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.
Highlights
Diabetes mellitus (DM) affects more than 463 million people globally, and this number is supposed to increase to 700 million by 2045 [1]
Excluding each study, one by one, did not significantly change the results, indicating that the combined results were stable. In this meta-analysis, we found that Retinol-binding protein 4 (RBP4) levels were significantly elevated in the micro, macro, and micro+macro albuminuria groups compared with those in the normal albuminuria group of subjects with type 2 DM (T2DM)
Compared with the non-DM control, the concentrations of RBP4 were increased in the microalbuminuria and macroalbuminuria DM groups but were similar in the normal albuminuria DM group
Summary
Diabetes mellitus (DM) affects more than 463 million people globally, and this number is supposed to increase to 700 million by 2045 [1]. Diabetic nephropathy (DN) is a common and serious complication of DM [2] and is one of the leading causes of end-stage renal disease (ESRD) worldwide [3]. It is associated with cardiovascular and all-cause mortality [4]. The purpose of this study was to perform a systematic review and metaanalysis of the role of circulating retinol-binding protein 4 (RBP4) in the type 2 diabetes mellitus (T2DM) patients with kidney diseases. 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]. Circulating RBP4 could be a reliable biomarker for kidney diseases in T2DM
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