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. 2025 Mar 5;37(3):328-338.
doi: 10.4103/tcmj.tcmj_211_24. eCollection 2025 Jul-Sep.

Pancreatic stone protein as a novel biomarker of microvascular complications in type II diabetes mellitus: A systematic review and meta-analysis

Nicolas Daniel Widjanarko  1 , Nanny Natalia Mulyani Soetedjo  2 , Maria Riastuti Iryaningrum  3 , Erlangga Saputra Arifin  1 , Steven Alvianto  4 , Stevan Kristian Lionardi  1 , Archie Fontana Iskandar  5 , Kevin Axel Chandra  6
Affiliations

Pancreatic stone protein as a novel biomarker of microvascular complications in type II diabetes mellitus: A systematic review and meta-analysis

Nicolas Daniel Widjanarko et al. Tzu Chi Med J. .

Abstract

Objectives: 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.

Materials and methods: 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.

Results: 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, P < 0.00001). Further subgroup analysis showed PSP was substantially higher in T2DM with complications (SMD = -1.57, 95% CI: -2.12 to -1.02, P < 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.

Conclusion: 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.

Keywords: Pancreatic stone protein; Regenerating protein; Type 2 diabetes mellitus.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Preferred Reporting Items for Systematic Reviews and Meta-Analysis 2020 flow diagram of the literature search
Figure 2
Figure 2
Meta-analysis results [forest plot] for pancreatic stone protein values in various spectrum of type 2 diabetes mellitus (T2DM) (1.2.1. Newly Diagnosed T2DM, 1.2.2. T2DM without complication) compared to T2DM with complication groups
See this image and copyright information in PMC

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