Department of Gastroenterology, Zhoukou Central Hospital Affiliated to Xinxiang Medical University, Zhoukou 466000, Henan Province, China.
Department of Gastroenterology, Zhoukou Central Hospital, Zhoukou 466000, Henan Province, China.
World J Gastroenterol. 2023 Aug 21;29(31):4797-4808. doi: 10.3748/wjg.v29.i31.4797.
The relationship between copeptin and the severity of circulatory dysfunction and systemic stress response in patients with chronic liver disease (CLD) has been established. Nevertheless, the potential of serum copeptin levels to predict the prognosis of CLD patients remains unclear.
To conduct a systematic review and meta-analysis to investigate the correlation between serum copeptin and transplant-free survival (TFS) in this population.
To achieve the objective of the meta-analysis, PubMed, Embase, the Cochrane Library, and the Web of Science were searched to identify observational studies with longitudinal follow-up. The Cochrane test was utilized to assess between-study heterogeneity, and the statistic was estimated. Random-effects models were employed to combine the outcomes, taking into account the potential influence of heterogeneity.
Ten datasets including 3133 patients were involved. The follow-up durations were 1 to 48 mo (mean: 12.5 mo). Overall, it was shown that a high level of serum copeptin was associated with a poor TFS [risk ratio (RR): 1.82, 95% confidence interval: 1.52-2.19, < 0.001; = 0%]. In addition, sensitivity analysis by omitting one dataset at a time showed consistent results (RR: 1.73-2.00, < 0.05). Finally, subgroup analyses according to study country, study design, patient diagnosis, cutoff of copeptin, follow-up duration, and study quality score also showed similar results ( for subgroup difference all > 0.05).
Patients with CLD who have high serum copeptin concentrations may be associated with a poor clinical prognosis.
已经证实， copeptin 与慢性肝病（CLD）患者循环功能障碍和全身应激反应的严重程度之间存在关系。然而，血清 copeptin 水平预测 CLD 患者预后的潜力尚不清楚。
进行系统评价和荟萃分析，以调查该人群中血清 copeptin 与无移植生存（TFS）之间的相关性。
为了实现荟萃分析的目标，检索了 PubMed、Embase、Cochrane 图书馆和 Web of Science，以确定具有纵向随访的观察性研究。采用 Cochrane 检验评估研究间异质性，并估计 统计量。采用随机效应模型组合结果，考虑异质性的潜在影响。
纳入了 10 项数据集，共 3133 例患者。随访时间为 1 至 48 个月（平均：12.5 个月）。总体而言，高血清 copeptin 水平与较差的 TFS 相关[风险比（RR）：1.82，95%置信区间：1.52-2.19，<0.001； = 0%]。此外，每次删除一个数据集的敏感性分析也显示出一致的结果（RR：1.73-2.00，<0.05）。最后，根据研究国家、研究设计、患者诊断、copeptin 截断值、随访时间和研究质量评分进行亚组分析，也显示出类似的结果（对于亚组差异，均>0.05）。
患有高血清 copeptin 浓度的 CLD 患者可能与较差的临床预后相关。
