Department of Nephrology, The 1st hospital of Jilin University, Changchun 130021, China.
Department of Thyroid Surgery, The 1st hospital of Jilin University, Changchun 130021, China.
Dis Markers. 2020 Oct 2;2020:8830471. doi: 10.1155/2020/8830471. eCollection 2020.
Diabetic nephropathy is a common and serious complication of diabetes mellitus (DM) and is one of the leading causes of end-stage renal disease worldwide. Although there have been many investigations on biomarkers for DN, there is no consistent conclusion about reliable biomarkers. The purpose of this study was to perform a systematic review and meta-analysis of the role of circulating retinol-binding protein 4 (RBP4) in the type 2 diabetes mellitus (T2DM) patients with kidney diseases.
We searched the PubMed, MEDLINE, EMBASE, and Web of Science databases for publications. For the 12 cross-sectional studies that we included in the review, we calculated standard mean differences (SMD) with 95% confidence intervals (CI) for continuous data when the applied scales were different. Risk of bias of included trials was assessed by using the Newcastle-Ottawa Scale.
RBP4 concentrations in the micro-, macro-, or micro+macroalbuminuria groups were significantly higher than those in the normal albuminuria group of T2DM patients [ = 0.001, SMD 1.07, 95% CI (0.41, 1.73)]. The estimated glomerular filtration rate (eGFR) was negatively associated with circulating RBP4 concentrations in patients with T2DM [summary Fisher's = -0.48, 95% CI (-0.69, -0.26), < 0.0001]. The albumin-to-creatinine ratio (ACR) was positively associated with circulating RBP4 concentrations in patients with T2DM [summary Fisher's = 0.20, 95% CI (0.08, 0.32), = 0.001].
The levels of circulating RBP4 were significantly higher both in T2DM subjects with micro/macroalbuminuria and in T2DM subjects with declined eGFR. The levels of circulating RBP4 were positively correlated with ACR but negatively correlated with eGFR. Circulating RBP4 could be a reliable biomarker for kidney diseases in T2DM.
糖尿病肾病是糖尿病（DM）的常见且严重的并发症，也是全球范围内导致终末期肾病的主要原因之一。尽管已经有许多关于糖尿病肾病生物标志物的研究，但对于可靠的生物标志物尚无一致结论。本研究旨在对循环视黄醇结合蛋白 4（RBP4）在 2 型糖尿病（T2DM）合并肾脏疾病患者中的作用进行系统评价和荟萃分析。
我们检索了 PubMed、MEDLINE、EMBASE 和 Web of Science 数据库中的文献。对于纳入的综述中的 12 项横断面研究，当应用的量表不同时，我们计算了连续数据的标准化均数差（SMD）及其 95%置信区间（CI）。采用纽卡斯尔-渥太华量表评估纳入试验的偏倚风险。
T2DM 患者微量、大量或微量+大量白蛋白尿组的 RBP4 浓度明显高于正常白蛋白尿组[SMD 为 1.07，95%CI（0.41，1.73）， = 0.001]。估计肾小球滤过率（eGFR）与 T2DM 患者循环 RBP4 浓度呈负相关[汇总 Fisher's = -0.48，95%CI（-0.69，-0.26）， ＜0.0001]。T2DM 患者的白蛋白与肌酐比值（ACR）与循环 RBP4 浓度呈正相关[汇总 Fisher's = 0.20，95%CI（0.08，0.32）， = 0.001]。
在 T2DM 微量/大量白蛋白尿患者和 eGFR 下降的 T2DM 患者中，循环 RBP4 水平显著升高。循环 RBP4 水平与 ACR 呈正相关，与 eGFR 呈负相关。循环 RBP4 可能是 T2DM 肾脏疾病的可靠生物标志物。
