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23.11.2023 | Meta- Analysis

Urinary and circulatory netrin-1 as biomarker in diabetes and its related complications: a systematic review and meta-analysis

verfasst von: Amir Hossein Behnoush, Amirmohammad Khalaji, Zahra Shokri Varniab, Afshin Rahbarghazi, Elahe Amini, Aleksandra Klisic

Erschienen in: Endocrine | Ausgabe 2/2024

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Abstract

Background

Novel biomarkers have been suggested for the diagnosis and prognosis of diabetes mellitus. The biomarker utility of netrin-1 in diabetes as an extracellular protein has been investigated. In this systematic review and meta-analysis, we reviewed the role of netrin-1 as a biomarker in prediabetes, diabetes, and complications of diabetes.

Methods

PubMed, Embase, Scopus, and Web of Science were systematically searched for studies that measured circulatory and/or urinary netrin-1 levels in diabetes and compared them with non-diabetic patients or evaluated the prognostic role of this marker. Standardized mean difference (SMD) and 95% confidence interval (CI) were calculated using random-effect meta-analysis to compare netrin-1 levels between groups. The impact of mean age, male sex percentage, sample size, mean body mass index, and publication year on the overall heterogeneity was assessed using meta-regression.

Results

Among 413 records from international databases, 19 original studies were included with 2061 cases (1137 diabetics, 196 prediabetics, and 728 healthy controls). Meta-analysis of eight studies measuring netrin-1 in patients with diabetes and comparing it with healthy controls showed no significant difference between the two groups (SMD 0.69, 95% CI −0.78 to 2.16, I² = 98%, p-value = 0.36). On the other hand, a meta-analysis of netrin-1 levels in patients with prediabetes in comparison with healthy controls revealed that they had lower levels (SMD −0.51, 95% CI −0.81 to −0.21, p-value < 0.01). Diabetic patients with microalbuminuria and macroalbuminuria had significantly higher circulatory netrin-1 levels compared to normoalbuminuric group SMD 1.18, 95% CI 0.83 to 1.53, p-value < 0.01 and SMD 1.67, 95% CI 0.76 to 2.58, p-value < 0.01, respectively). Moreover, no difference in urinary netrin-1 levels was found between micro-, macro-, and normoalbuminuric groups (p-value > 0.05).

Conclusion

Netrin-1 showed promising results as a biomarker in diabetes prognosis. However, more studies are required to confirm our findings, and higher sample size studies are needed to evaluate the diagnostic utility of this marker.

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Titel: Urinary and circulatory netrin-1 as biomarker in diabetes and its related complications: a systematic review and meta-analysis
verfasst von: Amir Hossein Behnoush
Amirmohammad Khalaji
Zahra Shokri Varniab
Afshin Rahbarghazi
Elahe Amini
Aleksandra Klisic
Publikationsdatum: 23.11.2023
Verlag: Springer US
Erschienen in: Endocrine / Ausgabe 2/2024
Print ISSN: 1355-008X
Elektronische ISSN: 1559-0100
DOI: https://doi.org/10.1007/s12020-023-03598-y

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Urinary and circulatory netrin-1 as biomarker in diabetes and its related complications: a systematic review and meta-analysis