果糖胺检测对糖尿病诊断价值的Meta分析

Value of fructosamine test in the diagnosis of diabetes mellitus:A meta-analysis

目的评价果糖胺检测在糖尿病诊断中的临床价值。方法检索PubMed、EMbase、Ovid、CNKI、万方数据库,系统评价果糖胺检测对糖尿病的诊断价值。采用RevMan 5.2和Meta-Disc 1.4软件行综合定量评价,Stata 11.0软件评价发表偏倚。结果最终纳入19篇文献。Meta分析结果显示,合并敏感性0.76（95%CI：0.74~0.78）,合并特异性0.89（95%CI：0.88~0.90）,阳性似然比8.47（95%CI：5.47~13.12）,阴性似然比0.24（95%CI：0.19~0.30）,合并诊断比值比41.05（95%CI：23.37~72.10）,异质性的差异有统计学意义（P〈0.01）;受试者工作特征（ROC）曲线下面积（AUC）为0.9205,Q＊指数为0.8540;Begg（P=0.484）和Egger检验（P=0.155）均提示不存在发表偏倚。结论果糖胺检测对糖尿病诊断有一定参考价值。

Objective To evaluate the clinical value of fructosamine test in the diagnosis of diabetes mellitus. Methods The value of fructosamine in the diagnosis of diabetes mellitus was evaluated by systematically searching PubMed,EMbase,Ovid,CNKI and WanFang data bases.RevMan 5.2and MetaDisc 1.4 software were used to perform comprehensive quantitative assessment for all included studies.Stata 11.0software was used to evaluate the publication bias. Results A total of 19 studies were included.Meta-analysis showed combined sensitivity was 0.76（95%CI：0.74~0.78）,combined specificity was 0.89（95%CI：0.88~0.90）,combined positive likelihood ratio was 8.47（95%CI：5.47~13.12）,combined negative likelihood ratio was 0.24（95%CI：0.19~0.30）,and combined diagnostic odds ratios was 41.05（95% CI：23.37~72.10）.The difference of heterogeneity reached the statistical significance（P〈0.01）.The area under the curve（AUC）of receiver operating characteristic（ROC）was0.9205 and Q＊index was 0.8540.Beggtest（P=0.484）and Eggertest（P=0.155）showed that there was no publication bias. Conclusion Fructosamine test have some value in the diagnosis of diabetes mellitus.