尿NGAL对糖尿病肾病诊断价值的Meta分析

Diagnostic value of urinary NGAL in diabetic kidney disease:a Meta-analysis

目的通过Meta分析评价尿中性粒细胞明胶酶相关脂质运载蛋白(NGAL)在糖尿病肾病(DKD)中的诊断价值。方法检索PubMed、Embase、Cochrane Library、中国知网和万方数据库中收录的尿NGAL诊断DKD相关文献,采用Stata 13.1软件进行Meta分析。结果最终纳入18篇中高等质量文献,共包含2388例糖尿病患者和1255例DKD患者。Meta分析结果显示,合并灵敏度为0.83(95%CI:0.77~0.88),合并特异度为0.81(95%CI:0.68~0.90),合并阳性似然比为4.45(95%CI:2.51~7.88),合并阴性似然比为0.20(95%CI:0.14~0.29),合并诊断比值比为21.87(95%CI:10.06~47.53),综合受试者工作特征曲线下面积为0.89(95%CI:0.86~0.91)。采用Deek漏斗图不对称检验对所纳入研究的发表偏倚进行检验,结果显示所纳入研究不存在发表偏移(P=0.31)。结论尿NGAL对DKD具有潜在的诊断价值,有望成为DKD诊断的新型标志物。

Objective To evaluate the diagnostic value of urinary neutrophil gelatase-associated lipid carrier protein(NGAL)in diabetic kidney disease(DKD)by Meta-analysis.Methods The literature related to urinary NGALs in the diagnosis of DKD was searched from PubMed,Embase,Cochrane Library,CNKI and Wanfang database,and then Meta-analysis was performed with Stata 13.1 software.Results Eighteen medium and high quality literature was finally included,including 2388 diabetics and 1255 patients with DKD.The results of Meta-analysis showed that the combined sensitivity was 0.83(95%CI:0.77-0.88),the combined specificity was 0.81(95%CI:0.68-0.90),the combined positive likelihood ratio was 4.45(95%CI:2.51-7.88),the combined negative likelihood ratio was 0.20(95%CI:0.14-0.29),the combined diagnostic odds ratio was 21.87(95%CI:10.06-47.53),and the area under the summary receiver operating characteristic curve was 0.89(95%CI:0.86-0.91).The publication bias of the included studies was tested using the Deek funnel asymmetry test,and the results showed that there was no publication bias in the included studies(P=0.31).Conclusion Urinary NGAL has potential diagnostic value for DKD and is expected to be a new marker for DKD diagnosis.