性分析和预设亚组分析，以评估潜在的异质性。进行随机效应荟萃回归分析，以评估潜在混杂因素对估计效应大小的影响。本研究的方案按照系统评价和荟萃分析的首选报告项目（PRISMA）在 PROSPERO 中进行了注册（编号：CRD42018105861）。
共有 13 项研究，共纳入 536 名受试者，纳入了这项荟萃分析。我们发现，子痫前期的风险与内脏脂肪素水平的统计学显著升高相关[SMD（1.33μg/l）（95%CI 0.37，2.2）=0.007]。荟萃分析未观察到显著的发表偏倚。亚组和敏感性分析表明，合并效应大小受到收缩压[SMD（1.82μg/l）95%CI（0.94，2.7），<0.05]、胎龄[SMD（2.01μg/l）95%CI（0.57，3.4），=0.006]、体重指数[SMD（1.6μg/l）95%CI（0.37，3），<0.05]和妊娠周期[SMD（2.3μg/l）95%CI（0.95，3.7），=0.001]的影响。随机效应荟萃回归显示，内脏脂肪素水平与子痫前期患者的潜在混杂因素（包括收缩压、胎龄和出生体重）之间存在显著关联。
总的来说，我们的数据表明，内脏脂肪素水平的升高可能与子痫前期的风险有关。然而，需要进一步研究子痫前期人群以证实我们的发现。
