Diagnostic value of serum cystatin C for diabetic nephropathy: a meta-analysis

Abstract

Background: Although dozens of studies have investigated the relationship between the content of serum cystatin C (Cys-C) and diabetic nephropathy (DN), the results are still controversial. Hence, This study aims to explore the accuracy of serum Cys-C for diagnosing DN by meta-analysis. Methods: The studies about serum Cys-C diagnosing DN were searched from six online databases from inception to September 22, 2020. The data were processed by Stata 15.0 statistic software. The corresponding diagnostic effect sizes, such as sensitivity and specificity, were obtained. We drew a summary receiver operating characteristic (SROC) curve. We assess the risk of literature bias was following the QUADAS-2 guidelines. Results: Twenty-six published studies were identified. The results showed a pooled sensitivity of 0.86 (95% confidence interval (CI): 0.82–0.90), specificity of 0.89 (95%CI: 0.85–0.92), positive likelihood ratio of 7.59 (95%CI: 5.66–10.19), negative likelihood ratio of 0.16 (95%CI: 0.12–0.21), and diagnostic odds ratio of 48.03 (95%CI: 30.64–75.29). The area under the SROC curve was given a value of 0.94 (95%CI: 0.91–0.96). Conclusion: Serum cystatin C has an excellent diagnostic value with good sensitivity and specificity for diabetic nephropathy.