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Meta-Analysis
. 2021 Dec;43(1):231-240.
doi: 10.1080/0886022X.2020.1866010.

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

Yu Li  1 , Xiaoxuan Su  1 , Qing Ye  1 , Xiaodan Guo  1 , Bo Xu  1 , Tianjun Guan  1   2 , Anqun Chen  1
Affiliations
Free PMC article
Meta-Analysis

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

Yu Li et al. Ren Fail. 2021 Dec.
Free PMC article

Abstract

This systematic review and meta-analysis aimed to assess the predictive value of diabetic retinopathy (DR) on further diabetic nephropathy (DN) risk in patients with type 2 diabetes (T2D) based on the prospective cohort studies. PubMed, Embase, and the Cochrane Library were systematically searched for eligible prospective cohort studies through March 2020. The predictive value of DR was assessed using sensitivity, specificity, positive likelihood ratio (PLR) and negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the receiver operating characteristic curve (AUC) through the bivariate generalized linear mixed model and the random-effects model. Ten prospective cohort studies recruited 635 patients with T2D. The pooled sensitivity and specificity of DR for predicted DN were noted to be 0.64 (95% CI, 0.54-0.73) and 0.77 (95% CI, 0.60-0.88), respectively. The pooled PLR and NLR of DR for predicted DN were 2.72 (95% CI, 1.42-5.19) and 0.47 (95% CI, 0.33-0.67), respectively. The summary DOR for the relationship between DR and subsequent DN for T2D patients was 5.53 (95% CI, 2.00-15.30), and the AUC of DR for predicted DN was 0.73 (95% CI, 0.69-0.77). This study found significant associations between DR and subsequent DN risk for patients with T2D. Moreover, the predictive value of DR on subsequent DN risk was relatively lower.

Keywords: Diabetic retinopathy; diabetic nephropathy; meta-analysis; type 2 diabetes.

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Conflict of interest statement

The authors report no conflict of interest.

Figures

Figure 1.
Figure 1.
Flowchart of literature search and the selection process of the studies.
Figure 2.
Figure 2.
The summary sensitivity and specificity of DR on subsequent DN in patients with T2D.
Figure 3.
Figure 3.
The summary PLR and NLR of DR on subsequent DN in patients with T2D.
Figure 4.
Figure 4.
The summary DOR of DR on subsequent DN in patients with T2D.
Figure 5.
Figure 5.
The summary AUC on subsequent DN in patients with T2D.
Figure 6.
Figure 6.
Publication bias.
See this image and copyright information in PMC

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Grants and funding

This work was supported by the National Natural Science Foundation of China under grant number 81800637, Natural Science Foundation of Fujian Province under Grant numbers 2019J01560 and 2020J01122591, Xiamen Science and Technology Project under grant number 3502Z20194014, and Fujian Medical Technology Innovation Fund from China under grant number 2017-CXB-16.