The Role of Circulating RBP4 in the Type 2 Diabetes Patients with Kidney Diseases: A Systematic Review and Meta-Analysis

Abstract EN

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 [P=0.001, 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 Z=−0.48, 95% CI (-0.69, -0.26), P<0.0001].

The albumin-to-creatinine ratio (ACR) was positively associated with circulating RBP4 concentrations in patients with T2DM [summary Fisher’s Z=0.20, 95% CI (0.08, 0.32), P=0.001].

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.