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. 2019 Mar 6;7(5):585-599.
doi: 10.12998/wjcc.v7.i5.585.

Maternal serum level of resistin is associated with risk for gestational diabetes mellitus: A meta-analysis

Shi-Min Hu  1 , Meng-Shi Chen  1 , Hong-Zhuan Tan  2
Affiliations

Maternal serum level of resistin is associated with risk for gestational diabetes mellitus: A meta-analysis

Shi-Min Hu et al. World J Clin Cases. .

Abstract

Background: Resistin is most likely involved in the pathogenesis of gestational diabetes mellitus (GDM), but the existing findings are inconsistent.

Aim: To review the literature investigating the associations of the risk of GDM with serum level of resistin.

Methods: A systematic literature search was performed using MEDLINE, EMBASE, and Web of Science (all databases). This meta-analysis included eligible studies that: (1) investigated the relationship between the risk of GDM and serum resistin; (2) included GDM cases and controls without GDM; (3) diagnosed GDM according to the oral glucose-tolerance test; (4) were performed in humans; (5) were published as full text articles in English; and (6) provided data with median and quartile range, median and minimum and maximum values, or mean and standard deviation. The pooled standardized mean difference (SMD) and 95% confidence interval (CI) were calculated to estimate the association between the risk of GDM and serum resistin. To analyze the potential influences of need for insulin in GDM patients and gestational age at blood sampling, we performed a subgroup analysis. Meta-regression with restricted maximum likelihood estimation was performed to assess the potentially important covariate exerting substantial impact on between-study heterogeneity.

Results: The meta-analysis for the association between serum resistin level and GDM risk included 18 studies (22 comparisons) with 1041 cases and 1292 controls. The total results showed that the risk of GDM was associated with higher serum resistin level (SMD = 0.250, 95%CI: 0.116, 0.384). The "after 28 wk" subgroup, "no need for insulin" subgroup, and "need for insulin" subgroup indicated that higher serum resistin level was related to GDM risk ("after 28 wk" subgroup: SMD = 0.394, 95%CI: 0.108, 0.680; "no need for insulin" subgroup: SMD = 0.177, 95%CI: 0.018, 0.336; "need for insulin" subgroup: SMD = 0.403, 95%CI: 0.119, 0.687). The "before 14 wk" subgroup, "14-28 wk" subgroup, and "no information of need for insulin" subgroup showed a nonsignificant association between serum resistin level and GDM risk ("before 14 wk" subgroup: SMD = 0.087, 95%CI: -0.055, 0.230; "14-28 wk" subgroup: SMD = 0.217, 95%CI: -0.003, 0.436; "no information of need for insulin" subgroup: SMD = 0.356, 95%CI: -0.143, 0.855). The postpartum subgroup included only one study and showed that higher serum resistin level was related to GDM risk (SMD = 0.571, 95%CI: 0.054, 1.087) The meta-regression revealed that no need for insulin in GDM patients, age distribution similar between cases and controls, and ELISA all had a significant impact on between-study heterogeneity.

Conclusion: This meta-analysis supports that the maternal serum resistin level is associated with GDM risk.

Keywords: Gestational age; Gestational diabetes mellitus; Meta-analysis; Resistin.

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Conflict of interest statement

Conflict-of-interest statement: The authors deny any conflict of interest.

Figures

Equation 1
Equation 1
Equation(A1).
Equation 2
Equation 2
Equation(A1).
Figure 1
Figure 1
PRISMA flow diagram of the study selection process. GDM: Gestational diabetes mellitus.
Figure 2
Figure 2
Meta-analysis for the association of serum resistin level with gestational diabetes mellitus risk using a random effects model.
Figure 3
Figure 3
Gestational age at blood sampling subgroup analysis using a random effects model.
Figure 4
Figure 4
Need for insulin subgroup analysis using a random effects model.
Figure 5
Figure 5
Results of sensitivity analysis of serum resistin level with gestational diabetes mellitus risk.
Figure 6
Figure 6
Begg’s funnel plot for publication bias test of serum resistin level with gestational diabetes mellitus risk. SMD: Standardized mean difference.
See this image and copyright information in PMC

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