Maternal serum irisin levels in normotensive and preeclamptic pregnancies: a systematic review and meta-analysis  

Abstract

Background

Altered irisin levels have been reported in pregnancy-associated disorders, such as preeclampsia.

Objective

A systematic review and meta-analysis were conducted to evaluate the changes in maternal circulatory irisin levels in preeclampsia as compared to normotensive healthy pregnant controls.

Methods

Relevant studies were identified by searching PubMed and other databases. Random-effects model was used to obtain standardized mean differences (SMDs) and its 95% confidence intervals (CIs). The sub-group meta-regression analyses were conducted to explore heterogeneity. The presence of publication bias and the study robustness was tested using funnel plot and sensitivity analyses, respectively.

Results

This meta-analysis finally included 14 observations from eight studies. Compared with controls, preeclampsia patients showed significantly decreased serum irisin levels (SMD: −1.13; 95% CI: −1.63 to −0.62, p < .0001). The sub-group analysis showed that this decrease in irisin is regardless of body mass index (BMI) and gestational age of preeclampsia patients. The meta-regression analysis indicated that blood pressure is significantly associated with the observed results. There was no significant publication bias as indicated by the funnel plot analysis followed by Begg’s (p = .35) and Egger’s tests (p = .39). The sensitivity analysis indicated that no single study had a significant influence on the overall outcome, suggesting the robustness of this meta-analysis.

Conclusions

This meta-analysis showed significantly decreased maternal serum irisin level in preeclampsia patients as compared to normotensive pregnant women. This study highlights the need for future studies evaluating the diagnostic utilities and associations of irisin with the fetal and neonatal outcomes in preeclampsia.

血压正常和子痫前期孕妇血清鸢尾素水平的系统综述和Meta分析 摘要

背景：在妊娠相关疾病中, 如先兆子痫, 已经报道过鸢尾素水平的改变。

目的：通过系统综述和Meta分析评价子痫前期孕妇循环中鸢尾素水平的变化, 并与血压正常的健康孕妇对照。

方法：通过检索pubmed和其他数据库, 确定相关研究。采用随机效应模型获得标准化平均差（SMDs）及其95%置信区间（CIs）。采用亚组meta回归分析探讨异质性。发表偏倚的存在和研究的稳健性分别用漏斗图和灵敏度分析进行检验。

结果：这个Meta分析最终包括了来自8个研究的14个观察结果。与对照组相比, 子痫前期患者血清鸢尾素水平显著降低（SMD -1.13；95% CI -1.63 ∼ -0.62, p< 0.0001）。亚组分析显示, 这种鸢尾素的下降与子痫前期患者的体重指数（BMI）和胎龄无关。Meta回归分析表明, 血压与观察结果有显著相关性。漏斗图分析显示没有明显的出版偏差, 然后是Begg检验（p=0.35）和Egger检验（p=0.39）。敏感度分析显示, 没有一项研究对总体结果有显著影响, 表明这种Meta分析的稳健性。

结论：这项Meta分析显示子痫前期患者的母体血清鸢尾素水平显著低于血压正常孕妇。这项研究强调了未来研究的必要性, 评估鸢尾素对子痫前期胎儿和新生儿结局的诊断效用和相关性。

Keywords:

• Adipokine
• irisin
• meta-analysis
• preeclampsia

Acknowledgments

Dr. S.R. Varikasuvu specially acknowledges Bhairavi Sisters (Sahasra and Aagneya) for the time I could not give them during this work as it was performed before 8 am and after 6 pm from its initiation to completion.

Disclosure statement

The authors report no conflicts of interest. The costs involved in the conduction of this systematic review and meta-analysis were borne by the authors themselves.