Zhao Feng, Wang Guolei
Obstetrics Medical Center, Weifang People's Hospital, Weifang, China.
Ginekol Pol. 2025;96(5):420-430. doi: 10.5603/gpl.100165. Epub 2025 Mar 12.
The present meta-analysis evaluated the value of miRNAs in the diagnosis of gestational diabetes mellitus (GDM).
Eligible studies were gathered from MEDLINE, EMBASE, PubMed, Chinese National Knowledge Infrastructure (CNKI), WanFang, and CQVIP information databases. Combined sensitivity, specificity, and summary receiver operating characteristic (SROC) curves of enrolled studies were analyzed using STATA 12.0. Diagnostic accuracy was examined by diagnostic likelihood ratio (DLR), diagnostic score, and diagnostic odds ratio (DOR). Publication bias was calculated using Deeks' funnel plot.
18 articles (29 studies) were included in this meta-analysis. The pooled sensitivity of overall miRNAs was 0.83 (95% CI = 0.77-0.88), and the specificity was 0.79 (95% CI = 0.72-0.84). The area under SROC curve (AUC) was 0.88 (95% CI = 0.85-0.90). The positive DLR was 3.94 (95% CI = 2.98-5.21), and the negative DLR was 0.22 (95% CI = 0.16-0.30). The diagnostic score was 2.91 (95% CI = 2.44-3.37), and the DOR was 18.27 (95% CI = 11.44-29.17). These results suggest that miRNAs have high diagnostic accuracy for GDM. High heterogeneity may be caused by study design, gestational age, and cutoff value. Subgroup analysis indicates that sensitivity and specificity are higher in case-control studies than in cohort studies. Specificity differs significantly in the cutoff value subgroup.
Overall, miRNAs showed high accuracy in diagnosing of metabolic changes in GDM patients. High heterogeneity may be caused by study design, sampling gestational age, and cutoff value.
本荟萃分析评估了微小RNA(miRNAs)在妊娠期糖尿病(GDM)诊断中的价值。
从MEDLINE、EMBASE、PubMed、中国知网(CNKI)、万方和维普资讯数据库中收集符合条件的研究。使用STATA 12.0分析纳入研究的合并敏感性、特异性和汇总接受者操作特征(SROC)曲线。通过诊断似然比(DLR)、诊断评分和诊断比值比(DOR)检验诊断准确性。使用Deeks漏斗图计算发表偏倚。
本荟萃分析纳入了18篇文章(29项研究)。总体miRNAs的合并敏感性为0.83(95%可信区间[CI]=0.77-0.88),特异性为0.79(95%CI=0.72-0.84)。SROC曲线下面积(AUC)为0.88(95%CI=0.85-0.90)。阳性DLR为3.94(95%CI=2.98-5.21),阴性DLR为0.22(95%CI=0.16-0.30)。诊断评分为2.91(95%CI=2.44-3.37),DOR为18.27(95%CI=11.44-29.17)。这些结果表明,miRNAs对GDM具有较高的诊断准确性。研究设计、孕周和临界值可能导致高度异质性。亚组分析表明,病例对照研究中的敏感性和特异性高于队列研究。临界值亚组中的特异性存在显著差异。
总体而言,miRNAs在诊断GDM患者的代谢变化方面显示出较高的准确性。研究设计、采样孕周和临界值可能导致高度异质性。