University of Milano Bicocca, Materials Science Department, Milan, Italy.
University of Eastern Piedmont, Department of Translational Medicine, Novara, Italy.
Invest Ophthalmol Vis Sci. 2020 Oct 1;61(12):9. doi: 10.1167/iovs.61.12.9.
To evaluate the potential of lactoferrin (Lf) as a diagnostic biomarker for ocular diseases using a meta-analytic approach.
All original studies reporting an estimate of the average Lf concentration in healthy subjects and those affected by ocular diseases were searched up to March 2020. The DerSimonian and Laird method was used to calculate the random effects pooled mean difference and the corresponding 95% confidence interval (CI) in Lf concentration between healthy subjects and those affected by dry eye (DE), Sjögren syndrome (SS), and diabetic retinopathy, separately. The presence of between-study heterogeneity was evaluated using the Cochran's Q test and the I2 index. Stratified analyses were performed to assess potential sources of heterogeneity and influence and cumulative analyses to evaluate the robustness of the results obtained. Publication bias was also evaluated using funnel plot and the Egger's test.
The pooled mean differences in Lf concentrations between healthy subjects and those with DE, Sjögren syndrome, and diabetic retinopathy were respectively 0.62 (95% CI, 0.35-0.89) for DE, 3.78 (95% CI, -6.64 to 14.17), and 0.19 (95% CI, -4.00 to 4.39). Regarding DE, the stratified analysis showed that geographical area (P value Q test < 0.0001) and sample size (P < 0.0005) were sources of heterogeneity. Moreover, no study substantially influenced the results obtained and the pooled mean difference became statistically significant after a sample size of 220. Publication bias may affect the results of DE.
The results of the current meta-analysis suggest that Lf level in tears is a good candidate as dry eye syndrome diagnostic biomarker.
采用荟萃分析方法评估乳铁蛋白（Lf）作为眼部疾病诊断生物标志物的潜力。
检索至 2020 年 3 月，所有报告健康受试者和眼部疾病患者Lf 平均浓度估计值的原始研究均被纳入。采用 DerSimonian 和 Laird 法计算健康受试者与干眼症（DE）、干燥综合征（SS）和糖尿病性视网膜病变患者之间Lf 浓度的随机效应汇总均数差值及其相应的 95%置信区间（CI）。采用 Cochran's Q 检验和 I2 指数评估研究间异质性。进行分层分析以评估潜在的异质性来源和影响，以及累积分析以评估获得结果的稳健性。还采用漏斗图和 Egger 检验评估发表偏倚。
健康受试者与 DE、SS 和糖尿病性视网膜病变患者之间 Lf 浓度的汇总均数差值分别为 0.62（95%CI，0.35-0.89）、3.78（95%CI，-6.64 至 14.17）和 0.19（95%CI，-4.00 至 4.39）。对于 DE，分层分析表明地理区域（P 值 Q 检验<0.0001）和样本量（P<0.0005）是异质性的来源。此外，没有研究显著影响获得的结果，并且在样本量达到 220 后，汇总均数差值变得具有统计学意义。发表偏倚可能影响 DE 的结果。
当前荟萃分析的结果表明，泪液中的 Lf 水平是干燥综合征诊断生物标志物的良好候选物。
