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Meta-Analysis
. 2024 Apr 22:15:1356131.
doi: 10.3389/fendo.2024.1356131. eCollection 2024.

Diagnostic value of retinol-binding protein 4 in diabetic nephropathy: a systematic review and meta-analysis

Xiaodan Cao  1 , Guanghui Zhong  2 , Tinglong Jin  3 , Weijiao Hu  1 , Jin Wang  3 , Bo Shi  1 , Renxiong Wei  1
Affiliations
Meta-Analysis

Diagnostic value of retinol-binding protein 4 in diabetic nephropathy: a systematic review and meta-analysis

Xiaodan Cao et al. Front Endocrinol (Lausanne). .

Abstract

Objective: Diabetic nephropathy (DN) is a major microvascular complication of diabetes and the leading cause of end-stage renal disease. Early detection and prevention of DN are important. Retinol-binding protein 4 (RBP4) has been considered as a single diagnostic marker for the detection of renal impairment. However, the results have been inconsistent. The present meta-analysis aimed to determine the diagnostic potential of RBP4 in patients in type 2 diabetes mellitus (T2DM) with DN.

Methods: We searched PubMed, Web of Science, Embase, Wanfang and CNKI databases from inception until January 2024. The meta-analysis was performed by Stata version 15.0, and sensitivity, specificity, positive and negative likelihood ratios (PLR and NLR), diagnostic odds ratio (DOR) and area under the curve (AUC) were pooled. The Quality Assessment of Diagnostic Accuracy Studies-2 tool was utilized to assess the quality of each included study. In addition, heterogeneity and publication bias were evaluated.

Results: Twenty-nine studies were included in the meta-analysis. The pooled sensitivity and specificity were 0.76 [95% confidence interval (CI), 0.71-0.80] and 0.81 (95% CI, 0.76-0.85), respectively. The results showed a pooled PLR of 4.06 (95% CI, 3.16-5.21), NLR of 0.29 (95% CI, 0.24-0.36) and DOR of 13.76 (95% CI, 9.29-20.37). The area under the summarized receiver operating characteristic curve was given a value of 0.85 (95% CI, 0.82-0.88). No obvious publication bias existed in the Deeks' funnel plot asymmetry test.

Conclusion: Our findings suggest that RBP4 has a promising diagnostic value with good sensitivity and specificity for patients with T2DM with DN.

Keywords: biomarkers; diabetic nephropathy; diagnosis; meta-analysis; retinol-binding protein 4.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram of literature selection.
Figure 2
Figure 2
Bias risk assessment by Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS−2). (A) QUADAS−2 summary plot (B) QUADAS−2 bar plot.
Figure 3
Figure 3
Forest plot of pooled sensitivity and specificity.
Figure 4
Figure 4
Forest plot of pooled positive likelihood ratio (PLR) and negative likelihood ratio (NLR).
Figure 5
Figure 5
Forest plot of pooled diagnostic score and diagnostic odds ratio (DOR).
Figure 6
Figure 6
Summary receiver operating characteristic (SROC) plots.
Figure 7
Figure 7
Fagan nomogram of retinol-binding protein 4 for the diagnosis of diabetic nephropathy.
Figure 8
Figure 8
Meta-regression analysis for examining sensitivity and specificity of retinol-binding protein 4 for the diagnosis of diabetic nephropathy. *P<0.05, **P<0.01, ***P<0.001.
Figure 9
Figure 9
Diagram of sensitivity analysis showing (A) goodness-of-fit; (B) bivariate normality; (C) influence analysis; (D) outlier detection.
Figure 10
Figure 10
Deeks’ funnel plot asymmetry test for publication bias.
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