Association between circulating visfatin and pre-eclampsia: a systematic review and meta-analysis

Abstract

Objective

Pre-eclampsia (PE) is a serious pregnancy status characterized by high blood pressure. Although visfatin is usually associated with PE. Observational studies evaluating the relationship between circulating visfatin and pre-eclampsia have reported inconsistent results. We conducted this systematic review and meta-analysis to summarize published data on the association between visfatin and pre-eclampsia

Methods

Electronic databases PubMed, ISI web of science, EMBASE, Scopus and the Cochrane library were comprehensively searched for selection of eligible studies until January 5, 2020. A random-effects model and the generic inverse variance method were used for quantitative data synthesis. The assessment of study quality was performed using the e Newcastle–Ottawa scale and the Agency for Healthcare Research and Quality. Sensitivity analyses and prespecified subgroup were conducted to evaluate potential heterogeneity. Random-effects meta-regression was conducted to assess the impact of potential confounders on the estimated effect sizes. The protocol for this study was registered in PROSPERO (No. CRD42018105861) in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).

Results

Thirteen studies comprising a total of 536 subjects were included in this meta-analysis. We observed that the pre-eclampsia risk is associated with a statistically significant elevation of visfatin level [SMD (1.33 µg/l) (95% CI 0.37, 2.2) p = .007]. No significant publication bias was observed in the meta-analysis. Subgroup and sensitivity analyses indicated that the pooled effects size were affected by systolic blood pressure [SMD (1.82 µg/l) 95% CI (0.94, 2.7), p < .05], gestational age [SMD (2.01 µg/l) 95% CI (0.57, 3.4), p = .006], body mass index [SMD (1.6 µg/l) 95% CI (0.37, 3), p < .05] and pregnancy trimesters[SMD (2.3 µg/l) 95% CI (0.95, 3.7), p = .001]. Random-effects meta-regression showed a significant association of visfatin level with potential confounders including systolic blood pressure, gestational age and birth weight at delivery of pre-eclampsia patients.

Conclusions

Collectively, our data revealed that the increase of visfatin level can be associated with the risk of pre-eclampsia. However, further studies on pre-eclampsia populations are warranted for corroboration of our findings.

Keywords:

• Visfatin
• pre-eclampsia
• pregnancy
• biomarker

Ethical approval

This study received the approval from the clinical ethics committee of the faculty of paramedical sciences of Shahid Beheshti University of Medical.

Acknowledgments

We would like thank Proteomics Research Center of Shahid Beheshti University of Medical Sciences.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author contributions

Mehdi Koushki and Nasrin Amiri-Dashatan conceptualized and designed the research, Mostafa Rezaei Tavirani, Amir Hossein Doustimotlagh, Hadi Khodabandehloo and Mojtaba Fathi critically reviewed the manuscript and approved the final manuscript as submitted. Mehdi Koushki, Nasrin Amiri-Dashatan and Hossein Hosseini wrote the draft of this paper, Data collection, statistical analyses and Data interpretation.