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

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Summary

Introduction

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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