Abstract
BackgroundIn recent years, many studies have discovered that cystatin C (Cys C) may play an important role in respiratory diseases, especially in chronic obstructive pulmonary disease (COPD). However, the findings of these studies were inconsistent. This systematic review and meta-analysis aimed to assess the relationship between serum Cys C and COPD.MethodsWe conducted a systematic literature search in PubMed, Embase, Web of Science, Wanfang databases, and the China National Knowledge Infrastructure. The standardized mean difference (SMD), Fisher’s Z-value and 95% confidence interval (CI) were calculated to investigate the effect sizes. Subgroup analyses were performed on disease status, ethnicity, assay method, and study design. Sensitivity was performed, and publication bias was assessed.ResultsA total of 15 studies, including 4079 COPD patients and 5949 controls, were included in this meta-analysis. The results showed that serum Cys C levels in patients with COPD were significantly higher than those in controls (SMD = 0.99, 95% CI =0.62–1.37, P < 0.001), especially in AECOPD (SMD = 1.59, 95% CI =1.05–2.13, P < 0.001), and there were statistically different among AECOPD and SCOPD (SMD = 0.35, 95% CI =0.10–0.59, P = 0.005). The serum Cys C levels were negatively correlated with FEV1%pre (Z = − 0.45, 95%CI = -0.58--0.32, P = 0.011) and FEV1/FVC (Z = − 0.32, 95%CI = -0.50--0.14, P = 0.006). The serum Cys C levels were independent of ethnicity, assay method, and study design.ConclusionSerum Cys C levels were associated with COPD and COPD exacerbation, and they were inversely correlated with FEV1%pre and FEV1/FVC.
Highlights
In recent years, many studies have discovered that cystatin C (Cys C) may play an important role in respiratory diseases, especially in chronic obstructive pulmonary disease (COPD)
Literature search strategy We had searched PubMed, Embase, Web of Science, Wanfang databases, and the China National Knowledge Infrastructure (CNKI, www. cnki.net) to collect articles involving the role of Cys C in Chronic obstructive pulmonary disease (COPD), and the retrieval time was before Jul 312,019
The results showed that the meta-analysis indicated an inverse correlation between serum Cys C levels and FEV1%pre (Z = -0.45, 95%confidence interval (CI) = -0.58--0.32, P = 0.011) or FEV1/FVC (Z = -0.32, 95%CI = -0.50--0.14, P = 0.006; Fig. 6)
Summary
Many studies have discovered that cystatin C (Cys C) may play an important role in respiratory diseases, especially in chronic obstructive pulmonary disease (COPD). This systematic review and meta-analysis aimed to assess the relationship between serum Cys C and COPD. There are many studies on the clinical significance of serum Cys C levels changes in respiratory diseases. It has been studied that Cys C plays a role in pathogenesis of obstructive sleep apnea syndrome [10,11,12,13,14,15,16,17,18,19,20], lung malignancy [21], pleural effusions [22], and emphysema [23]
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