Tumor necrosis factor-α and diabetic retinopathy: Review and meta-analysis

• Published in: Clinica chimica acta Vol. 485; pp. 210 - 217
• Main Authors: Yao, Yang, Li, Rong, Du, Junhui, Li, Xiangnan, Zhao, Lei, Long, Lihui, Li, Dongmin, Lu, Shemin
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.10.2018
• Subjects: Diabetic retinopathy; Meta-analysis; Tumor necrosis factor-α; Diabetic retinopathy; CI; DM; SMD; Tumor necrosis factor-α; DR; Meta-analysis; NOS; TNF-α; NPDR; ME; Anti-VEGF; MOOSE; NDR; PDR; BMI; ELISA
• ISSN: 0009-8981; 1873-3492
• DOI: 10.1016/j.cca.2018.06.028

Tumor necrosis factor-alpha (TNF-α) is produced by multinuclear giant cells and acts as local intensification signals in pathological processes associated with chronic eye inflammation. This meta-analysis was performed to provide a better understanding of the relationship between TNF-α and diabetic retinopathy (DR). Online electric databases were searched to retrieve all relevant articles published before October 2017. The standard mean difference (SMD) and their 95% confidence intervals (CI) were included and then pooled with a random effects model. A total of 16 articles with 1286 participants were included in this meta-analysis. No difference in the level of TNF-α was found between DR patients and healthy controls (SMD = 0.39, 95% CI = −0.09 to 0.68, P = 0.01). Subgroup analysis showed that with respect to the level of TNF-α, the association was significant for studies conducted in Europe (SMD: 0.57, 95% CI: 0.11–1.02, P = 0.01), patients with type 1 DM (SMD: 1.06, 95% CI: 0.09–2.04, P = 0.03), studies based on serum samples (SMD: 0.57, 95% CI: 0.12–1.02, P = 0.01) and studies with a sample size >50 (SMD: 0.39, 95% CI: 0.03–0.75, P = 0.04). The results this meta-analysis indicated that the level of TNF-α in DR patients was significantly different from that in the healthy controls, so TNF-α represents a candidate biomarker for DR. •The first study showing the relationship between TNF-a and DR by meta analysis.•The first study indicating TNF-a is associated with studies conducted in Europe, type 1 DM patients, serum samples, and sample size >50.•The first study indicating TNF-a level was significantly different in DR vs. healthy controls, and it may be used as biomarkers in DR.