Comparison of monocyte distribution width and Procalcitonin as diagnostic markers for sepsis: Meta-analysis of diagnostic test accuracy studies.

AIM: We aimed to perform a meta-analysis to find out whether PCT and MDW could be used as accurate diagnostic markers for sepsis. METHODS: We searched PUBMED, WOS, and SCOPUS databases. Inclusion criteria were any observational or clinical trials that compared monocyte Distribution Width [MDW] with Procalcitonin [PCT] as diagnostic markers in a patient with sepsis. Case reports, editorials, conference abstracts, and animal studies were excluded. RevMan software [5.4] was used to perform the meta-analysis. RESULTS: After the complete screening, 5 observational studies were included in the meta-analysis. The total number of patients included in the meta-analysis in the sepsis group is 565 and 781 in the control group. The pooled analysis between the sepsis group and controls showed a statistically significant association between sepsis and increased levels of MDW and PCT [MD = 3.94, 95% CI = 2.53 to 5.36, p-value < 0.00001] and [MD = 9.29, 95% CI = 0.67 to 17.91, p-value = 0.03] respectively. Moreover, the subgroup analysis showed that the p-value of MDW levels [< 0.00001] is more significant than the p-value of PCT levels = 0.03, the p-value between the two subgroups [< 0.00001]. Additionally, the overall ROC Area for MDW [0.790] > the overall ROC Area for PCT [0.760]. CONCLUSION: Our study revealed a statistically significant association between sepsis and increased MDW and PCT levels compared with controls and the overall ROC Area for MDW is higher than the overall ROC Area for PCT, indicating that the diagnostic accuracy of MDW is higher than PCT.MDW can be used as a diagnostic marker for sepsis patients in the emergency department. More multicenter studies are needed to support our findings.

Association Between Diabetes and Immunoglobulin M Antibodies Against Endogenous Gonadotropin-Releasing Hormone in Serum: A Meta-Analysis.

Our aim was to perform a meta-analysis to evaluate the possible link between diabetes and high levels of immunoglobulin M (IgM) antibodies against Gonadotropin-Releasing Hormone (GnRH). The search included PubMed, Web of Science, and Scopus databases. Inclusion criteria were any controlled clinical trials or observational studies that measured the level of IgM antibodies against GnRH hormone in diabetic patients, we excluded case reports, editorials, and animal studies. RevMan software, version 5.4 (The Cochrane Collaboration 2020) was used to perform the meta-analysis. Following the screening, three studies were included in the meta-analysis. The meta-analysis included 99 patients in the diabetes group and 318 healthy persons in the control group. The pooled effect showed no statistically significant association between diabetes and the prevalence of GnRH IgM antibodies compared with the control group (risk ratio {RR} = 1.64, 95% CI = 0.96 to 2.79, p-value = 0.03). The pooled effect showed a statistically significant association between diabetes and increased levels of GnRH IgM antibodies compared with the control group (mean difference {MD} = 2.13, 95% CI = 0.25 to 4.02, p-value = 0.03). Our study found a significant association between diabetes and increased levels of GnRH IgM antibodies. Therefore, GnRH IgM antibodies may play a role in the pathogenesis of diabetes or may be considered a unique immunological reaction in diabetic patients. More multicenter randomized studies are needed to support our results confirming the positive relationship between diabetes and high levels of IgM antibodies against GnRH hormone.