Abstract
Background. The objective of this study was to conduct a systematic review of literature evaluating human resistin expression as a diagnostic factor in osteoarthritis development and to quantify the overall diagnostic effect. Method. Relevant studies were identified and evaluated for quality through multiple search strategies. Studies analyzing resistin expression in the development of OA were eligible for inclusion. Data from eligible studies were extracted and included into the meta-analysis using a random-effects model. Results. Four case-control studies consisting of a total of 375 OA patients and 214 controls as well as three sex-stratified analyses composed of 53 males and 104 females were incorporated into our meta-analysis. Our results revealed that resistin levels were significantly higher in male OA subjects and OA patients overall. Country-stratified analysis yielded significantly different estimates in resistin levels between male OA subjects and female OA subjects in the Canadian subgroup but not among the French and USA subgroups. Based on the resistin levels in OA cases and controls, resistin levels were heightened in OA patients in the Dutch population. Conclusion. These results support the hypothesis that high expression of resistin represents a significant and reproducible marker of poor progression in OA patients, especially in males.
Highlights
Osteoarthritis (OA), characterized by articular cartilage loss, subchondral bone remodeling, soft tissue damage and inflammation, is the most common form of arthritis and a major cause of disability in the adult population [1, 2]
To be included in the systematic review, retrieved studies had to be assessed for their suitability by meeting the following criteria: (1) the study was conducted within a human population and published in a peer-reviewed journal; (2) only case-control or cohort studies examining the association of resistin level in the pathogenesis in OA were incorporated into the metaanalysis; (3) all patients were confirmed to have OA in accordance with the definitions and classification provided by the Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association [26]; (4) the article must present original data and supply sufficient information on resistin levels; (5) if studies provided overlapping data, we would choose the study that had the largest number
When concerned about the correlation between resistin levels and male/female OA subjects, results of the present study revealed that resistin showed significantly higher levels in male OA subjects in contrast to female OA subjects, according to the pooled standardized mean difference (SMD) in the three included studies (SMD = 0.45, 95% confidence interval (95% CI) = 0.08∼ 0.83, P = 0.018)
Summary
Osteoarthritis (OA), characterized by articular cartilage loss, subchondral bone remodeling, soft tissue damage and inflammation, is the most common form of arthritis and a major cause of disability in the adult population [1, 2]. OA is the main cause for hip and knee arthroplasties and presents a major public health problem [3] It is estimated by the World Health Organization Scientific Group on Rheumatic Diseases that 10% of the world’s population over 60 have significant clinical problems that can be attributed to OA [4]. The objective of this study was to conduct a systematic review of literature evaluating human resistin expression as a diagnostic factor in osteoarthritis development and to quantify the overall diagnostic effect. Our results revealed that resistin levels were significantly higher in male OA subjects and OA patients overall. These results support the hypothesis that high expression of resistin represents a significant and reproducible marker of poor progression in OA patients, especially in males
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