Department of Kidney Transplantation, The Second Xiangya Hospital of Central South University, Changsha, China.
Clinical Research Center for Organ Transplantation in Hunan Province, Changsha, China.
Ren Fail. 2023 Dec;45(1):2179336. doi: 10.1080/0886022X.2023.2179336.
Fibroblast growth factor 21 (FGF21) is deemed to play an important role in kidney outcomes, while the association between FGF21 and various kidney diseases remains largely unclear and inconsistent. Therefore, we conducted this meta-analysis to find out the role of FGF21 in various renal diseases.
The outcome indicator of our study was assessed by the pooled standard mean difference (SMD) with 95% confidence intervals (CIs) which were calculated by random-effect model analysis. The risk of bias was assessed by Non-Randomized Studies of Interventions (ROBINS-I) tool. Funnel plot combined with Egger's and Begg's tests was performed to estimate the publication bias that existed in the study.
A total of 28 eligible studies with 19348 participants were included in our research. The agreement between authors reached a kappa-value of 0.88. Overall, the serum FGF21 level was strongly higher in CKD patients (SMD = 0.97 (ng/L); 95% CI, 0.70-1.24 (ng/L)) and the renal outcomes in T2DM patients (SMD = 0.54 (ng/L); 95% CI, 0.39-0.70 (ng/L)) compared with the control group. Consistent with this, the incidence of CKD (OR = 2.56; 95% CI, 1.72-3.81) and the incidence of renal outcomes (OR = 1.63; 95% CI, 1.31-2.01) in T2DM patients was significantly higher in the patients with high FGF21 concentration, indicating that high serum FGF21 level may predict the incidence of CKD and the renal outcomes in T2DM patients.
Serum FGF21 may be one of the strong predictors for various kidney diseases including the progression of CKD and the hard renal outcomes in type 2 diabetes patients, but more large-scale clinical research are needed to confirm this finding.
成纤维细胞生长因子 21（FGF21）被认为在肾脏结局中发挥重要作用，而 FGF21 与各种肾脏疾病的关系在很大程度上仍不清楚且不一致。因此，我们进行了这项荟萃分析，以确定 FGF21 在各种肾脏疾病中的作用。
我们的研究结果指标通过汇总标准均数差（SMD）及其 95%置信区间（CI）进行评估，这些值通过随机效应模型分析计算得出。通过非随机干预研究（ROBINS-I）工具评估偏倚风险。采用漏斗图结合 Egger 和 Begg 检验来估计研究中存在的发表偏倚。
共有 28 项符合条件的研究，纳入了 19348 名参与者。作者之间的一致性达到了kappa 值 0.88。总的来说，CKD 患者的血清 FGF21 水平明显升高（SMD=0.97（ng/L）；95%CI，0.70-1.24（ng/L）），2 型糖尿病患者的肾脏结局也升高（SMD=0.54（ng/L）；95%CI，0.39-0.70（ng/L）），与对照组相比。与此一致，在 2 型糖尿病患者中，高 FGF21 浓度患者的 CKD 发生率（OR=2.56；95%CI，1.72-3.81）和肾脏结局发生率（OR=1.63；95%CI，1.31-2.01）显著更高，表明高血清 FGF21 水平可能预测 CKD 发生率和 2 型糖尿病患者的肾脏结局。
血清 FGF21 可能是各种肾脏疾病（包括 CKD 进展和 2 型糖尿病患者的肾脏不良结局）的一个强有力的预测因子，但需要更多大规模的临床研究来证实这一发现。
