Diagnostic Performance of Biomarkers Urinary KIM-1 and YKL-40 for Early Diabetic Nephropathy, in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis

There is a lack of prediction markers for early diabetic nephropathy (DN) in patients with type 2 diabetes mellitus (T2DM). The aim of this systematic review and meta-analysis was to evaluate the performance of two promising biomarkers, urinary kidney injury molecule 1 (uKIM-1) and Chitinase-3-like protein 1 (YKL-40) in the diagnosis of early diabetic nephropathy in type 2 diabetic patients. A comprehensive search was performed on PubMed by two reviewers until May 2020. For each study, a 2 × 2 contingency table was formulated. Sensitivity, specificity, and other estimates of accuracy were calculated using the bivariate random effects model. The hierarchical summary receiver operating characteristic curve hsROC) was used to pool data and evaluate the area under curve (AUC). The sources of heterogeneity were explored by sensitivity analysis. Publication bias was assessed using Deek’s test. The meta-analysis enrolled 14 studies involving 598 healthy individuals, 765 T2DM patients with normoalbuminuria, 549 T2DM patients with microalbuminuria, and 551 T2DM patients with macroalbuminuria, in total for both biomarkers. The AUC of uKIM-1 and YKL-40 for T2DM patients with normoalbuminuria, was 0.85 (95%CI; 0.82–0.88) and 0.91 (95%CI; 0.88–0.93), respectively. The results of this meta-analysis suggest that both uKIM-1 and YKL-40 can be considered as valuable biomarkers for the early detection of DN in T2DM patients with the latter showing slightly better performance than the former.

Download Full-text

Tailored mobile text messaging interventions targeting type 2 diabetes self-management: A systematic review and a meta-analysis

Digital Health ◽

10.1177/2055207619845279 ◽

2019 ◽

Vol 5 ◽

pp. 205520761984527 ◽

Cited By ~ 16

Author(s):

Cigdem Sahin ◽

Karen L Courtney ◽

PJ Naylor ◽

Ryan E Rhodes

Keyword(s):

Systematic Review ◽

Type 2 Diabetes ◽

Text Messaging ◽

Meta Analysis ◽

Scientific Evidence ◽

Self Management ◽

Reference List ◽

Pool Data ◽

Message Delivery

Objectives This study aimed to identify, assess and summarize available scientiﬁc evidence on tailored text messaging interventions focused on type 2 diabetes self-management. The systematic review concentrated on message design and delivery features, and tailoring strategies. The meta-analysis assessed the moderators of the effectiveness of tailored text messaging interventions. Methods A comprehensive search strategy included major electronic databases, key journal searches and reference list searching for related studies. PRISMA and Cochrane Collaboration's guidelines and recommended tools for data extraction, quality appraisal and data analysis were followed. Data were extracted on participant characteristics (age, gender, ethnicity), and interventional and methodological characteristics (study design, study setting, study length, choice of modality, comparison group, message type, format, content, use of interactivity, message frequency, message timing, message delivery, tailoring strategies and theory use). Outcome measures included diet, physical activity, medication adherence and glycated hemoglobin data (HbA1C). Where possible, a random effects meta-analysis was performed to pool data on the effectiveness of the tailored text messaging interventions and moderator variables. Results The search returned 13 eligible trials for the systematic review and 11 eligible trials for the meta-analysis. The majority of the studies were randomized controlled trials, conducted in high-income settings, used multi-modalities, and mostly delivered informative, educational messages through an automated message delivery system. Tailored text messaging interventions produced a substantial effect ( g = 0.54, 95% CI = 0.08–0.99, p < 0.001) on HbA1C values for a total of 949 patients. Subgroup analyses revealed the importance of some moderators such as message delivery ( QB = 18.72, df = 1, p = 0.001), message direction ( QB = 5.26, df = 1, p = 0.022), message frequency ( QB = 18.72, df = 1, p = 0.000) and using multi-modalities ( QB = 6.18, df = 1, p = 0.013). Conclusions Tailored mobile text messaging interventions can improve glycemic control in type 2 diabetes patients. However, more rigorous interventions with larger samples and longer follow-ups are required to confirm these findings and explore the effects of tailored text messaging on other self-management outcomes.

Download Full-text

Urinary N-Acetyl-β-d-glucosaminidase (uNAG) as an Indicative Biomarker of Early Diabetic Nephropathy in Patients with Diabetes Mellitus (T1DM, T2DM): A Systematic Review and Meta-Analysis

Diabetology ◽

10.3390/diabetology2040025 ◽

2021 ◽

Vol 2 (4) ◽

pp. 272-285

Author(s):

Arlinda R. Driza ◽

Georgia V. Kapoula ◽

Pantelis G. Bagos

Keyword(s):

Diabetes Mellitus ◽

Systematic Review ◽

Diabetic Nephropathy ◽

Meta Analysis ◽

Area Under The Curve ◽

Diabetic Patients ◽

Pool Data ◽

Patients With Diabetes ◽

Pubmed Search ◽

Renal Tubular

Diabetic nephropathy (DN) is the main cause of chronic kidney disease in patients with type 1 (T1DM) and type 2 diabetes mellitus (T2DM). Renal tubular lysosomal enzyme activities like N-acetyl-β-d-glucosaminidase (NAG) have been shown to increase in patients developing DN. The aim of this systematic review and meta-analysis is to evaluate the diagnostic accuracy of NAG, as a preventional biomarker in the early stages of DN in patients with diabetes mellitus. Two impartial reviewers conducted a complete PubMed search until July 2021. A 2 × 2 contingency table was created for each trial and sensitivity and specificity were estimated using a bivariate random effects model. To pool data and estimate the area under the curve (AUC), the hierarchical summary ROC (hsROC) approach was utilized. Deek’s test was used to estimate publication bias. The meta-analysis included 21 studies that evaluated 2783 patients with T1DM and T2DM, as well as 673 healthy individuals. The AUC of urinary NAG (uNAG) ranged from 0.69 (95% CI: 0.65–0.73) to 0.89 (95% CI: 0.86–0.92). According to the results, NAG in urine can be considered as a potential and effective biomarker for predicting DN in diabetic patients (T1DM, T2DM).

Download Full-text

The predictive value of diabetic retinopathy on subsequent diabetic nephropathy in patients with type 2 diabetes: a systematic review and meta-analysis of prospective studies

Renal Failure ◽

10.1080/0886022x.2020.1866010 ◽

2021 ◽

Vol 43 (1) ◽

pp. 231-240

Author(s):

Yu Li ◽

Xiaoxuan Su ◽

Qing Ye ◽

Xiaodan Guo ◽

Bo Xu ◽

...

Keyword(s):

Systematic Review ◽

Type 2 Diabetes ◽

Diabetic Retinopathy ◽

Diabetic Nephropathy ◽

Prospective Studies ◽

Predictive Value ◽

Meta Analysis

Download Full-text

Diagnsotic accuracy of YLK-40 for diabetic nephropathy in type 2 diabetic patients. A systematic review and meta-analysis

Clinica Chimica Acta ◽

10.1016/j.cca.2019.03.635 ◽

2019 ◽

Vol 493 ◽

pp. S308

Author(s):

G. Kapoula ◽

V. Anagnostopoulou ◽

I. Moisoglou ◽

P. Kontou ◽

P. Bagos

Keyword(s):

Systematic Review ◽

Diabetic Nephropathy ◽

Meta Analysis ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Type 2 Diabetic

Download Full-text

Effects of Antioxidant in Adjunct with Periodontal Therapy in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis

Antioxidants ◽

10.3390/antiox10081304 ◽

2021 ◽

Vol 10 (8) ◽

pp. 1304

Author(s):

Koji Mizutani ◽

Prima Buranasin ◽

Risako Mikami ◽

Kohei Takeda ◽

Daisuke Kido ◽

...

Keyword(s):

Systematic Review ◽

Type 2 Diabetes ◽

Meta Analysis ◽

Risk Of Bias ◽

Periodontal Therapy ◽

Periodontal Pocket ◽

Cochrane Library ◽

Diabetic Patients ◽

Extensive Literature

This review investigated whether the adjunctive use of antioxidants with periodontal therapy improves periodontal parameters in patients with type 2 diabetes. A systematic and extensive literature search for randomized controlled trials (RCTs) conducted before April 2021 was performed on the PubMed, Cochrane Library, and Web of Science databases. The risk of bias was assessed using the Cochrane risk-of-bias tool. A meta-analysis was performed to quantitatively evaluate the clinical outcomes following periodontal therapy. After independent screening of 137 initial records, nine records from eight RCTs were included. The risk-of-bias assessment revealed that all RCTs had methodological weaknesses regarding selective bias, although other risk factors for bias were not evident. This meta-analysis of two RCTs showed that periodontal pocket depths were significantly reduced in the groups treated with combined non-surgical periodontal therapy and melatonin than in those treated with non-surgical periodontal therapy alone. The present systematic review and meta-analysis suggest that the adjunctive use of melatonin, resveratrol, omega-3 fatty acids with cranberry juice, propolis, and aloe vera gel with periodontal therapy significantly improves periodontal disease parameters in patients with type 2 diabetes, and melatonin application combined with non-surgical periodontal therapy might significantly reduce periodontal pocket depth. However, there are still limited studies of melatonin in combination with non-surgical periodontal therapy in Type 2 diabetic patients, and more well-designed RCTs are required to be further investigated.

Download Full-text