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Meta-Analysis
. 2020 Oct 2:2020:8830471.
doi: 10.1155/2020/8830471. eCollection 2020.

The Role of Circulating RBP4 in the Type 2 Diabetes Patients with Kidney Diseases: A Systematic Review and Meta-Analysis

Li Zhang  1 , Yan-Li Cheng  1 , Shuai Xue  2 , Zhong-Gao Xu  1
Affiliations
Meta-Analysis

The Role of Circulating RBP4 in the Type 2 Diabetes Patients with Kidney Diseases: A Systematic Review and Meta-Analysis

Li Zhang et al. Dis Markers. .

Abstract

Background: Diabetic nephropathy is a common and serious complication of diabetes mellitus (DM) and is one of the leading causes of end-stage renal disease worldwide. Although there have been many investigations on biomarkers for DN, there is no consistent conclusion about reliable biomarkers. The purpose of this study was to perform a systematic review and meta-analysis of the role of circulating retinol-binding protein 4 (RBP4) in the type 2 diabetes mellitus (T2DM) patients with kidney diseases.

Materials and methods: We searched the PubMed, MEDLINE, EMBASE, and Web of Science databases for publications. For the 12 cross-sectional studies that we included in the review, we calculated standard mean differences (SMD) with 95% confidence intervals (CI) for continuous data when the applied scales were different. Risk of bias of included trials was assessed by using the Newcastle-Ottawa Scale.

Results: RBP4 concentrations in the micro-, macro-, or micro+macroalbuminuria groups were significantly higher than those in the normal albuminuria group of T2DM patients [P = 0.001, SMD 1.07, 95% CI (0.41, 1.73)]. The estimated glomerular filtration rate (eGFR) was negatively associated with circulating RBP4 concentrations in patients with T2DM [summary Fisher's Z = -0.48, 95% CI (-0.69, -0.26), P < 0.0001]. The albumin-to-creatinine ratio (ACR) was positively associated with circulating RBP4 concentrations in patients with T2DM [summary Fisher's Z = 0.20, 95% CI (0.08, 0.32), P = 0.001].

Conclusion: The levels of circulating RBP4 were significantly higher both in T2DM subjects with micro/macroalbuminuria and in T2DM subjects with declined eGFR. The levels of circulating RBP4 were positively correlated with ACR but negatively correlated with eGFR. Circulating RBP4 could be a reliable biomarker for kidney diseases in T2DM.

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Conflict of interest statement

The authors declare that there is no conflict of interest regarding the publication of this paper.

Figures

Figure 1
Figure 1
Flow chart of the study selection.
Figure 2
Figure 2
Meta-analysis forest plot of different albuminuria in DM.
Figure 3
Figure 3
Meta-analysis forest plot of the circulating RBP4 concentrations in the DM with CKD and DM without CKD groups.
Figure 4
Figure 4
Meta-analysis forest plot of correlation between RPB4 and eGFR (a) and between RBP4 and ACR (b).
Figure 5
Figure 5
Meta-analysis forest plot sensitivity analysis.
Figure 6
Figure 6
Subgroup analysis.
See this image and copyright information in PMC

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