Background. Diabetic nephropathy is a common and serious complication of diabetes mellitus (DM) and is one of the leading causes of end-stage renal disease worldwide. Although there have been many investigations on biomarkers for DN, there is no consistent conclusion about reliable biomarkers. The purpose of this study was to perform a systematic review and meta-analysis of the role of circulating retinol-binding protein 4 (RBP4) in the type 2 diabetes mellitus (T2DM) patients with kidney diseases. Materials and Methods. We searched the PubMed, MEDLINE, EMBASE, and Web of Science databases for publications. For the 12 cross-sectional studies that we included in the review, we calculated standard mean differences (SMD) with 95% confidence intervals (CI) for continuous data when the applied scales were different. Risk of bias of included trials was assessed by using the Newcastle-Ottawa Scale. Results. RBP4 concentrations in the micro-, macro-, or micro+macroalbuminuria groups were significantly higher than those in the normal albuminuria group of T2DM patients [, SMD 1.07, 95% CI (0.41, 1.73)]. The estimated glomerular filtration rate (eGFR) was negatively associated with circulating RBP4 concentrations in patients with T2DM [summary Fisher’s , 95% CI (-0.69, -0.26), ]. The albumin-to-creatinine ratio (ACR) was positively associated with circulating RBP4 concentrations in patients with T2DM [summary Fisher’s , 95% CI (0.08, 0.32), ]. Conclusion. The levels of circulating RBP4 were significantly higher both in T2DM subjects with micro/macroalbuminuria and in T2DM subjects with declined eGFR. The levels of circulating RBP4 were positively correlated with ACR but negatively correlated with eGFR. Circulating RBP4 could be a reliable biomarker for kidney diseases in T2DM.

中文翻译：

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循环 RBP4 在 2 型糖尿病肾病患者中的作用：系统评价和荟萃分析

背景。糖尿病肾病是糖尿病（DM）常见且严重的并发症，是全球终末期肾病的主要原因之一。尽管已经对DN的生物标志物进行了许多研究，但对于可靠的生物标志物并没有一致的结论。本研究的目的是对循环视黄醇结合蛋白 4 (RBP4) 在 2 型糖尿病 (T2DM) 肾病患者中的作用进行系统回顾和荟萃分析。材料和方法. 我们在 PubMed、MEDLINE、EMBASE 和 Web of Science 数据库中搜索了出版物。对于我们纳入审查的 12 项横断面研究，我们计算了标准均数差 (SMD) 和 95% 置信区间 (CI) 的连续数据，当应用的量表不同时。使用纽卡斯尔-渥太华量表评估纳入试验的偏倚风险。结果。T2DM 患者的微量、大量或微量+大量白蛋白尿组中的 RBP4 浓度显着高于正常白蛋白尿组中的 RBP4 浓度。, SMD 1.07, 95% CI (0.41, 1.73)]。估计的肾小球滤过率 (eGFR) 与 T2DM 患者的循环 RBP4 浓度呈负相关 [总结 Fisher's, 95% CI (-0.69, -0.26),]。白蛋白肌酐比 (ACR) 与 T2DM 患者的循环 RBP4 浓度呈正相关 [总结 Fisher's, 95% CI (0.08, 0.32),]。结论。具有微量/大量白蛋白尿的 T2DM 受试者和具有下降 eGFR 的 T2DM 受试者的循环 RBP4 水平显着升高。循环 RBP4 水平与 ACR 呈正相关，但与 eGFR 呈负相关。循环 RBP4 可能是 T2DM 肾脏疾病的可靠生物标志物。