Xu Fen, Luo Jun, Li Wenbin
Department of Neonatology, Shenzhen Baoan Women's and Children's Hospital, Guangdong, China.
Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Front Pediatr. 2025 May 9;13:1555671. doi: 10.3389/fped.2025.1555671. eCollection 2025.
Resistin (RETN) levels are potential diagnostic markers for sepsis in neonates and children. However, studies have yielded inconsistent results. This study aimed to compare the diagnostic accuracy of RETN levels with that of C-reactive protein (CRP) levels in the diagnosis of paediatric and neonatal sepsis through a comprehensive review of recent literature.
A standard methodology for systematic reviews and meta-analyses was followed. The PubMed, Embase and Cochrane databases were searched from January 1996 to October 2024 (PROSPERO CRD42024621872). Eligible studies were selected and analysed using Review Manager 5.4 and STATA 17. Meta-DiSc version 1.4 was used to describe and calculate the sensitivity, specificity, summary receiver operating characteristic (SROC) curves and areas under the curves (AUCs). SROC curve analysis was used to summarize the overall performance.
A total of 437 neonates and children were included in six identified studies, all of which demonstrated reasonable methodological quality. The pooled sensitivity for the RETN level was 0.88 [95% confidence interval (CI), 0.83-0.92], which surpassed that of the CRP level at 0.85 (95% CI, 0.79-0.90). However, the pooled specificity for the RETN level was 0.78 (95% CI, 0.71-0.83), which was lower than that of the CRP level at 0.84 (95% CI, 0.77-0.90). Furthermore, the SROC curves for RETN and CRP in predicting sepsis in neonates and children indicated high predictive abilities, with AUC values of 0.925 and 0.945, respectively.
The current evidence suggests that the RETN level is a valuable biomarker for detecting paediatric and neonatal sepsis.
https://www.crd.york.ac.uk/PROSPERO/, identifier [CRD42024621872].
抵抗素（RETN）水平是新生儿和儿童脓毒症的潜在诊断标志物。然而，研究结果并不一致。本研究旨在通过全面回顾近期文献，比较RETN水平与C反应蛋白（CRP）水平在儿科和新生儿脓毒症诊断中的诊断准确性。
遵循系统评价和Meta分析的标准方法。检索了1996年1月至2024年10月的PubMed、Embase和Cochrane数据库（PROSPERO CRD42024621872）。使用Review Manager 5.4和STATA 17对符合条件的研究进行选择和分析。使用Meta-DiSc 1.4版描述并计算敏感性、特异性、汇总受试者工作特征（SROC）曲线和曲线下面积（AUC）。采用SROC曲线分析总结总体性能。
六项纳入研究共纳入437例新生儿和儿童，所有研究均显示出合理的方法学质量。RETN水平的合并敏感性为0.88[95%置信区间（CI），0.83-0.92]，超过了CRP水平的0.85（95%CI，0.79-0.90）。然而，RETN水平的合并特异性为0.78（95%CI，0.71-0.83），低于CRP水平的0.84（95%CI，0.77-0.90）。此外，RETN和CRP预测新生儿和儿童脓毒症的SROC曲线显示出较高的预测能力，AUC值分别为0.925和0.945。
目前的证据表明，RETN水平是检测儿科和新生儿脓毒症的有价值的生物标志物。
