School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Endocrinology and Metabolism Population Sciences Institute, Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran.
PLoS One. 2023 Aug 9;18(8):e0289710. doi: 10.1371/journal.pone.0289710. eCollection 2023.
Chronic kidney disease (CKD) is one of the leading causes of morbidity and mortality worldwide. Endothelial dysfunction has been suggested to be involved in the pathophysiology of CKD. Endocan, as an endothelial factor, has been shown to increase in several diseases. The current systematic review and meta-analysis was performed with the aim of determining the association between endocan levels and CKD.
Four international databases, including PubMed, Embase, Scopus, and Web of Science were searched for relevant studies. Afterward, screening and extraction of data were performed. We conducted a random-effect meta-analysis to calculate the standardized mean difference (SMD) and 95% confidence interval (CI) to compare circulating endocan levels between patients with CKD (including patients undergoing hemodialysis) and healthy controls. Subgroup analysis based on the specimen in which endocan was measured (serum or plasma) was also performed.
After screening by title/abstract and full-text review by the authors, 20 studies were included. Meta-analysis revealed that serum endocan is higher in CKD patients compared to healthy controls (SMD 1.34, 95% CI 0.20 to 2.48, p-value<0.01). This higher endocan level was also observed in the subgroup of studies that measured plasma endocan while this was not the case for the subgroup of studies assessing serum endocan. Meta-analysis was also performed for comparison of CKD patients without other comorbidities and healthy controls, which resulted in the same conclusion of higher endocan levels in patients with CKD (SMD 0.74, 95% CI 0.52 to 0.95, p-value<0.01). Moreover, endocan was associated with cardiovascular diseases in CKD.
Our study demonstrated that endocan is significantly increased in patients with CKD. This can have clinical implications as well as highlight the need for future research investigating the diagnostic and prognostic role of endocan in CKD.
慢性肾脏病（CKD）是全球发病率和死亡率的主要原因之一。内皮功能障碍被认为与 CKD 的病理生理学有关。内参，作为一种内皮因子，已在几种疾病中显示出增加。本系统评价和荟萃分析旨在确定内参水平与 CKD 之间的关系。
我们在包括 PubMed、Embase、Scopus 和 Web of Science 在内的四个国际数据库中搜索了相关研究。然后，进行了筛选和数据提取。我们进行了随机效应荟萃分析，以计算标准化均数差（SMD）和 95%置信区间（CI），以比较 CKD（包括接受血液透析的患者）患者和健康对照组之间循环内参水平。还根据测量内参的标本（血清或血浆）进行了亚组分析。
经过作者标题/摘要筛选和全文审查，共纳入 20 项研究。荟萃分析显示，CKD 患者的血清内参水平高于健康对照组（SMD 为 1.34，95%CI 为 0.20 至 2.48，p 值<0.01）。在测量血浆内参的研究亚组中观察到了这种更高的内参水平，而在评估血清内参的研究亚组中则没有。我们还对无其他合并症的 CKD 患者与健康对照组进行了比较，得出了相同的结论，即 CKD 患者的内参水平更高（SMD 为 0.74，95%CI 为 0.52 至 0.95，p 值<0.01）。此外，内参与 CKD 中的心血管疾病相关。
我们的研究表明，CKD 患者的内参水平显著升高。这可能具有临床意义，并强调需要进一步研究内参在 CKD 中的诊断和预后作用。
