河北医科大学学报 ›› 2024, Vol. 45 ›› Issue (1): 113-117.doi: 10.3969/j.issn.1007-3205.2024.01.021

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血清Lp-PLA2与糖尿病肾病关联性的荟萃分析

  

  1. 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

  • 出版日期:2024-01-25 发布日期:2024-01-31
  • 作者简介:张晓双（1985-），女，河北衡水人，河北省儿童医院主管检验师，医学学士，从事代谢疾病诊治研究。
  • 基金资助:
    河北省医学科学研究课题计划（20220252）

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

  1. 1.Department of Clinical Laboratory, Hebei Children′s Hospital, Shijiazhuang 050030， China； 
    2.Department of Laboratory， Bethune International Peace Hospital, 
    Hebei Province, Shijiazhuang 050082， China

  • Online:2024-01-25 Published:2024-01-31

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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，2 876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。


关键词: 糖尿病肾病, 脂蛋白相关磷脂酶A2, Meta分析

Abstract: 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 2 876 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.


Key words: diabetic nephropathies, lipoprotein-related phospholipase A2, Meta-analysis

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