A meta-analysis of urinary transferrin for early diagnosis of diabetic nephropathy.

ABSTRACT

OBJECTIVE: To assess the diagnostic value of urinary transferrin (Tf) in early diabetic nephropathy (DN) to propose a more sensitive and noninvasive biomarker for screening and monitoring DN in clinical practice. METHODS: We searched 3 databases from their inception to May 2023, to identify studies investigating the diagnostic value of Tf in patients with DN. Meta-DiSc software, version 1.4, and Stata software, version 15.1 (StataCorp) were used to conduct a meta-analysis and evaluate the diagnostic accuracy of urine Tf levels for DN. RESULTS: The meta-analysis included 6 relevant studies investigating the diagnostic value of Tf level for DN. Urinary Tf as a diagnostic marker demonstrated a combined sensitivity of 0.82 (95% CI, 0.71-0.89) and specificity of 0.88 (0.84-0.92). the positive diagnostic likelihood ratio was 7.07 (4.57-10.93), the negative diagnostic likelihood ratio was 0.20 (0.12-0.35), and the diagnostic odds ratio was 34.49 (13.61-87.44). Also, the area under the receiver operating characteristic curve was 0.92 (0.89-0.94), indicating that urinary Tf has a decent discriminative ability in diagnosing DN. CONCLUSION: Tf level is a valuable biological marker for early diagnosis and monitoring of DN in clinical practice. It has statistically significant predictive value for patients in the early phases of DN.