Meta-analysis of the value of exosomal miRNA for the diagnosis of chronic kidney disease
Chen Guanting1, Zhang Linqi2, Li Qingru1
1First Clinical Medical College of Henan University of Chinese Medicine, Zhengzhou 450003, Henan Province, China; 2First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou 450003, Henan Province, China
Abstract: OBJECTIVE: To evaluate the diagnostic significance of exosomal miRNA for chronic kidney disease by meta-analysis.
METHODS: The clinical research on the diagnosis of chronic kidney disease by exosomal miRNA published from the establishment of Wanfang, CNKI, China Biology Medicine disc, VIP, Web of Science, Cochrane Library, PubMed, and Embase to May 2022 was searched by computer. After screening and extracting the data, the quality of the article was evaluated through the quality assessment of diagnostic accuracy studies-2 in Review Manager 5.3. Meta-disc 1.4 software was used to analyze the heterogeneity of threshold/non threshold effects included in the literature, and calculate sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, area under the curve, and diagnostic odds ratio. StataMP 16.0 software was used to analyze sensitivity, heterogeneity, and publication bias.
RESULTS: A total of six articles were included. Meta-analysis results exhibited that the Spearman correlation coefficient was -0.603 (P=0.038 < 0.05), and there was a threshold effect in this study. The diagnostic odds ratio Cochran-Q was 67.85 (P < 0.01), indicating that there was heterogeneity caused by non threshold effect in this study, and the effect size was pooled by using random effect model. The pooled sensitivity was 0.81 (0.78-0.84), pooled specificity 0.81(0.76-0.85), pooled positive likelihood ratio 3.32(1.98-5.57), pooled negative likelihood ratio 0.30(0.19-0.48), pooled area under the curve=0.840 1, Q-index=0.771 9; pooled diagnostic odds ratio was 12.20(4.74-31.42). Publication bias was present at this study, and there was one inclusion with strong sensitivity (P=0.01 < 0.05).
CONCLUSION: Exosomal miRNA expression levels have great value and significance for the diagnosis of chronic kidney disease. However, due to the small number and heterogeneity of included studies, more clinical studies are needed to find out the optimal exosomal miRNA for diagnosing chronic kidney disease.
Key words: exosome, chronic kidney disease, miRNA, meta-analysis, diagnosis