红细胞分布宽度水平在糖尿病肾病中预后价值的Meta分析

Meta-analysis of the Prognostic Value of Red Cell Distribution Width Lev-els in Diabetic

目的系统评价红细胞分布宽度(red cell distribution width,RDW)水平与糖尿病肾病(diabetic nephropa-thy,DN)病理分期的相关性及其预后价值。方法检索中国知网(CNKI)、万方(Wanfang)、维普网(VIP)、中国生物医学文献数据库(CBM)、PubMed、EMBase、Cochrane Library数据库,搜集从建库至2022年11月30日,关于RDW与DN相关的文章,研究类型包含病例对照研究、横断面研究、队列研究。根据制定好的纳入、排除标准层层筛选文献,采用Stata14.0软件对提取的相关数据进行Meta分析。结果检索相应数据库共得到115篇相关文献,根据纳入、排除标准最终17篇文献符合要求。具体病例情况如下:单纯2型糖尿病((type 2 dia-betes mellitus,T2DM))组1078例,早期DN组925例,中晚期DN组386例,健康对照组630例。Meta分析结果如下:T2DM组的RDW水平比健康人群组高1.11%(Z=3.64,P<0.05)。早期DN组的RDW水平比T2DM组高0.79%(Z=4.65,P<0.05)。中晚期DN组的RDW水平比早期DN组高1.04%(Z=2.72,P=0.007)。结论T2DM组RDW水平比健康人群高;随着DN疾病程度的增加,RDW水平也逐渐增加。RDW可作为T2DM、DN病理分期的一种新的炎性指标。RDW水平越高,DN的预后越差。

Objective To systematically evaluate the correlation between red cell distribution width(RDW)level and pathological stages of diabetic nephropathy(DN)and its prognostic value.Methods China National Knowledge Infra-structure(CNKI),Wanfang(Wanfang),Vip.com(VIP),China Biology Medicine disc(CBM),PubMed,EMBase,and Co-chrane Library databases were searched.Articles on RDW related to DN were collected from the time of database con-struction to November 30,2022,and the types of studies included case-control studies,cross-sectional studies,and cohort studies.Literature was screened according to the established inclusion and exclusion criteria,and the extracted data were analyzed by Meta-analysis using Stata 14.0 software.Results A total of 115 articles were retrieved from the corresponding databases,and 17 articles met the requirements according to the inclusion and exclusion criteria.The specific cases were as follows:1078 cases in the simple type 2 diabetes mellitus(T2DM)group,925 cases in the early DN group,386 cases in the middle-late DN group,and 630 cases in the healthy control group.The results of Meta-analysis were as follows:The level of RDW in the T2DM group was 1.11%higher than that in the healthy population group(Z=3.64,P<0.05).The RDW level in the early DN group was 0.79%higher than that in the T2DM group(Z=4.65,P<0.05).The RDW level in the middle-late DN group was 1.04%higher than that in the early DN group(Z=2.72,P=0.007).Conclusion RDW levels were higher in the T2DM group than in the healthy population.As the degree of DN disease increased,the RDW level increased gradually.RDW can be used as a new inflammatory index in the patho-logic staging of T2DM and DN.The higher the RDW level,the worse the prognosis of DN.