{"title":"The association between fibroblast growth factor 21 with diabetes retinopathy among type 2 diabetes mellitus patients: a systematic review, meta-analysis, and meta-regression.","authors":"Herni Basir, Annisa Salsabilla Dwi Nugrahani, Andi Makbul Aman, Syakib Bakri, Haerani Rasyid, Husaini Umar, Faridin H P, Andi Muhammad Ichsan, Andi Alfian Zainuddin","doi":"10.7717/peerj.18308","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Diabetic retinopathy (DR), a leading cause of vision loss worldwide, is a common complication of type 2 diabetes mellitus (T2DM) driven by chronic hyperglycemia and microvascular damage. Fibroblast growth factor 21 (FGF21) is crucial in blood sugar regulation and has been linked to DR incidence and severity. While some studies suggest that FGF21 levels may contribute to the DR incidence, others propose a protective role. This discrepancy necessitates further analysis, prompting this study to evaluate the association between FGF21 levels and DR incidence and severity in T2DM patients.</p><p><strong>Methods: </strong>A systematic search was conducted through MEDLINE, Web of Science, Scopus, and Embase up to May 2024 for studies evaluating the association between FGF21 and DR incidence and severity. A random-effect model meta-analysis was performed to calculate the pooled standardized mean difference (SMD) and 95% confidence intervals (CI). A univariate meta-regression was performed to analyze factors influencing pooled size estimates. All statistical analyses were performed using STATA 17 software.</p><p><strong>Result: </strong>This systematic review and meta-analysis of 5,852 participants revealed that FGF21 was positively correlated with DR (SMD 3.11; 95% CI [0.92-5.30], <i>p</i> = 0.005) and sight-threatening DR (STDR) incidence (SMD 3.61; 95% CI [0.82-6.41], <i>p</i> = 0.01). There was no significant difference in FGF21 levels in DR <i>vs</i> STDR (<i>p</i> = 0.79). Subgroup analysis revealed a significant difference in DR incidence between LDL groups, with higher DR incidence in the group with low-density lipoprotein (LDL) levels >100 (<i>P</i> < 0.00001). Meta-regression revealed no variables significantly influenced the pooled size estimates.</p><p><strong>Conclusion: </strong>A higher level of FGF21 was associated with higher DR and STDR incidence among T2DM patients, highlighting its potential utilization as a biomarker for DR detection and enabling the exploration of FGF21-based treatment strategies. However, variables independently predicting DR among patients with elevated FGF21 levels shall be explored further.</p><p><strong>Prospero id: </strong>CRD42024559142.</p>","PeriodicalId":19799,"journal":{"name":"PeerJ","volume":"12 ","pages":"e18308"},"PeriodicalIF":2.3000,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11648683/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"PeerJ","FirstCategoryId":"99","ListUrlMain":"https://doi.org/10.7717/peerj.18308","RegionNum":3,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"MULTIDISCIPLINARY SCIENCES","Score":null,"Total":0}
引用次数: 0
摘要
背景:糖尿病视网膜病变(DR)是全球视力丧失的主要原因,是 2 型糖尿病(T2DM)的常见并发症,由慢性高血糖和微血管损伤引起。成纤维细胞生长因子 21(FGF21)在血糖调节中起着至关重要的作用,并与 DR 的发病率和严重程度有关。一些研究表明,成纤维细胞生长因子 21 的水平可能会导致 DR 的发生,而另一些研究则认为其具有保护作用。这种差异需要进一步分析,因此本研究评估了 T2DM 患者中 FGF21 水平与 DR 发病率和严重程度之间的关系:截至 2024 年 5 月,通过 MEDLINE、Web of Science、Scopus 和 Embase 对评估 FGF21 与 DR 发病率和严重程度之间关系的研究进行了系统检索。采用随机效应模型进行荟萃分析,计算汇总的标准化平均差(SMD)和95%置信区间(CI)。为了分析影响集合规模估计值的因素,还进行了单变量元回归。所有统计分析均使用 STATA 17 软件进行:这项对 5,852 名参与者进行的系统回顾和荟萃分析表明,FGF21 与 DR(SMD 3.11;95% CI [0.92-5.30],p = 0.005)和视力威胁性 DR(STDR)发病率(SMD 3.61;95% CI [0.82-6.41],p = 0.01)呈正相关。DR与STDR的FGF21水平无明显差异(p = 0.79)。亚组分析显示,低密度脂蛋白组之间的DR发生率存在显著差异,低密度脂蛋白(LDL)水平>100组的DR发生率更高(P < 0.00001)。元回归显示,没有变量对集合规模估计值产生显著影响:结论:FGF21水平越高,T2DM患者的DR和STDR发生率越高,这表明FGF21有可能被用作检测DR的生物标记物,并有助于探索基于FGF21的治疗策略。然而,还需要进一步探讨在 FGF21 水平升高的患者中独立预测 DR 的变量:crd42024559142.
The association between fibroblast growth factor 21 with diabetes retinopathy among type 2 diabetes mellitus patients: a systematic review, meta-analysis, and meta-regression.
Background: Diabetic retinopathy (DR), a leading cause of vision loss worldwide, is a common complication of type 2 diabetes mellitus (T2DM) driven by chronic hyperglycemia and microvascular damage. Fibroblast growth factor 21 (FGF21) is crucial in blood sugar regulation and has been linked to DR incidence and severity. While some studies suggest that FGF21 levels may contribute to the DR incidence, others propose a protective role. This discrepancy necessitates further analysis, prompting this study to evaluate the association between FGF21 levels and DR incidence and severity in T2DM patients.
Methods: A systematic search was conducted through MEDLINE, Web of Science, Scopus, and Embase up to May 2024 for studies evaluating the association between FGF21 and DR incidence and severity. A random-effect model meta-analysis was performed to calculate the pooled standardized mean difference (SMD) and 95% confidence intervals (CI). A univariate meta-regression was performed to analyze factors influencing pooled size estimates. All statistical analyses were performed using STATA 17 software.
Result: This systematic review and meta-analysis of 5,852 participants revealed that FGF21 was positively correlated with DR (SMD 3.11; 95% CI [0.92-5.30], p = 0.005) and sight-threatening DR (STDR) incidence (SMD 3.61; 95% CI [0.82-6.41], p = 0.01). There was no significant difference in FGF21 levels in DR vs STDR (p = 0.79). Subgroup analysis revealed a significant difference in DR incidence between LDL groups, with higher DR incidence in the group with low-density lipoprotein (LDL) levels >100 (P < 0.00001). Meta-regression revealed no variables significantly influenced the pooled size estimates.
Conclusion: A higher level of FGF21 was associated with higher DR and STDR incidence among T2DM patients, highlighting its potential utilization as a biomarker for DR detection and enabling the exploration of FGF21-based treatment strategies. However, variables independently predicting DR among patients with elevated FGF21 levels shall be explored further.
期刊介绍:
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