小说的鉴定,然而,容易测量的炎症和氧化应激的生物标志物可能有助于风湿性疾病(RD)患者的诊断和治疗.我们对研究胆红素循环浓度的研究进行了系统评价和荟萃分析,血红素代谢的最终产物和具有抗炎特性的有效内源性抗氧化剂,在患有RD和健康对照的患者中。电子数据库PubMed,Scopus,和WebofScience从成立到2023年12月31日进行了相关文章的搜索。我们使用JoannaBriggs清单和建议等级评估了偏见的风险和证据的确定性,评估,发展,和评估工作组系统,分别。在17项符合条件的研究中,所有的偏见风险都很低,与对照组相比,患有RD的患者的总胆红素浓度明显降低(标准平均差,SMD=-0.68,95%CI-0.91至-0.44,p<0.001;I2=92.5%,p<0.001;证据确定性低),直接(结合)胆红素(SMD=-0.67,95%CI-0.92至-0.41,p<0.001;I2=81.7%,p<0.001;证据的确定性非常低),和活性抗氧化剂和抗炎间接(未结合)形式的胆红素(SMD=-0.71,95%CI-1.18至-0.24,p=0.003;I2=95.1%,p<0.001;证据的确定性非常低)。在敏感性分析中,荟萃分析结果稳定。在元回归中,总胆红素的SMD与一些临床和人口统计学特征之间没有显着关联,包括年龄,男女比例,参与人数,肝酶和红细胞沉降率。在亚组分析中,总胆红素的SMD在一系列RD中显著,包括类风湿性关节炎,系统性红斑狼疮,原发性干燥综合征,和肌炎。因此,我们的系统评价和荟萃分析的结果表明,在患有RDs的患者中观察到的胆红素浓度降低反映了由于胆红素消耗导致的抗氧化和抗炎防御受损的状态,并突出了这种内源性产物作为RDs生物标志物的有希望的作用.
■https://www.crd.约克。AC.英国/普华永道/,标识符CRD42023500649。
The identification of novel, yet easily measurable biomarkers of inflammation and oxidative stress might assist in the diagnosis and management of patients with rheumatic diseases (RDs). We conducted a systematic review and meta-analysis of studies investigating the circulating concentrations of bilirubin, the end product of heme metabolism and a potent endogenous antioxidant with anti-inflammatory properties, in patients with RDs and healthy controls. The electronic databases PubMed, Scopus, and Web of Science were searched from inception to 31 December 2023 for relevant articles. We evaluated the risk of bias and the certainty of evidence using the Joanna Briggs Checklist and the Grades of Recommendation, Assessment, Development, and Evaluation Working Group system, respectively. In 17 eligible studies, all with low risk of bias, compared to controls, patients with RDs had significantly lower concentrations of total bilirubin (standard mean difference, SMD=-0.68, 95% CI -0.91 to -0.44, p<0.001; I2 = 92.5%, p<0.001; low certainty of evidence), direct (conjugated) bilirubin (SMD=-0.67, 95% CI -0.92 to -0.41, p<0.001; I2 = 81.7%, p<0.001; very low certainty of evidence), and the active antioxidant and anti-inflammatory indirect (unconjugated) form of bilirubin (SMD=-0.71, 95% CI -1.18 to -0.24, p=0.003; I2 = 95.1%, p<0.001; very low certainty of evidence). The results of the meta-analysis were stable in sensitivity analysis. In meta-regression, there were no significant associations between the SMD of total bilirubin and several clinical and demographic characteristics, including age, male to female ratio, number of participants, liver enzymes and erythrocyte sedimentation rate. In subgroup analysis, the SMD of total bilirubin was significant across a range of RDs, including rheumatoid arthritis, systemic lupus erythematosus, primary Sjögren syndrome, and myositis. Therefore, the results of our systematic review and meta-analysis suggests that the reductions in bilirubin concentrations observed in patients with RDs reflect a state of impaired antioxidant and anti-inflammatory defence due to bilirubin consumption and highlight the promising role of this endogenous product as a biomarker of RDs.
UNASSIGNED: https://www.crd.york.ac.uk/prospero/, identifier CRD42023500649.