尿微量白蛋白与2型糖尿病视网膜病变发生风险的Meta分析

Microalbuminuria and incidence risk of type 2 diabetic retinopathy:a Meta-analysis

目的:探讨尿微量白蛋白与2型糖尿病视网膜病变(diabetic retinopathy,DR)发生风险的关系。方法:在PubMed、Web of Science、the Cochrane Library、中国生物医学文献数据库(Chinese Biomedical Database,CBM)、中国知网(CNKI)和万方数据库中检索2020年4月20日之前发表的文献。由两名评价者独立针对检验DR的尿微量白蛋白的病例对照试验进行评价汇总,并复查其准确性,计算合并效应量优势比(OR)值或均方差(MD)值。结果:14项研究纳入分析,微量白蛋白尿连续性变量合并MD有统计学意义[MD=45.72,95%Cl(29.89,61.54),P<0.00001],按照测量方法分类的亚组分析中,晨尿微量蛋白尿MD值[MD=17.32,95%CI(6.26,28.37),P=0.002]及24 h尿液亚组MD值[MD=125.02,95%CI(110.81,139.24),P<0.00001]亦有统计学意义;微量白蛋白尿二分类变量合并OR值[OR=2.45,95%CI(2.01,2.98),P<0.00001]和大量白蛋白尿OR值[OR=8.45,95%CI(3.63,19.67),P<0.00001]有统计学意义。结论:现有证据表明,尿微量白蛋白在DR病人中呈高表达,与DR联系密切,是DR的危险因素。

Objective:To investigate the relationship between microalbuminuria and incidence risk of type 2 diabetic retinopathy.Methods:Articles published before April 20,2020 were searched from PubMed,Web of Science,the Cochrane Library,Chinese Biomedical database(CBM),CNKI and Wanfang database.The case-control trials of Microalbuminuria patients checking the DR were evaluated and summarized by two reviewers independently.The accuracy of data was re-tested.Then the odds ratio(OR)or mean difference(MD)were calculated and consolidated.Conclusion:14 studies were included in the analysis.The continuous variables of microalbuminuria were combined with MD[MD=45.72,95%CI(29.89,61.54),P<0.00001].In the subgroup analysis classified according to measure ment method,showed MD value of morning urine subgroup[MD=17.32,95%CI(6.26,28.37),P=0.002],MD value of 24-hour urine subgroup[MD=125.02,95%CI(110.81,139.24),P<0.00001],OR value of microalbuminuria combined with binary variables[OR=2.45,95%CI(2.01,2.98),P<0.00001],OR value of massive albuminuria[OR=8.45,95%CI(3.63,19.67),P<0.00001].Conclusion:Current evidences shows that microalbuminuria is highly expressed in DR patients,which is closely related to DR and is a risk factor for DR.