Behnoush Amir Hossein, Samavarchitehrani Amirsaeed, Shirazi Ghaleno Amir Masoud, Klisic Aleksandra
School of Medicine, Tehran University of Medical Sciences, Poursina St., Keshavarz Blvd., Tehran, 1417613151 Iran.
Endocrinology and Metabolism Population Sciences Institute, Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran.
J Diabetes Metab Disord. 2024 Dec 28;24(1):31. doi: 10.1007/s40200-024-01533-0. eCollection 2025 Jun.
Diabetic retinopathy (DR) is one of the main microvascular complications of diabetes and one of the most common causes of vision loss worldwide. Fetuin-A is a glycoprotein correlated with insulin resistance and has been measured in DR patients. Herein, we aimed to investigate these studies through a systematic review and meta-analysis.
Four online databases, including PubMed, Embase, Scopus, and the Web of Science were searched comprehensively in order to retrieve relevant studies that compared blood fetuin-A levels in patients with DR vs. non-DR, DR vs. non-diabetic controls, non-DR vs. non-diabetic controls, and proliferative vs. non- proliferative DR. Random-effect meta-analysis was performed for the calculation of the standardized mean difference (SMD) and 95% confidence interval (CI).
From the 186 found results through database search, after eligibility assessment, seven studies were included. A total of 1104 cases with a mean age of 57.24 ± 9.62 years were investigated. Meta-analysis showed that fetuin-A levels were significantly higher in patients with DR compared to both non-DR diabetic patients (SMD 0.41, 95% CI 0.10 to 0.72, = 0.009), and non-diabetic healthy controls (SMD 0.77, 95% CI 0.47 to 1.07, < 0.0001). Additionally, patients with proliferative DR had higher fetuin-A levels than those with non-proliferative DR (SMD 0.35, 95% CI 0.11 to 0.59, = 0.004). However, no significant difference was found between diabetic patients without DR and healthy controls.
Based on our findings, fetuin-A was higher in patients with DR and could be potentially used for measurement in clinical settings if confirmed in future large-scale studies. Moreover, the fact that higher fetuin-A levels were associated with proliferative DR could have clinical implications.
The online version contains supplementary material available at 10.1007/s40200-024-01533-0.
糖尿病视网膜病变（DR）是糖尿病主要的微血管并发症之一，也是全球视力丧失最常见的原因之一。胎球蛋白-A是一种与胰岛素抵抗相关的糖蛋白，已在糖尿病视网膜病变患者中进行检测。在此，我们旨在通过系统评价和荟萃分析来研究这些研究。
全面检索了四个在线数据库，包括PubMed、Embase、Scopus和Web of Science，以检索比较糖尿病视网膜病变患者与非糖尿病视网膜病变患者、糖尿病视网膜病变患者与非糖尿病对照、非糖尿病视网膜病变患者与非糖尿病对照以及增殖性糖尿病视网膜病变与非增殖性糖尿病视网膜病变血胎球蛋白-A水平的相关研究。采用随机效应荟萃分析计算标准化平均差（SMD）和95%置信区间（CI）。
通过数据库检索得到186项结果，经过资格评估后，纳入7项研究。共调查了1104例患者，平均年龄为57.24±9.62岁。荟萃分析显示，与非糖尿病视网膜病变的糖尿病患者（SMD 0.41，95%CI 0.10至0.72，P = 0.009）和非糖尿病健康对照（SMD 0.77，95%CI 0.47至1.07，P < 0.0001）相比，糖尿病视网膜病变患者的胎球蛋白-A水平显著更高。此外，增殖性糖尿病视网膜病变患者的胎球蛋白-A水平高于非增殖性糖尿病视网膜病变患者（SMD 0.35，95%CI 0.11至0.59，P = 0.004）。然而，无糖尿病视网膜病变的糖尿病患者与健康对照之间未发现显著差异。
基于我们的研究结果，糖尿病视网膜病变患者的胎球蛋白-A水平较高，如果在未来大规模研究中得到证实，可能在临床中用于检测。此外，胎球蛋白-A水平较高与增殖性糖尿病视网膜病变相关这一事实可能具有临床意义。
在线版本包含可在10.1007/s40200-024-01533-0获取的补充材料。
