Elevated levels of the circulatory ischemia-modified albumin in patients with polycystic ovary syndrome: a meta-analysis

Abstract

Oxidative stress (OS) has been reported to be associated with the pathogenesis of polycystic ovary syndrome (PCOS). Ischemia-modified albumin (IMA) levels in the circulation have been recently studied as a novel marker of OS. The studies in the literature on IMA levels in PCOS are inconsistent. This meta-analysis was conducted to compare circulatory IMA levels between PCOS patients and non-PCOS controls. Relevant studies were retrieved by online database and manual searching. The standardized mean differences (SMDs) with 95% confidence intervals (CIs) were obtained by a random-effects meta-analysis. The funnel plot analysis with Begg’s and Egger’s tests was used for publication bias. A total of nine studies were included in this meta-analysis. The results indicated that the serum IMA levels were significantly elevated in PCOS patients as compared to non-PCOS controls (SMD = 0.49, 95% CI = 0.23–0.75, Z = 3.75, p = .0002). A one-study leave-out sensitivity analysis indicated that no single study had a significant influence on the overall outcome, suggesting the good validity and stability of these meta-analytic results. There was no evidence of publication bias as evidenced by the Egger (p = .28) and Begg’s tests (p = .21). The present meta-analysis suggests that IMA might be considered as a reliable and novel marker reflecting increased OS in PCOS.

Chinese abstract

已有报道称氧化应激（OS）与多囊卵巢综合征（PCOS）的发生机制相关。近期有研究将缺血修饰白蛋白（IMA）水平作为OS的新型标志物。关于PCOS中IMA水平的文献研究不一致, 本荟萃分析旨在比较PCOS患者和非PCOS对照之间的循环IMA水平。经在线数据库和人工搜索检索相关研究, 通过随机效应荟萃分析获得具有95％置信区间（CI）的标准化平均差异（SMD）。使用Begg和Egger测试的漏斗图分析用于发表偏倚, 本荟萃分析共纳入9项研究, 结果显示, 与非PCOS对照相比, PCOS患者的血清IMA水平显着升高（SMD = 0.49, 95% CI = 0.23–0.75, Z = 3.75, p = .0002）。敏感性分析显示没有任何一项研究对总体结果有显著性影响, 表示荟萃分析的结果有良好的有效性和稳定性。Egger（p = .28）和Begg的测试（p = .21）显示没有证据表明存在发表偏倚。本荟萃分析显示, IMA可被认为是一种可靠且新颖的标志物, 可反映PCOS中OS的升高。

Keywords:

• Ischemia-modified albumin
• meta-analysis
• oxidative stress
• polycystic ovary syndrome

Acknowledgements

Dr. V.S. Reddy is very much thankful to Prof. Tiejun Tong, and Luo Dehui (PhD Scholar), Department of Mathematics, Hong Kong Baptist University for their expert statistical help in the methodology.

Disclosure statement

No potential conflict of interest was reported by the authors.

Funding

The costs involved in the conduction of this systematic review and meta-analysis were borne by the authors themselves.