Serum Cystatin C In Predicting Diabetic Nephropathy Among Patients With Diabetes Mellitus:A Meta-analysis

Background:Clinically,there is lack of predictors for diabetic nephropathy(DN)in diabetes mellitus(DM)without microalbuminuria,macroalbuminuria or retinopathy.Methods:PubMed,Chinese Biomedical Database,Cochrane Library,EMBASE and Elsevier Database were searched from inception to August 13,2016.Studies involvi-ng patients with DM and containing data on cystatin C measurements and the measured glomerular filtration rate(mGFR)were included.Pooled sensitivity,specificity,positive predictive value,negative predictive value and other diagnostic indices were evaluated using a random effect model.Source of heterogeneity was explored using regression analysis and sensitivity analysis,then,it was solved by subset analysis.Results:The meta-analysis enrolled 9 studies with 1417 patients.The pooled sensitivity and specificity of serum cystatin C for predicting DN were 0.88(95% CI 0.85-0.91)and 0.85(95% CI 0.82-0.87),respectively.The pooled positive and negative predictive values of serum cystatin C for predicting DN were 7.04(95% CI 4.33-11.43)and 0.13(95% CI 0.09-0.20),respectively.The area under the summary receiver operating characteristic(SROC)curve was0.9549,and the diagnostic odds ratio was 66.80(95% CI 27.92-159.86).Regression analysis suggested that the methods for measuring cystainc C cause heterogeneity mainly.After subgroup analysis,the heterogeneity was improved.Conclusion:Serum cystatin C is an early predictor of DN among patients with DM.