Liver and renal biochemical profiles of people with sickle cell disease in Africa: a systematic review and meta-analysis of case-control studies.

IF 6.3 4区医学 Q1 MEDICINE, GENERAL & INTERNAL Systematic Reviews Pub Date : 2024-10-15 DOI:10.1186/s13643-024-02662-6

Silvia Awor, Felix Bongomin, Mark Mohan Kaggwa, Francis Pebalo Pebolo, Jackie Epila, Geoffrey Maxwell Malinga, Christine Oryema, Proscovia Nnamuyomba, Benard Abola, Acaye Ongwech, David Musoke

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Abstract

Background: Sickle cell disease (SCD) is a genetic blood disorder characterized by a painful vaso-occlusive crisis due to the sickling of red blood cells in capillaries. Complications often lead to liver and renal dysfunctions, contributing to morbidity and mortality, particularly for children under 5. This systematic review and meta-analysis aimed to evaluate the liver and renal functions of people with SCD (HbSS) compared to those without it (HbAA) in Africa.

Methods: The protocol was registered with PROSPERO (CRD42022346771). We searched PubMed, Embase, Web of Science, and Google Scholar using the keywords "liver function", "renal function", "sickle cell disease", and "Africa" on 6th May 2023 for peer-reviewed articles with abstracts in English. We included case-control studies comparing SCD (HbSS) with controls without hemoglobinopathies (HbAA). We used the random-effect model to calculate the pooled average values for the blood tests of people with SCD in RStudio version 4.2.2.

Results: Overall, 17 articles were analyzed from five African countries involving 1312 people with SCD and 1558 controls. The pooled mean difference of liver enzymes aspartate transaminase (AST) was 8.62 (95% CI - 2.99-20.23, I² = 97.0%, p < 0.01), alanine transaminase (ALT) 7.82 (95% CI - 0.16-15.80, I² = 99%, p < 0.01) and alkaline phosphatase (ALP) - 2.54 (95% CI - 64.72 - 59.64, I² = 99%, p < 0.01) compared to controls. The pooled mean difference for the renal biochemical profiles creatinine - 3.15 (95% CI - 15.02; 8.72, I²=99%, p < 0.01) with a funnel plot asymmetry of t = 1.09, df = 9, p = 0.3048 and sample estimates bias of 6.0409. The pooled mean difference for serum urea was - 0.57 (95% CI - 3.49; 2.36, I² = 99%, p < 0.01), and the estimated glomerular filtration (eGFR) rate was 19.79 (95% CI 10.89-28.68 mL/min/1.73 m², I² = 87%, p < 0.01) compared to controls.

Conclusion: People with SCD have slightly elevated liver enzymes and estimated glomerular filtration rates compared to controls in Africa. With all the heterogeneity (I²) > 50%, there was substantial variation in the reported articles' results.

Systematic review registration: PROSPERO CRD42022346771.

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非洲镰状细胞病患者的肝脏和肾脏生化特征：病例对照研究的系统回顾和荟萃分析。

背景：镰状细胞病（SCD）是一种遗传性血液疾病，其特征是由于红细胞在毛细血管中镰状化而导致的令人痛苦的血管闭塞危象。其并发症通常会导致肝脏和肾脏功能障碍，从而增加发病率和死亡率，尤其是 5 岁以下儿童。本系统综述和荟萃分析旨在评估非洲 SCD 患者（HbSS）与非 SCD 患者（HbAA）的肝肾功能比较：该研究方案已在 PROSPERO 注册（CRD42022346771）。我们于 2023 年 5 月 6 日在 PubMed、Embase、Web of Science 和 Google Scholar 上以 "肝功能"、"肾功能"、"镰状细胞病 "和 "非洲 "为关键词，检索同行评审过的英文摘要文章。我们纳入了比较 SCD（HbSS）与无血红蛋白病（HbAA）对照组的病例对照研究。我们在 RStudio 4.2.2 版中使用随机效应模型计算了 SCD 患者血液检测的汇总平均值：共分析了来自五个非洲国家的 17 篇文章，涉及 1312 名 SCD 患者和 1558 名对照者。肝酶天门冬氨酸转氨酶（AST）的汇总平均差异为 8.62（95% CI - 2.99-20.23，I2 = 97.0%，P 2 = 99%，P 2 = 99%，P 2 = 99%，P 2 = 99%，P 2，I2 = 87%，P 结论：与非洲的对照组相比，SCD 患者的肝酶和肾小球滤过率略有升高。由于所有文章的异质性（I2）均大于50%，因此报告的结果存在很大差异：系统综述注册：prospero crd42022346771。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Systematic Reviews Medicine-Medicine (miscellaneous)

CiteScore

8.30

自引率

0.00%

发文量

241

审稿时长

11 weeks

期刊介绍： Systematic Reviews encompasses all aspects of the design, conduct and reporting of systematic reviews. The journal publishes high quality systematic review products including systematic review protocols, systematic reviews related to a very broad definition of health, rapid reviews, updates of already completed systematic reviews, and methods research related to the science of systematic reviews, such as decision modelling. At this time Systematic Reviews does not accept reviews of in vitro studies. The journal also aims to ensure that the results of all well-conducted systematic reviews are published, regardless of their outcome.