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The Value of Circulating microRNAs for Diagnosis and Prediction of Preeclampsia: a Meta-analysis and Systematic
Shiting Qin1,2, Ningxia Sun1,3, Longqiang Xu4
1Department of Medical Genetic, The Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao, 266003, China.
Abstract:
Preeclampsia (PE) is one of the main causes of maternal death worldwide, but our understanding of the molecular characteristics of disease progression is limited. In this meta-analysis, we aimed to assess the value of peripheral blood microRNAs (miRNAs) as diagnostic and predictive markers of PE. We screened PubMed, Web of Science, and Embase databases; searched articles about "miRNAs and PE" up to November 30, 2020; and conducted biological information and subgroup analysis. We used QUADAS-2 (quality assessment of diagnostic accuracy studies-2) to evaluate the included articles by two independent reviewers, calculated the combined diagnostic and predictive indicators using the random effects model, explored the sources of potential heterogeneity through subgroup analysis, and evaluated publication bias using Deeks' funnel plot asymmetry test using Stata 14.0 and Review Manager 5.3 software. Forty-three miRNAs from 15 studies, including 2042 healthy controls and 2685 PE patients, had a pooled sensitivity of 0.86 (95% CI: 0.81-0.90), specificity of 0.89 (95% CI: 0.85-0.92), and an AUC of 0.94 (95% CI: 0.91-0.96). Moreover, before 20 weeks of gestation, the combined sensitivity was 0.86 (95% CI: 0.75-0.92), and the specificity was 0.90 (95% CI: 0.83-0.95), which indicated that some of the circulating miRNAs had changed significantly before the clinical symptoms appeared in PE patients. Circulating miRNAs have high diagnostic and predictive accuracy and may be used as non-invasive biomarkers for the diagnosis and prediction of PE. However, a large sample prospective study is still needed.
Insights
Peripheral blood microRNAs (miRNAs) show high accuracy for diagnosing and predicting preeclampsia (PE). These circulating miRNAs can serve as non-invasive biomarkers, even before clinical symptoms manifest.
Area of Science:
- Biomarkers
- Molecular Diagnostics
- Reproductive Medicine
Background:
- Preeclampsia (PE) is a leading cause of maternal mortality globally.
- Understanding PE's molecular progression is crucial but limited.
- Peripheral blood microRNAs (miRNAs) are potential biomarkers.
Purpose of the Study:
- To evaluate circulating miRNAs as diagnostic and predictive markers for PE.
- To assess the accuracy of miRNAs in early PE detection.
Main Methods:
- Meta-analysis of 15 studies (2042 controls, 2685 PE patients).
- Screened PubMed, Web of Science, Embase databases up to Nov 2020.
- QUADAS-2 used for quality assessment; random effects model for pooled indicators.
Main Results:
- Pooled sensitivity: 0.86, specificity: 0.89, AUC: 0.94 for PE diagnosis.
- High diagnostic and predictive accuracy demonstrated.
- Significant miRNA changes detected before 20 weeks gestation.
Conclusions:
- Circulating miRNAs exhibit high accuracy for PE diagnosis and prediction.
- miRNAs show potential as non-invasive biomarkers for PE.
- Further large-scale prospective studies are warranted.
