A meta-analysis of serum Hcy in diagnosis of diabetic nephropathy

Objective This meta-analysis aims to investigate the diagnostic performance of serum homocysteine (Hcy) as a biomarker for diabetic nephropathy (DN). Methods Clinical publications relevant to serum Hcy level and DN were systematic searched in the electronic databases of; Pubmed, Cochrane Library, Embase, Web of science, CNKI and CBM. The diagnostic data from each included original study was extracted and pooled by the effect size of diagnostic sensitivity, specificity, positive likely hood ratio (+LR), negative likely hood ratio (-LR), diagnostic odds ratio (DOR) and area under the symmetric ROC curve (AUC). Results 18 publications relevant to serum Hcy and DN were included in the meta-analysis. The I-2 test demonstrated significant statistical heterogeneity across the 18 studies for the effect size of diagnostic. The pooled diagnostic sensitivity, specificity, +LR, -L, DOR, AUC were 0.76 (95%CI: 0.74-0.78), 0.84 (95%CI:0.82-0.86), 5.05 (95%CI:3.52-7.24) , 0.27 (95%CI:19-0.39), 21.68 (95% CI:11.15to 42.14) and 0.90 respectively in the random effect model. Conclusion Based on the present publications, serum Hcy is a promising serological marker for DN diagnosis.