Association Between Circulating Levels of C1q/TNF-Related Protein-9 and Type 2 Diabetes Mellitus: A Systematic Review and Meta-analysis

Abstract

Context C1q/TNF-Related Protein-9 (CTRP9) appears to be linked to type 2 diabetes mellitus (T2DM), according to growing research. But the literature on circulating levels of CTRP9 in patients with T2DM has been contradictory. Objective This is a systematic review and meta-analysis to reassess the circulating level of CTRP9 in patients with T2DM, with and without complications. Data Source Relevant studies published until October 31 2021, were identified from the PubMed, Embase, Web of Science, The Cochrane Library, WanFang, CNKI, VIP, and CBM databases. Study selection Participants with age ≥ 18 years with clinically diagnosed T2DM. Sex and diabetes complication type were not restricted. Data extraction The data were extracted by 2 reviewers independently using a standard data collection form. Data Synthesis Analysis demonstrated significantly lower circulating levels of CTRP9 in patients with T2DM in comparison to patients without diabetes [(SMD=-1.36; 95%CI (-1.78 to -0.93); P<0.001), I2=97.5%, P<0.001]. Furthermore, the circulating level of CTRP9 in patients with T2DM related complications is lower than that in patients with T2DM without complications, regardless of macrovascular complications or microvascular complications [(SMD=-1.062; 95%CI (-1.466 to -0.658); P<0.001), I2=91.3%, P<0.001]. Subgroup analyses revealed that factors such as body mass index (BMI), T2DM duration, and fasting glucose (FBS) were the sources of heterogeneity (P=0.047, P=0.034, and P=0.07, respectively). Conclusions The present systematic review and meta-analysis found CTRP9 levels were lower in T2DM patients with or without complications. However, since it is a meta-analysis of most observational studies, these findings still need to be verified by further studies with a large sample size.

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