Circulating MicroRNAs as Potential Diagnostic Biomarkers for Diabetic Retinopathy: A Meta-Analysis

Abstract

ObjectiveDiabetic retinopathy (DR) is a common diabetic microvascular complication and a major cause of acquired vision loss. Finding effective biomarkers for the early identification and diagnosis of DR is crucial. This study aimed to comprehensively evaluate the accuracy of microRNAs (miRNAs) in the diagnosis of DR via a meta-analysis of previously published diagnostic studies. This study has been registered on the PROSPERO website, with the number CRD42022323238.MethodsWe searched PubMed, Cochrane Library, Embase, Web of Science, China Wanfang database, and China Knowledge Network database to identify relevant articles published from the time of database creation to April 10, 2022. Stata 14.0 software was used to calculate the pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic ratio (DOR), and area under the summary receiver operating characteristic (ROC) curve to assess the accuracy of miRNAs in the diagnosis of DR. Heterogeneity between studies was assessed using Cochran-Q test and I2 statistic for quantitative analysis. The random-effect model was selected due to significant heterogeneity. Subgroup analysis and regression analysis were also performed to determine the potential sources of heterogeneity.ResultsWe included 25 articles detailing 52 studies with 1987 patients with DR and 1771 non-DR controls. The findings demonstrated overall sensitivity (0.82, 95% CI: 0.78 ~ 0.85), specificity (0.84, 95% CI: 0.81 ~ 0.86), PLR (5.0, 95% CI: 4.2 ~ 5.9), NLR (0.22, 95% CI: 0.18 ~ 0.26), and the area under the summary ROC curve (0.90, 95% CI: 0.87 ~ 0.92). Furthermore, we performed subgroup analysis and found that panels of multiple miRNAs could enhance the pooled sensitivity (sensitivity, specificity, and AUC values were 0.89, 0.87, and 0.94, respectively).ConclusionThe meta-analysis showed that miRNAs can be used as potential diagnostic markers for DR, with high accuracy of diagnoses observed with the detection of miRNAs in plasma and serum.

Diagnostic accuracy of circulating miRNAs to discriminate hepatocellular carcinoma from liver cirrhosis: a systematic review and meta-analysis

“…Additionally, the subgroup analysis by miRNAs expression, upregulated miRNAs had favorable diagnostic efficacy compared to downregulated miRNAs in differentiating HCC from LC, with an AUC of 0.89. The result is in line with other meta-analyses ( 57 , 58 ). This may be attributed to their heightened sensitivity as markers of abnormal cell growth and proliferation.…”

Advances in Research Related to MicroRNA for Diabetic Retinopathy

“…These miRNAs can be stably present in bodily fluids and serve as biomarkers for several diseases such as cancer, DR, diabetes, and prostate cancer [71,[78][79][80][81][82]. Several studies have demonstrated that miRNAs have high sensitivity and specificity for the diagnosis of DR and can be used as an effective noninvasive biomarker, and the diagnostic effectiveness can be further improved by using a combination of multiple miRNAs [80,83]. For instance, it has been reported that miR-9-5p and miR-17-3p are downregulated while miR-210 is upregulated in the serum of patients with DR [84,85].…”

Advances and Perspectives in Relation to the Molecular Basis of Diabetic Retinopathy—A Review

“…It was consistently shown that miRNA-27b was downregulated in two experiments using serum samples [130]. However, most recently, analysis assessed miRNA panels' superior diagnostic value to single parameters results [131]. Furthermore, another result is the fact that miRNA-21 in five studies was revealed to be a useful tool in the diagnosis of DR and an early predictor of reactive oxygen species-mediated damage among patients at high risk for diabetes [130,131] (Figure 4).…”