Circulating Galectin-3 levels and Diabetic Nephropathy: a systematic review and meta-analysis

Changes of serum galectin-3 (Gal-3) is associated with the pathogenesis of diabetic nephropathy (DN). However, current literature indicates that the given results remain debatable and inconsistent. Hence, the aim of this present meta-analysis was to focus on the predictive role of serum Gal-3 in patients with DN.

The PubMed, Embase, Cochrane Library and Web of Science databases were systematically searched for studies that reported the relationship between Gal-3 levels and DN risk, from the inception of each database to March, 2023. The literature we selected for inclusion based on inclusion and exclusion criteria. The standard mean difference (SMD) with corresponding 95% confidence intervals (95% CI) were used to investigate the association. When I2 value exceeding 50%, we will consider it has the presence of a higher level of heterogeneity. A sensitivity analysis and subgroup analysis were performed to seek the potential sources of heterogeneity. The quality assessment was performed using according to the Newcastle-Ottawa Quality Assessment Scale (NOS). The data analysis was conducted using STATA version 13.0 software.

We ultimately enrolled 9 studies enrolling a total of 3137 patients in the final analysis. The SMD of serum Gal-3 was higher in patients with DN group (SMD 1.10 ng/mL [0.63, 1.57]; I2: 96.1%). Upon removal of a study in sensitivity analysis, patients with DN had higher serum Gal-3 levels compared to control patients (SMD 1.03 ng/mL [0.52, 1.54], I2: 94.4%). Further subgroup analysis was performed based on the region. No matter in Asia, Europe or Africa, the serum Gal-3 level of DN patients is significantly higher than that of the control population (SMD: 0.73; 95% CI: 0.58 to 0.87 for Asian; SMD: 0.79; 95% CI: 0.48 to 1.10 for Europe; SMD: 3.15; 95% CI: 2.73 to 3.56 for Africa).

In conclusion, these results suggested that higher serum Gal-3 may increase the risk of DN. More fundamental studies are necessary to clarify the exact physiopathological basis mechanisms of Gal-3 effects. In addition, further research, especially emphasis on the cut-off value should be given, and is best to predict their actual importance as well as the diagnostic accuracy.