Department of Clinical Laboratory, Ningbo Municipal Hospital of Traditional Chinese Medicine, Affiliated to Zhejiang Chinese Medical University, Ningbo, China.
Department of Nephrology, Ningbo Municipal Hospital of Traditional Chinese Medicine, Affiliated to Zhejiang Chinese Medical University, Ningbo, China.
Front Endocrinol (Lausanne). 2024 Apr 22;15:1356131. doi: 10.3389/fendo.2024.1356131. eCollection 2024.
Diabetic nephropathy (DN) is a major microvascular complication of diabetes and the leading cause of end-stage renal disease. Early detection and prevention of DN are important. Retinol-binding protein 4 (RBP4) has been considered as a single diagnostic marker for the detection of renal impairment. However, the results have been inconsistent. The present meta-analysis aimed to determine the diagnostic potential of RBP4 in patients in type 2 diabetes mellitus (T2DM) with DN.
We searched PubMed, Web of Science, Embase, Wanfang and CNKI databases from inception until January 2024. The meta-analysis was performed by Stata version 15.0, and sensitivity, specificity, positive and negative likelihood ratios (PLR and NLR), diagnostic odds ratio (DOR) and area under the curve (AUC) were pooled. The Quality Assessment of Diagnostic Accuracy Studies-2 tool was utilized to assess the quality of each included study. In addition, heterogeneity and publication bias were evaluated.
Twenty-nine studies were included in the meta-analysis. The pooled sensitivity and specificity were 0.76 [95% confidence interval (CI), 0.71-0.80] and 0.81 (95% CI, 0.76-0.85), respectively. The results showed a pooled PLR of 4.06 (95% CI, 3.16-5.21), NLR of 0.29 (95% CI, 0.24-0.36) and DOR of 13.76 (95% CI, 9.29-20.37). The area under the summarized receiver operating characteristic curve was given a value of 0.85 (95% CI, 0.82-0.88). No obvious publication bias existed in the Deeks' funnel plot asymmetry test.
Our findings suggest that RBP4 has a promising diagnostic value with good sensitivity and specificity for patients with T2DM with DN.
糖尿病肾病（DN）是糖尿病的一种主要微血管并发症，也是终末期肾病的主要原因。早期发现和预防 DN 非常重要。视黄醇结合蛋白 4（RBP4）已被认为是检测肾功能损害的单一诊断标志物。然而，结果并不一致。本荟萃分析旨在确定 RBP4 在 2 型糖尿病伴 DN 患者中的诊断潜力。
我们检索了 PubMed、Web of Science、Embase、万方和中国知网数据库，检索时间从建库至 2024 年 1 月。使用 Stata 版本 15.0 进行荟萃分析，并汇总了敏感性、特异性、阳性和阴性似然比（PLR 和 NLR）、诊断优势比（DOR）和曲线下面积（AUC）。采用 Quality Assessment of Diagnostic Accuracy Studies-2 工具评估每个纳入研究的质量。此外，还评估了异质性和发表偏倚。
共有 29 项研究纳入荟萃分析。汇总的敏感性和特异性分别为 0.76（95%置信区间[CI]，0.71-0.80）和 0.81（95% CI，0.76-0.85）。结果显示，汇总的阳性似然比为 4.06（95% CI，3.16-5.21），阴性似然比为 0.29（95% CI，0.24-0.36），诊断优势比为 13.76（95% CI，9.29-20.37）。汇总受试者工作特征曲线下的面积为 0.85（95% CI，0.82-0.88）。Deeks 漏斗图不对称检验未发现明显的发表偏倚。
我们的研究结果表明，RBP4 对 2 型糖尿病伴 DN 患者具有良好的诊断价值，具有较高的敏感性和特异性。
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