PDF(Pubmed)
Abstract：
The identification of novel, robust biomarkers for the diagnosis of rheumatic diseases (RDs) and the presence of active disease might facilitate early treatment and the achievement of favourable long-term outcomes. We conducted a systematic review and meta-analysis of studies investigating the acute phase reactant, serum amyloid A (SAA), in RD patients and healthy controls to appraise its potential as diagnostic biomarker. We searched PubMed, Scopus, and Web of Science from inception to 10 April 2024 for relevant studies. We evaluated the risk of bias and the certainty of evidence using the JBI Critical Appraisal Checklist and GRADE, respectively (PROSPERO registration number: CRD42024537418). In 32 studies selected for analysis, SAA concentrations were significantly higher in RD patients compared to controls (SMD = 1.61, 95% CI 1.24-1.98, p < 0.001) and in RD patients with active disease compared to those in remission (SMD = 2.17, 95% CI 1.21-3.13, p < 0.001). Summary receiving characteristics curve analysis showed a good diagnostic accuracy of SAA for the presence of RDs (area under the curve = 0.81, 95% CI 0.78-0.84). The effect size of the differences in SAA concentrations between RD patients and controls was significantly associated with sex, body mass index, type of RD, and study country. Pending the conduct of prospective studies in different types of RDs, the results of this systematic review and meta-analysis suggest that SAA is a promising biomarker for the diagnosis of RDs and active disease.
摘要：
小说的鉴定，用于诊断风湿性疾病(RDs)和活动性疾病的可靠生物标志物可能有助于早期治疗和获得有利的长期结局.我们对研究急性期反应物的研究进行了系统评价和荟萃分析，血清淀粉样蛋白A（SAA），在RD患者和健康对照中评估其作为诊断生物标志物的潜力。我们搜索了PubMed,Scopus,和WebofScience从成立到2024年4月10日进行相关研究。我们使用JBI关键评估清单和等级评估了偏见的风险和证据的确定性，分别(PROSPERO注册号:CRD42024537418)。在选择进行分析的32项研究中，与对照组相比，RD患者的SAA浓度显着升高（SMD=1.61，95％CI1.24-1.98，p<0.001），而活动性疾病的RD患者的SAA浓度明显高于缓解期患者（SMD=2.17，95％CI1.21-3.13，p<0.001）。总结接收特征曲线分析显示SAA对RDs的存在具有良好的诊断准确性（曲线下面积=0.81，95％CI0.78-0.84）。RD患者和对照组之间SAA浓度差异的效应大小与性别显著相关，身体质量指数,RD的类型,学习国家。在对不同类型的RD进行前瞻性研究之前，本系统综述和荟萃分析的结果表明,SAA是诊断RD和活动性疾病的有前景的生物标志物.
