Widjanarko Nicolas Daniel, Soetedjo Nanny Natalia Mulyani, Iryaningrum Maria Riastuti, Arifin Erlangga Saputra, Alvianto Steven, Lionardi Stevan Kristian, Iskandar Archie Fontana, Chandra Kevin Axel
Faculty of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia.
Division of Endocrine and Metabolic, Department of Internal Medicine, Faculty of Medicine Padjajaran University, Bandung, Indonesia.
Tzu Chi Med J. 2025 Mar 5;37(3):328-338. doi: 10.4103/tcmj.tcmj_211_24. eCollection 2025 Jul-Sep.
Pancreatic stone protein (PSP) has been identified as an indicator of systemic stress and is elevated in individuals diagnosed with type 2 diabetes mellitus (T2DM), potentially serving as a prognostic marker for both the onset and progression of the disease.
This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis 2020 guidelines. Articles were sourced from MEDLINE, ProQuest, Science Direct, Google Scholar, and Cochrane Library electronic databases. Studies included are all observational studies examining PSP/Reg1α serum levels in patients with T2DM. The quality of the study was evaluated using the Newcastle-Ottawa Scale, as well as Review Manager 5.4 to perform the meta-analysis.
Seven studies met the criteria for inclusion. Pooled analysis revealed significant differences in PSP values between T2DM individuals and healthy controls (standardized mean difference [SMD] = 2.14, 95% confidence interval CI: 1.05-1.92, < 0.00001). Further subgroup analysis showed PSP was substantially higher in T2DM with complications (SMD = -1.57, 95% CI: -2.12 to -1.02, < 0.00001) compared to T2DM without complications (SMD = -1.39, 95% CI: -2.17 to - 0.61) and newly diagnosed T2DM (SMD = -1.85, 95% CI: -2.96 to -0.74). Grading of Recommendations, Assessment, Development, and Evaluations demonstrated moderate quality of evidence.
Our analysis revealed a progressive elevation in PSP values concomitant with the worsening T2DM disease state across the entire spectrum. PSP exhibits promising potential as a biomarker for predicting both disease initiation and subsequent clinical course.
胰石蛋白（PSP）已被确定为全身应激的指标，在2型糖尿病（T2DM）患者中升高，可能作为该疾病发病和进展的预后标志物。
本研究按照系统评价和Meta分析的首选报告项目2020指南进行。文章来源于MEDLINE、ProQuest、科学Direct、谷歌学术和Cochrane图书馆电子数据库。纳入的研究均为观察性研究，检测T2DM患者的PSP/Reg1α血清水平。使用纽卡斯尔-渥太华量表评估研究质量，并使用Review Manager 5.4进行Meta分析。
七项研究符合纳入标准。汇总分析显示，T2DM患者与健康对照者的PSP值存在显著差异（标准化均值差[SMD]=2.14，95%置信区间CI：1.05-1.92，P<0.00001）。进一步的亚组分析显示，与无并发症的T2DM（SMD=-1.39，95%CI：-2.17至-0.61）和新诊断的T2DM（SMD=-1.85，95%CI：-2.96至-0.74）相比，有并发症的T2DM患者的PSP显著更高（SMD=-1.57，95%CI：-2.12至-1.02，P<0.00001）。推荐分级、评估、制定和评价显示证据质量中等。
我们的分析显示，在整个TIDM疾病范围内，PSP值随着疾病状态的恶化而逐渐升高。PSP作为预测疾病发生和后续临床病程的生物标志物具有广阔的潜力。
