Association between circulating adipocytokine concentrations and microvascular complications in patients with type 2 diabetes mellitus: A systematic review and meta-analysis of controlled cross-sectional studies.

Autor: Rodríguez AJ; Department of Genome Sciences, The John Curtin School of Medical Research, The Australian National University, Canberra, 131 Garran Rd, Acton, ACT, 2601, Australia. Electronic address: alexander.rodriguez@monash.edu., Nunes Vdos S; Department of Internal Medicine, Botucatu Medical School, State University/UNESP, Sao Paulo, Faculdade de Medicina, Distrito de Rubião Júnior s/n, Botucatu, SP, CEP 18618-000, Brazil. Electronic address: vsnunes@fmb.unesp.br., Mastronardi CA; Department of Genome Sciences, The John Curtin School of Medical Research, The Australian National University, Canberra, 131 Garran Rd, Acton, ACT, 2601, Australia. Electronic address: claudio.mastronardi@anu.edu.au., Neeman T; Statistical Consulting Unit, The Australian National University, Canberra, John Dedman Mathematical Sciences Building, 27 Union Lane, Acton, ACT, 2601, Australia. Electronic address: teresa.neeman@anu.edu.au., Paz-Filho GJ; Department of Genome Sciences, The John Curtin School of Medical Research, The Australian National University, Canberra, 131 Garran Rd, Acton, ACT, 2601, Australia. Electronic address: gilberto.pazfilho@anu.edu.au.
Jazyk: angličtina
Zdroj: Journal of diabetes and its complications [J Diabetes Complications] 2016 Mar; Vol. 30 (2), pp. 357-67. Date of Electronic Publication: 2015 Nov 07.
DOI: 10.1016/j.jdiacomp.2015.11.004
Abstrakt: Background: The adipocytokines leptin and adiponectin have been variously associated with diabetic microvascular complications. No comprehensive clinical data exist examining the association between adipocytokines and the presence of these complications.
Methods: This is a systematic review of cross-sectional studies comparing circulating adipocytokines in patients with type 2 diabetes mellitus (T2DM), with and without microvascular complications. Studies were retrieved from MEDLINE, EMBASE, Scopus and Cochrane databases. Study quality was evaluated using a modified Newcastle-Ottawa Scale. Meta-analysis was performed using an inverse-variance model, providing standardised mean differences (SMD) and 95% confidence intervals (CI). Heterogeneity was determined by I(2) statistic.
Results: Amongst 554 identified studies, 28 were included in the review. Study quality range was 3.5-9 (maximum 11). Higher leptin levels were associated with microalbuminuria (SMD=0.41; 95% CI=0.14-0.67; n=901; p=0.0003), macroalbuminuria (SMD=0.68; 95% CI=0.30-1.06; n=406; p=0.0004), and neuropathy (SMD=0.26; 95% CI=0.07-0.44; n=609; p=0.008). Higher adiponectin levels were associated with microalbuminuria (SMD=0.55; 95% CI=0.29-0.81, n=274; p<0.001), macroalbuminuria (SMD=1.37; 95% CI=0.78-1.97, n=246; p<0.00001), neuropathy (SMD=0.25; 95% CI=0.14-0.36; n=1516; p<0.00001), and retinopathy (SMD=0.38; 95% CI=0.25-0.51; n=1306; p<0.00001). Meta-regression suggested no influence of body mass index and duration of diabetes on effect size, and a weak trend in terms of age on effect size.
Discussion: Our meta-analysis suggests leptin and adiponectin levels are higher in T2DM patients with microvascular complications. Studies were limited by cross-sectional design. Large prospective analyses are required to validate these findings.
(Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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