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2017 ; 96
(15
): e6583
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Changes of transforming growth factor beta 1 in patients with type 2 diabetes and
diabetic nephropathy: A PRISMA-compliant systematic review and meta-analysis
#MMPMID28403088
Qiao YC
; Chen YL
; Pan YH
; Ling W
; Tian F
; Zhang XX
; Zhao HL
Medicine (Baltimore)
2017[Apr]; 96
(15
): e6583
PMID28403088
show ga
BACKGROUND: The existing evidence indicates increased levels of transforming
growth factor beta 1 (TGF-?1) in patients with type 2 diabetes mellitus (T2DM)
and those with type 2 diabetic nephropathy (T2DN); yet no meta-analysis displays
a reliable result. Here we conducted a meta-analysis to evaluate characteristic
changes of TGF-?1 in T2DM and diabetic nephropathy. METHODS: A systematic search
was conducted for eligible studies, which reported the association of TGF-?1
withT2DM and T2DN patients, in PubMed, Wangfang, Chinese-Cqvip, and China
National Knowledge Infrastructure database, from February 1, 1991 to December 15,
2015. The association of serum and urine TGF-?1 in T2DM and T2DN patients should
be evaluated in case-control studies. The Newcastle-Ottawa Scale was used to
access the quality of the included studies, and pooling data were synthesized as
standard mean difference (SMD) and 95% confidence interval (CI). The collected
data were synthesized according to Cochrane Handbook for Systematic Reviews
criteria. Subgroup analysis was conducted by albuminuria and ethnicity.
Regression analysis and sensitivity analysis were used to explore the sources of
heterogeneity. Publication bias was judged by the Egger test. RESULTS:
Sixty-three case-control studies of 364 T2DM patients (1604 T2DN patients) and
2100 healthy controls were included for meta-analysis. Compared with the
controls, the cases had increased TGF-?1 levels in both serum (T2DM: SMD
1.78??g/L; 95% CI 0.98-2.59, P?.001; T2DN: SMD 4.70??g/L, 95% CI 3.55-5.85,
P?.001) and urine samples (T2DM: SMD 1.27?pg/mg.creatinine, 95% CI 0.16-2.38,
P?.001; SMD 1.19?ng/L, 95% CI 0.77-1.62, P?.001; T2DN: SMD
3.14?pg/mg.creatinine, 95% CI 2.15-4.13, P?.001; SMD 4.50?ng/L, 95% CI
3.16-5.83, P?.001). The increase of serum TGF-?1 persisted in patients with
either microalbuminuria or macroalbuminuria (all P?.001) in Chinese and
non-Chinese population. High heterogeneity exists in some comparisons and
small-sample studies. CONCLUSIONS: Patients with T2DM and those with albuminuria,
Chinese or non-Chinese, had increased serum and urine TGF-?1 levels.
|Albuminuria/blood/etiology/urine
[MESH]
|Biomarkers/blood/urine
[MESH]
|Case-Control Studies
[MESH]
|Diabetes Mellitus, Type 2/*blood/complications/*urine
[MESH]