Abstract
ObjectiveGlycosylated hemoglobin (HbA1c) has obvious clinical value in the diagnosis of diabetes, but the conclusions on the diagnostic value of diabetic retinopathy (DR) are not consistent. This study aims to comprehensively evaluate the accuracy of glycosylated hemoglobin in the diagnosis of diabetic retinopathy through the meta-analysis of diagnostic tests.MethodsCochrane Library, Embase, PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), China Wanfang Database, Chinese Biomedical Literature Database (CBM) were searched until November, 2020. The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool was used to assess the quality of the included studies. The pooled sensitivity, specificity, positive likelihood ratio (+LR), negative likelihood ratio (-LR), diagnostic odds ratio (DOR) and areas under the receiver operating characteristic (ROC) curve were calculated by Stata 15.0 software.ResultsAfter screening, 18 high-quality papers were included. The results of meta-analysis showed that the combined DOR = 18.19 (95% CI: 10.99–30.11), the sensitivity= 0.81 (95% CI): 0.75 ~ 0.87), specificity = 0.81 (95%CI: 0.72 ~ 0.87), +LR = 4.2 (95%CI: 2.95 ~ 6.00), −LR = 0.23 (95%CI: 0.17 ~ 0.31), and the area under the Summary ROC curve was 0.88 (95%CI: 0.85 ~ 0.90).ConclusionThe overall accuracy of HbA1cC forin diagnosing diabetic retinopathy is good. As it is more stable than blood sugar and is not affected by meals, it may be a suitable indicator for diabetic retinopathy.
Highlights
Diabetes mellitus (DM) is a global pandemic
The International Diabetes Federation predicts [1] that the number of diabetes will rise to 552 million by 2030, of which type 2 diabetes mellitus (T2DM) will accounts for 90%, while the situation in
Retrieval strategy Two researchers independently searched Cochrane Library, Embase, PubMed, Web of Science, China Knowledge Network China National Knowledge Infrastructure (CNKI), China Wanfang Database, Chinese Biomedical Literature Database (CBM) from inception to November 2020 to evaluate the value of HbA1C in the diagnosis of diabetic retinopathy
Summary
Diabetes mellitus (DM) is a global pandemic. According to statistics, the number of diabetes in the world reached 366 million in 2011 and 422 million in 2014 (accounting for 8.5% of the population). Due to the slow onset of diabetic retinopathy, if the disease does not invade the macula, it is not easy to be diagnosed until the patient comes to see a doctor with symptoms such as blurred vision and decreased vision. At this time, the disease has developed to the stage of irreversible and severe microangiopathy, when it has well past the best period of treatment, so it is very difficult to treat it, and the treatment effect is relatively poor, which eventually results in patients’ blindness
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