Performance of Serum Angiotensin-Converting Enzyme in Diagnosing Sarcoidosis and Predicting the Active Status of Sarcoidosis: A Meta-Analysis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Search Strategy
2.2. Selection of Publications
2.3. Data Extraction and Quality Assessment
2.4. Statistical Analysis
3. Results
3.1. Study Selection
3.2. Clinical Characteristics of the Included Studies
3.3. Risk of Bias Assessment
3.4. Diagnosis Utility of sACE for Sarcoidosis
3.5. Predictive Accuracy of sACE for the Active Status of Sarcoidosis
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Author | Year | Country | Criterial | Diseased Region | Method | Sarcoidosis | Control | Design | Cut-Off | TP | FP | FN | TN | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Case | Age | Gender (M/F) | sACE | Unit | Control | Age | Gender (M/F) | sACE | Unit | ||||||||||||
Lieberman et al. [26] | 1975 | US | Histology | NA | Spectrophotometry | 17 | NA | NA | 13.65 ± 2.26 | U/mL | 296 | NA | NA | NA | U/mL | NA | 11.6 | 15 | 9 | 2 | 287 |
Silverstein et al. [27] | 1976 | US | NA | NA | Spectrophotometry | 58 | 48.3 ± 4.8 | NA | 48.3 + 4.8 | nmol/min/mL | 256 | NA | NA | NA | nmol/min/mL | NA | 30.48 | 20 | 15 | 38 | 241 |
Studdy et al. [28] | 1978 | UK | Histology | NA | Spectrophotometry | 90 | NA | NA | 58 ± 24 | nmol/min/mL | 194 | NA | NA | NA | nmol/min/mL | NA | 52 | 45 | 14 | 45 | 180 |
Turton et al. [29] | 1979 | UK | Histology | NA | Spectrophotometry | 72 | 37(19–67) | 31/41 | 35.6 ± 14.4 | U/mL | 87 | NA | NA | NA | U/mL | NA | 41 | 21 | 3 | 51 | 84 |
Lieberman et al. [30] | 1979 | US | NA | NA | Spectrophotometry | 391 | 39.6 ± 10 | NA | NA | U/mL | 1150 | NA | NA | NA | U/mL | NA | 35 | 226 | 30 | 165 | 1120 |
Rohrbach et al. [31] | 1979 | US | Histology | NA | Radiochemistry | 42 | 44.8 | 22/20 | 71.9 ± 19.2 | U/mL | 60 | NA | NA | 40.2 ± 8.6 | U/mL | R | 57 | 33 | 3 | 9 | 57 |
Rohatgi et al. [32] | 1980 | US | Histology | NA | Radiochemistry | 55 | 17–69 | NA | NA | mU/mL | 122 | NA | NA | NA | mU/mL | NA | 137.5 | 35 | 7 | 20 | 115 |
Ryder et al. [33] | 1981 | US | Clinical findings and/or histology | NA | Spectrophotometry | 40 | NA | NA | 44 ± 8 | kU/L | 60 | NA | NA | NA | kU/L | P | 35 | 36 | 5 | 4 | 55 |
Ainslie et al. [35] | 1985 | South Africa | Histology | NA | Spectrophotometry | 303 | NA | NA | NA | nmol/min/mL | 210 | NA | NA | NA | nmol/min/mL | R | 54 | 176 | 34 | 127 | 176 |
Baarsma et al. [36] | 1987 | Netherlands | Clinical and biochemical findings | Ocular sarcoidosis | Spectrophotometry | 12 | NA | NA | NA | U/L | 209 | NA | NA | NA | U/L | NA | 50 | 10 | 10 | 2 | 199 |
Bunting et al. [37] | 1987 | Canada | Clinical findings or histology | NA | Fluorimetry | 120 | NA | NA | NA | U/L | 74 | NA | NA | NA | U/L | NA | 50 | 76 | 5 | 44 | 69 |
Power et al. [38] | 1995 | US | Histology | Ocular sarcoidosis | Spectrophotometry | 22 | 35 (22–64) | 10/12 | NA | U/L | 70 | 39 (17–58) | 29/41 | NA | U/L | R | 52 | 16 | 12 | 6 | 58 |
Khan et al. [39] | 1998 | Pakistan | Clinical findings and/or histology | NA | Spectrophotometry | 51 | NA | NA | 104.44 | IU/L | 62 | NA | NA | NA | IU/L | R | 52 | 44 | 24 | 7 | 38 |
Bons et al. [40] | 2007 | Netherlands | WASOG | NA | Spectrophotometry | 35 | 45.67 ± 8.8 | 18/17 | 22.0 (16.0–24.0) | U/L | 35 | 47.37 ± 9.8 | 16/19 | 13.5 (12.0–17.8) | U/L | p | 16.5 | 25 | 10 | 10 | 25 |
Kawaguchi et al. [41] | 2007 | Japan | Histology | Ocular sarcoidosis | NA | 60 | NA | NA | NA | NA | 86 | NA | NA | NA | NA | R | NA | 35 | 4 | 25 | 82 |
Smet et al. [42] | 2010 | Belgium | Histology | NA | Spectrophotometry | 36 | NA | 21/15 | 48 (39–80) | U/L | 117 | NA | 65/52 | 27 (19–40) | U/L | R | 34 | 30 | 39 | 6 | 78 |
Gungor et al. [43] | 2015 | Turkey | Histology | NA | Spectrophotometry | 48 | 44.29 ± 10.90 | 9/39 | 49.50 ± 41.04 | U/L | 20 | 38.05 ± 8.36 | 10/10 | 25.44 ± 13.38 | U/L | P | NA | 35 | 8 | 13 | 12 |
Gundlach et al. [17] | 2016 | Germany | IWOS | Ocular sarcoidosis | Spectrophotometry | 41 | NA | NA | NA | U/mL | 220 | NA | NA | NA | U/mL | R | 82 | 9 | 1 | 32 | 219 |
Hakan et al. [44] | 2017 | Netherlands | IWOS | Ocular sarcoidosis | Spectrophotometry | 37 | NA | NA | NA | U/L | 212 | NA | NA | NA | U/L | R | 51 | 20 | 64 | 17 | 148 |
Uysal et al. [45] | 2018 | Turkey | WASOG | NA | ELISA | 59 | NA | NA | NA | mg/mL | 25 | 46.1 ± 8.4 | 12/13 | NA | mg/mL | NA | 5.37 | 52 | 7 | 2 | 23 |
Niederer et al. [46] | 2018 | UK | IWOS | NA | NA | 110 | NA | NA | 32 (21–47) | NA | 925 | NA | NA | NA | NA | P | 52 | 85 | 111 | 25 | 814 |
Csongrádi et al. [47] | 2018 | Hungary | Histology | NA | Fluorimetry | 40 | 39.0 ± 11.0 | 22/18 | NA | U/L | 11 | 54.0 ± 15.2 | 8/3 | 9.12 ± 2.07 | U/L | P | 21.4 | 9 | 0 | 31 | 11 |
Eurelings et al. [48] | 2019 | Netherlands | ATS/ERS/WASOG | NA | Spectrophotometry | 101 | 43 (35–52) | 50/51 | 77 (44–109) | U/mL | 88 | 44 (31–57) | 36/52 | 51(31–69) | U/mL | R | 68 | 63 | 21 | 38 | 67 |
Baba et al. [49] | 2019 | Japan | JSSOG 2015 | NA | Spectrophotometry | 79 | 65.0 (55.0–71.0) | 27/52 | 20.3 (16.0–24.4) | IU/L | 299 | NA | NA | 15.4 (12.8–18.5) | IU/L | R | 17.7 | 53 | 93 | 26 | 206 |
Ishihara et al. [50] | 2020 | Japan | Clinical findings and/or histology | Ocular sarcoidosis | Spectrophotometry | 52 | 58.8 ± 15.2 | 13/39 | 26.4 ± 9.18 | U/L | 74 | 49.6 ± 16.5 | 40/34 | 13.5 ± 3.83 | U/L | R | NA | 23 | 0 | 29 | 74 |
Enyedi et al. [51] | 2020 | Hungary | Histology | NA | Fluorimetry | 69 | 40.9 (±12.3) | 30/39 | 11.89 (10.5–13.7) | U/L | 168 | NA | NA | NA | U/L | P | NA | 17 | 0 | 52 | 168 |
Komoriyama et al. [52] | 2020 | Japan | Histology | NA | Spectrophotometry | 37 | 57 ± 12 | 7/30 | 15.5 ± 7.9 | IU/L | 57 | 61 ± 9 | 12/45 | 12.4 ± 6.9 | IU/L | R | 13.5 | 21 | 26 | 16 | 31 |
Suzukiet al. [53] | 2021 | Japan | Histology | Ocular sarcoidosis | ELISA | 77 | 54.6 ± 14.8 | NA | NA | U/L | 79 | 43.2 ± 17.8 | NA | NA | U/L | R | 12.7 | 29 | 2 | 48 | 77 |
Papasavvas et al. [54] | 2021 | Switzerland | IWOS | Ocular sarcoidosis | Spectrophotometry | 37 | 54.52 ± 23.74 | NA | 49.17 ± 29 | U/L | 30 | 41 ± 11.3 | NA | 27.4 ± 15.34 | U/L | R | NA | 10 | 1 | 27 | 29 |
Sunaga et al. [55] | 2022 | Japan | Histology | NA | Spectrophotometry | 112 | 61(14–86) | 36/78 | 20.2 (0–56.4) | IU/L | 62 | NA | NA | NA | IU/L | R | 21.4 | 46 | 0 | 66 | 62 |
Wang et al. [56] | 2022 | China | Histology | NA | Spectrophotometry | 70 | 55.94 ± 11:83 | 14/56 | 56:61 ± 30.80 | U/L | 14 | 55.25 ± 16:70 | 8/6 | 28:07 ± 14.11 | U/L | P | 44 | 43 | 1 | 27 | 13 |
Author | Year | Country | Criterial | Method | Sarcoidosis | Control | Design | Cut-Off | TP | FP | FN | TN | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Number | Age | Gender (M/F) | sACE | Unit | Number | Age | Gender (M/F) | sACE | Unit | |||||||||||
Lieberman et al. [26] | 1975 | US | Histology | Spectrophotometry | 17 | NA | NA | 13.65 ± 2.26 | U/mL | 6 | NA | NA | NA | U/mL | NA | 11.6 | 15 | 0 | 2 | 6 |
Turton et al. [29] | 1979 | UK | Histology | Spectrophotometry | 17 | NA | NA | NA | U/mL | 30 | NA | NA | NA | U/mL | NA | 41 | 8 | 2 | 9 | 28 |
Rohatgi et al. [32] | 1980 | UK | Histology | Radiochemistry | 40 | NA | NA | 177.7 ± 59.7 | U/mL | 15 | NA | NA | NA | U/mL | NA | 137.5 | 34 | 1 | 6 | 14 |
Klech et al. [34] | 1982 | Austria | Histology | Spectrophotometry | 35 | NA | NA | NA | U/mL | 25 | NA | NA | NA | U/mL | NA | 24 | 27 | 3 | 8 | 22 |
Ainslie et al. [35] | 1985 | South Africa | Histology | Spectrophotometry | 114 | NA | NA | 100.4 ± 45.7 | nmol/min/mL | 189 | NA | NA | 51.9 ± 19.9 | nmol/min/mL | R | 54 | 105 | 71 | 9 | 118 |
Popević et al. [15] | 2016 | Serbia | Histology | Spectrophotometry | 230 | NA | NA | 43 (26–62) | U/L | 199 | NA | NA | 30 (20–44) | U/L | NA | 32 | 152 | 92 | 78 | 107 |
Uysal et al. [45] | 2018 | Turkey | WASOG | ELISA | 20 | 45.15 ± 11.55 | 4/16 | NA | U/L | 39 | 42.4 ± 10.4 | 15/24 | NA | U/L | NA | 26.23 | 17 | 11 | 3 | 28 |
Lopes et al. [19] | 2019 | Brazil | WASOG | ELISA | 27 | 46 (13.5) | 8/19 | 470.96 (407.81–534.09) | ng/mL | 19 | 56 (18.5) | 7/12 | 337.866 (262.47–413.26) | ng/mL | NA | 270 | 24 | 10 | 3 | 9 |
Francesco et al. [57] | 2021 | Italy | Histology | ELISA | 33 | 63(56.5–74.5) | 5/28 | 34.0 (26.0–62.0) | UI/L | 19 | 65.0 (56.0–71.0) | NA | NA | UI/L | NA | 65 | 9 | 1 | 24 | 18 |
Sensitivity | Specificity | PLR | NLR | DOR | Area under the Curve (95% CI) | |
---|---|---|---|---|---|---|
Sarcoidosis | 60% | 93% | 8.4 | 0.43 | 19 | 0.84 (0.80–0.87) |
Ocular sarcoidosis | 48% | 96% | 13.3 | 0.54 | 25 | 0.77 (0.73–0.80) |
Active sarcoidosis | 76% | 80% | 3.9 | 0.29 | 13 | 0.85 (0.82–0.88) |
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Hu, X.; Zou, L.; Wang, S.; Zeng, T.; Li, P.; Shen, Y.; Chen, L. Performance of Serum Angiotensin-Converting Enzyme in Diagnosing Sarcoidosis and Predicting the Active Status of Sarcoidosis: A Meta-Analysis. Biomolecules 2022, 12, 1400. https://doi.org/10.3390/biom12101400
Hu X, Zou L, Wang S, Zeng T, Li P, Shen Y, Chen L. Performance of Serum Angiotensin-Converting Enzyme in Diagnosing Sarcoidosis and Predicting the Active Status of Sarcoidosis: A Meta-Analysis. Biomolecules. 2022; 12(10):1400. https://doi.org/10.3390/biom12101400
Chicago/Turabian StyleHu, Xueru, Li Zou, Shuyan Wang, Tingting Zeng, Ping Li, Yongchun Shen, and Lei Chen. 2022. "Performance of Serum Angiotensin-Converting Enzyme in Diagnosing Sarcoidosis and Predicting the Active Status of Sarcoidosis: A Meta-Analysis" Biomolecules 12, no. 10: 1400. https://doi.org/10.3390/biom12101400
APA StyleHu, X., Zou, L., Wang, S., Zeng, T., Li, P., Shen, Y., & Chen, L. (2022). Performance of Serum Angiotensin-Converting Enzyme in Diagnosing Sarcoidosis and Predicting the Active Status of Sarcoidosis: A Meta-Analysis. Biomolecules, 12(10), 1400. https://doi.org/10.3390/biom12101400