血清Lp-PLA2与糖尿病肾病关联性的荟萃分析  

Meta-analysis of the association between serum Lp-PLA2 and diabetic nephropathy

作　　者：张晓双 张佳佳 雷达鑫 曾倩 陈晶[2] 贺政新[2] ZHANG Xiao-shuang;ZHANG Jia-jia;LEI Da-xin;ZENG Qian;CHEN Jing;HE Zheng-xin(Department of Clinical Laboratory,Hebei Children′s Hospital,Hebei Province,Shijiazhuang 050031,China;Department of Laboratory,Bethune International Peace Hospital,Hebei Province,Shijiazhuang 050082,China)

机构地区：[1]河北省儿童医院检验科,河北石家庄050031 [2]白求恩国际和平医院检验科,河北石家庄050082

出　　处：《河北医科大学学报》2024年第1期113-117,共5页Journal of Hebei Medical University

基　　金：河北省医学科学研究课题计划(20220252)。

摘　　要：目的系统评价血清脂蛋白相关磷脂酶A2(lipoprotein-associated phospholipase A2,Lp-PLA2)与糖尿病肾病的相关性。方法计算机在线检索PubMed,Embase,the Cochrane Library,中国知网,中国生物医学文献,维普网,万方数据库和CHKD数据库,检索各数据库建立至今发布的国内外相关文献,提取数据,采用Stata12.0进行分析。结果共纳入9篇文献,2876例参与者符合纳入标准。Meta分析结果显示:糖尿病肾病患者血清Lp-PLA2水平较对照组明显升高[标准化均值(standardized mean difference,SMD)=2.91,95%CI:1.85~3.98,P<0.05]。根据尿蛋白排泄率进行分组分析,微量白蛋白尿组中,早期糖尿病肾病患者血清Lp-PLA2的水平明显高于对照组(SMD=1.57,95%CI:0.39~2.75,P<0.05)。大量白蛋白尿组中,与微量蛋白尿组相比,随着尿蛋白排泄率的增加,Lp-PLA2的血清水平持续性升高(SMD=0.67,95%CI:0.30~1.05,P<0.05)。血脂水平的Meta分析显示,糖尿病肾病组的患者胆固醇、三酰甘油、低密度脂蛋白与对照组相比,血清水平升高,而高密度脂蛋白的血清水平降低。结论血清Lp-PLA2的升高是糖尿病肾病的重要危险因素。在糖尿病肾病的发生发展过程中,血清Lp-PLA2水平逐渐升高,可以视为糖尿病肾病早期筛选和随访的检测指标。Objective To systematically evaluate the correlation between serum lipoprotein-associated phospholipase A2(Lp-PLA2)and diabetic nephropathy(DN).Methods PubMed,Embase,the Cochrane Library,CNKI,CBM,VIP,Wanfang database and CHKD database were searched online.The related literatures published since the inception of each database were searched.The data were retrieved and analyzed by Stata 12.0.Results Nine literatures were included,including 2876 participants that met the inclusion criteria.Meta-analysis results showed that serum Lp-PLA2 levels in DN patients were significantly higher than those in the control group[the combined standardized mean difference(SMD)=2.91,95%confidence interval(95%CI):1.85-3.98,P<0.05].Grouping analysis based on urine protein excretion rate showed that in the microalbuminuria group,the level of serum Lp-PLA2 in patients with early DN was significantly higher than that in the control group(SMD=1.57,95%CI:0.39-2.75,P<0.05).In the macroalbuminuria group,compared with the microalbuminuria group,as the urine protein excretion rate increased,the serum level of Lp-PLA2 continued to increase(SMD=0.67,95%CI:0.30-1.05,P<0.05).The Meta-analysis of blood lipid levels showed that compared with the control group,the serum levels of cholesterol,triglycerides,and low-density lipoprotein of patients in the DN group increased,while the serum levels of high-density lipoprotein decreased.Conclusion The increase of serum Lp-PLA2 is an important risk factor for DN.During the occurrence and development of DN,serum Lp-PLA2 levels gradually increase,which can be regarded as a detection index for early screening and follow-up of DN.

关 键 词：糖尿病肾病 脂蛋白相关磷脂酶A2 META分析 

分 类 号：R587.24[医药卫生—内分泌]