Diagnostic value of TWEAK for predicting active lupus nephritis in patients with systemic lupus erythematosus

Diagnostic value of TWEAK for predicting active lupus nephritis in patients with systemic lupus erythematosus

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Purpose

Accumulative studies showed that tumor necrosis factor (TNF)-like weak inducer of apoptosis (TWEAK) was up-regulated in the blood and urine from patients diagnosed with lupus nephritis (LN) and that it might be used as a novel biomarker for active LN. This meta-analysis aimed to determine the diagnostic value of TWEAK in active LN.

Methods

We searched the Cochrane Library, Embase, PubMed, Springer, Wanfang and CNKI databases for articles published up to 20 August 2020. THe diagnostic capacity of TWEAK for active LN was assessed using pooled sensitivity and specicity, positive and negative likelihood ratios (PLR and NLR), diagnostic odds ratio (DOR), and area under the receiver operating characteristic curve (AUC). Quality assessment and publication bias were also evaluated. STATA 11.0 and Meta-Disc 1.4 were used to perform these analyses.

Results

Nine cross-sectional studies were included in this meta-analysis. A FLowchart of the selection process is shown in Fig 1.

Quality assessment and publication bias

To assess the potential role of publication bias, the funnel plot method was used. Deeks’ funnel plot revealed no small trial bias of TWEAK in the diagnosis of active LN in the included studies (Fig 2. p = .32).

The overall pooled sensitivity of TWEAK for the diagnosis of active LN was 0.69 (95% CI, 0.63–0.75), and specicity was 0.77 (95% CI, 0.71–0.82). e overall pooled PLR and NLR were 3.31 (95% CI, 2.05–5.35) and 0.38 (95% CI, 0.26–0.55), respectively, with a DOR of 10.89 (95% CI, 6.73–17.63) and AUC (SE) of 0.8276 (0.0289). (Fig 3.)

The SROC curve was calculated by sensitivity against (1-specificity). Figure 4 depicted an AUC (standard error, SE) of 0.8276 (0.0289) with a Q* value (SE) of 0.7604 (0.0262), indicating a high diagnostic accuracy of TWEAK for predicting active LN.

Conclusion

The results suggest that TWEAK might be a potential biomarker for patients with active LN. Future cross-sectional and longitudinal studies are needed to confirm its diagnostic value, as well as to establish a more definite cutoff for active LN.

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