术后早期测量 Copeptin 在预测成人垂体手术后糖尿病性尿崩症中的作用：系统综述加荟萃分析。

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2024-10-28 DOI:10.1016/j.wneu.2024.10.006

Alireza Sharifi , Peter H. Hwang , Ali Kouhi , Mohaddeseh Zojaji , Mohammad E. Ghaffari , Sahar Ghaedsharaf

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引用次数: 0

摘要

目的：垂体手术后的并发症--糖尿病性尿崩症（DI）的早期诊断可避免嗜睡甚至死亡等灾难性后果。精氨酸加压素（AVP）的测定有助于早期诊断，但其直接测定具有挑战性。与 AVP 等摩尔量共同分泌的 Copeptin 被认为是预测术后 DI 的可靠标志物。因此，本系统综述和荟萃分析旨在发现这种可能的作用：方法：对谷歌学术、PubMed、Scopus、Web of Science、Embase 和 Cochrane 图书馆进行了系统检索（截至 2024 年 8 月）。采用了系统综述和荟萃分析首选报告项目（PRISMA）和问题/人群、干预、比较和结果（PICO）指南。两位作者独立审阅了符合条件的文章，并对其质量进行了评估。进行了一项荟萃分析以评估 copeptin 的鉴别性能：共有 8 项队列研究（包括 1255 名参与者）符合纳入标准。在所有纳入的研究中，与非DI组相比，DI组的中位数 copeptin 水平明显较低（P < 0.005）。AUCs的元分析表明，早期测量宫缩肽水平的准确度为0.791（SE：0.0198，95% CI：0.752至0.830），具有统计学意义（P < 0.001）：结论：接受垂体手术的DI患者的谷丙转氨酶水平明显低于非DI患者。垂体手术后尽早（术后 1 小时至 48 小时内）测量谷丙转氨酶对排除术后 DI 有良好但非极佳的准确性。

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Role of Early Postoperative Measurement of Copeptin in Prediction of Diabetes Insipidus Following Pituitary Surgery in Adults: A Systematic Review Plus Meta-analysis

Background

Early diagnosis of diabetes insipidus (DI), a complication following pituitary surgery, can avoid catastrophic results such as lethargy or even death. Measurement of arginine vasopressin (AVP) may help the early diagnosis, but its direct assaying is challenging. Copeptin, which is co-secreted in equimolar quantities to AVP, is suggested to be a reliable marker in prediction of postoperative DI. Therefore, this systematic review plus meta-analysis aims to discover this possible role.

Methods

Google Scholar, PubMed, Scopus, Web of Science, Embase, and Cochrane library were systematically searched up to August 2024. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and Problem/Population, Intervention, Comparison, and Outcome (PICO) guidelines were used. Two authors independently reviewed the eligible articles and assessed the quality of them. A meta-analysis was conducted to assess the discriminative performance of copeptin.

Results

In total, 8 cohort studies including 1255 participants met the inclusion criteria. The median copeptin levels were significantly lower in DI groups compared with non-DI groups in all included studies (P < 0.005). Meta-analysis of areas under the curve demonstrated that early measurement of copeptin level had an accuracy of 0.791 (standard error: 0.0198, 95% CI: 0.752 to 0.830), which was statistically significant (P < 0.001).

Conclusions

Copeptin level was significantly lower in DI patients than in non-DI patients who underwent pituitary surgery. Early measurement, as soon as possible (from the first hour to 48 hours after the operation) of copeptin after pituitary surgeries has good, but not excellent, accuracy to exclude postoperative DI.

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.