胰岛素受体底物1对阿尔茨海默病诊断价值的Meta分析

A Meta-analysis of the diagnostic value of insulin receptor substrate 1 in Alzheimer′s disease

目的系统评价胰岛素受体底物1(IRS-1)对阿尔茨海默病(AD)的诊断价值。方法检索PubMed、MEDLINE、Embase、Web of Science、中国知网、万方数据库、维普网,收集整理有关利用IRS-1诊断AD的临床研究,通过文献的纳入和排除标准筛选出相关文献,评价纳入文献的质量,提取文献中的相关数据,应用Stata14.0软件进行Meta分析。结果最终纳入5篇相关文献,共包含731例研究对象,其中病例组301例,对照组430例。Meta分析结果表明,IRS-1诊断AD的合并灵敏度=0.85(95%CI:0.80~0.88),合并特异度=0.86(95%CI:0.83~0.89),合并阳性似然比=6.17(95%CI:4.85~7.86),合并阴性似然比=0.18(95%CI:0.14~0.23),合并诊断比值比=34.86(95%CI:22.97~52.90)。集成受试者工作特征曲线分析结果显示,IRS-1诊断AD的曲线下面积为0.92(95%CI:0.80~0.94)。结论IRS-1对AD具有较高的临床诊断价值,可指导临床诊断。

Objective To systematically evaluate the diagnostic value of insulin receptor substrate 1(IRS-1)in Alzheimer′s disease(AD).Methods PubMed,MEDLINE,Embase,Web of Science,CNKI,Wanfang database,VIP network were searched to collect and collate clinical studies on the diagnosis of AD using IRS-1.Relevant literatures were screened through inclusion and exclusion criteria,and the quality of the included literatures was evaluated.Relevant data were extracted from the literatures and Meta-analysis was performed using Stata14.0 software.Results Finally,5 related literatures were included,including a total of 731 subjects,including 301 cases in the case group and 430 cases in the control group.The results of Meta-analysis showed that the combined sensitivity of IRS-1 in the diagnosis of AD was 0.85(95%CI:0.80-0.88),the combined specificity was 0.86(95%CI:0.83-0.89),the combined positive likelihood ratio was 6.17(95%CI:4.85-7.86),the combined negative likelihood ratio was 0.18(95%CI:0.14-0.23),the combined diagnostic odds ratio was 34.86(95%CI:22.97-52.90).Summary receiver operating characteristic curve analysis showed that the area under the curve of IRS-1 in the diagnosis of AD was 0.92(95%CI:0.80-0.94).Conclusion IRS-1 has high clinical diagnostic value for AD and can guide clinical diagnosis.