Background
Methods
Search strategy and study selection
Inclusion/exclusion criteria
Data extraction
Quality assessment
Statistical analysis
Results
Literature search
Quality assessment
Study and patient’s characteristics
First author (Ref.) | Year | SS | Gender (M/F) | Mean Duration of DM (Months) | Population (ethnicity) | Study design | NOSa |
---|---|---|---|---|---|---|---|
Zhao W. et al. [4] | 2016 | 469 | 283/186 | 120 | China (A) | Cross-sectional | 8 |
Wu F. et al. [5] | 2017 | 1134 | 645/489 | 78 | China (A) | Cross-sectional | 8 |
ALMA R. et al. [6] | 2014 | 82 | 52/30 | 99.6 | Canada (AM) | Case control | 8 |
Yang J. et al. [7] | 2017 | 1511 | 743/768 | 105 | China/A | Cross-sectional | 8 |
Bilir B. et al. [8] | 2016 | 99 | 47/52 | NA | Turkey/A | Clinical study | 7 |
Sharon L. et al. [9] | 2017 | 1981 | 1001/980 | 144 | Singapore/A | Cross-sectional | 8 |
Yong J. et al. [10] | 2015 | 180 | 96/84 | 135.6 | China/A | Case control | 8 |
Su J. et al. [11] | 2018 | 563 | 299/264 | 67.2 | China/A | Cross-sectional | 8 |
Zhang Y. et al. [12] | 2017 | 1059 | 589/470 | 102.7 | China/A | Case control | 7 |
Won J. et al. [13] | 2012 | 3999 | 1939/2060 | 121.2 | Korea/A | Cross-sectional | 7 |
Lin X. et al. [53] | 2017 | 200 | 123/77 | 109 | China/A | Cross-sectional | 8 |
Qiao X. et al. [54] | 2017 | 185 | 79/106 | 123 | China/A | Cross-sectional | 8 |
Sadosky A. et al. [34] | 2014 | 323,378 | 151,927/171451 | NA | USA/NA | Retrospective | 8 |
YM. S. et al. [55] | 2018 | 982 | 497/485 | 64 | China/A | Cross-sectional | 7 |
Khawaja N. et al. [56] | 2018 | 1003 | 480/523 | 120 | Jordan/A | Cross-sectional | 7 |
Zhang Q. et al. [57] | 2018 | 254 | 127/127 | 138 | China/A | Case control | 8 |
Jangh M. et al. [58] | 2006 | 810 | 289/521 | 98.4 | Iran/A | Cross-sectional | 8 |
Kim S. et al. [59] | 2013 | 1338 | 593/745 | 145 | Korea/A | Cross-sectional | 8 |
Bansal D. et al. [14] | 2014 | 2006 | 989/1017 | 104.4 | India/A | Cross-sectional | 8 |
Buraczy M. et al. [15] | 2016 | 1244 | 594/650 | 153.6 | Poland/EU | Case control | 8 |
Luo Y. et al. [16] | 2015 | 412 | 233/179 | 150 | China/A | Cross-sectional | 7 |
Ren Z. et al. [17] | 2015 | 787 | 395/392 | 179.4 | China/A | Case control | 8 |
Andersen S. et al. [44] | 2018 | 1256 | 735/521 | 156 | Denmark/EU | Cohort study | 7 |
Anastasi T. et al. [45] | 2017 | 381 | 220/161 | 147 | Greece/EU | Cross-sectional | 8 |
Xu T. et al. [46] | 2017 | 537 | 161/376 | NA | China/A | Observational | 8 |
Zhu T. et al. [52] | 2014 | 64 | 31/33 | NA | China/A | Cross-sectional | 8 |
Deng W. et al. [51] | 2014 | 202 | 115/87 | 98 | China/A | Cross-sectional | 8 |
Thainá R. et al. [50] | 2018 | 426 | 162/264 | 92 | Brazil/SA | Cohort study | 7 |
Miric D. et al. [35] | 2016 | 80 | 33/47 | 72 | Serbia/EU | Case control | 7 |
Hussain G. et al. [42] | 2013 | 86 | 38/48 | 96 | India/A | Cross-sectional | 7 |
Li L. et al. [43] | 2014 | 3359 | 1607/1268 | 91 | China/A | Cross-sectional | 8 |
Pai Y. et al. [36] | 2018 | 2837 | 1661/1186 | 130.4 | Taiwan/A | Cross-sectional | 7 |
Xu F. et al. [48] | 2014 | 90 | 46/44 | 66 | China/A | Cross-sectional | 8 |
Wang H. et al. [37] | 2013 | 207 | 88/119 | NA | China/A | Case control | 7 |
Wang H. et al. [40] | 2012 | 261 | 124/137 | 76.9 | China/A | Case control | 8 |
Pai Y. et al. [39] | 2018 | 626 | 333/293 | 184.8 | Taiwan/A | Case control | 8 |
Mao F. et al. [22] | 2018 | 950 | 555/395 | 106.2 | China/A | Cross-sectional | 8 |
Hoque S. et al. [33] | 2016 | 400 | 166/234 | 72 | Bangladesh/A | Cross-sectional | 8 |
First author (Ref.) | T2DM without DPN | T2DM with DPN | ||||||||
---|---|---|---|---|---|---|---|---|---|---|
N (M/F) | Age (yrs.) | LDL (mmol/L) | SBP (mmHg) | P-value* | N (M/F) | Age (yrs.) | LDL (mmol/L) | SBP (mmHg) | P-value** | |
Zhao W. et al. [4] | 365 (230/135) | 59.48 | 2.75 ± 0.86 | 130.29 ± 15.93 | 0.01 | 104 (53/51) | 66.94 | 2.62 ± 0.82 | 135.81 ± 17.65 | 0.133 |
Wu F. et al. [5] | 560 (338/222) | 53.20 | 2.84 ± 0.96 | 129.10 ± 17.30 | <0.01 | 574 (307/267) | 61.00 | 2.66 ± 0.95 | 134.4 ± 18.40 | 0.002 |
ALMA R. et al. [6] | 12 (6/6) | 53.60 | 2.20 ± 0.70 | NA | NA | 70 (46/24) | 60.23 | 2.30 ± 1.25 | NA | NA |
Yang J. et al. [7] | 1287 (626/661) | 58.61 | 2.78 ± 1.01 | 132.06 ± 20.54 | 0.03 | 224 (117/107) | 66.58 | 2.75 ± 0.99 | 134.72 ± 22.25 | 0.438 |
Bilir B. et al. [8] | 53 (24/29) | 58.85 | 3.59 ± 1.40 | 128.97 ± 11.73 | NA | 46 (23/23) | 56.91 | 3.15 ± 0.99 | 131.62 ± 14.25 | NA |
Sharon L. et al. [9] | 1767 (866/901) | 57.20 | 2.76 ± 0.83 | 137.60 ± 18.70 | < 0.01 | 214 (135/79) | 60.10 | 2.71 ± 0.81 | 146.00 ± 20.60 | 0.45 |
Yong J. et al. [10] | 90 (50/40) | 54.90 | 2.90 ± 0.88 | NA | NA | 90 (46/44) | 54.10 | 2.73 ± 0.82 | NA | 0.18 |
Su J. et al. [11] | 461 (248/213) | 56.00 | 2.67 ± 0.82 | 134.00 ± 17.00 | 0.10 | 102 (51/51) | 58.40 | 2.60 ± 0.86 | 137.00 ± 19.00 | 0.44 |
Zhang Y. et al. [12] | 642 (342/300) | 60.03 | 2.92 ± 0.96 | 134.29 ± 19.14 | 0.00 | 417 (247/170) | 61.66 | 2.95 ± 1.15 | 142.50 ± 22.39 | 0.60 |
Won J. et al. [13] | 2661 (1346/1315) | 59.40 | 2.60 ± 0.09 | 127.00 ± 14.40 | 0.39 | 1338 (593/745) | 62.70 | 2.40 ± 0.90 | 127.50 ± 15.50 | 0.02 |
Lin X. et al. [53] | 123 (NA) | 52.83 | 3.19 ± 0.94 | 135.52 ± 17.84 | < 0.05 | 77 (NA) | 60.79 | 3.39 ± 1.28 | 143.12 ± 22.72 | > 0.05 |
Qiao X. et al. [54] | 128 (53/75) | 62.30 | 2.96 ± 0.77 | 133.00 ± 16.00 | 0.03 | 57 (26/31) | 64.50 | 2.98 ± 1.09 | 141.00 ± 13.00 | 0.90 |
Sadosky A. et al. [34] | 288,328 (134,761/153580) | 61.40 | 2.62 ± 0.85 | NA | NA | 35,050 (17,166/17871) | 64.80 | 2.37 ± 0.84 | NA | 0.00 |
YM. S. et al. [55] | 785 (403/382) | 54.60 | 2.52 ± 0.81 | 132.00 ± 15.00 | 0.07 | 197 (94/103) | 57.10 | 2.5 ± 0.88 | 135.00 ± 17.00 | 0.76 |
Khawaja N. et al. [56] | 607 (201/195) | 62.70 | 2.61 ± 0.78 | 142.40 ± 18.10 | <0.01 | 396 (279/328) | 57.80 | 2.64 ± 0.80 | 138.30 ± 17.50 | <0.01 |
Zhang Q. et al. [57] | 159 (79/80) | 59.75 | 2.68 ± 0.95 | 133.30 ± 18.14 | 0.03 | 95 (48/47) | 64.02 | 2.54 ± 1.16 | 138.85 ± 21.18 | 0.29 |
Jangh M. et al. [58] | 202 (NA) | 49.40 | 3.39 ± 1.03 | 125.00 ± 21.30 | <0.05 | 608 (NA) | 53.80 | 3.37 ± 0.95 | 129.20 ± 23.40 | 0.90 |
Kim S. et al. [59] | 761 (360/401) | 62.50 | 2.44 ± 0.84 | 128.00 ± 16.00 | 0.41 | 577 (233/344) | 63.60 | 2.45 ± 0.88 | 127.00 ± 15.00 | 0.98 |
Bansal D. et al. [14] | 1420 (701/719) | 52.50 | 2.79 ± 1.03 | NA | NA | 586 (288/298) | 57.10 | 2.379 ± 1.20 | NA | <0.01 |
Buraczy M. et al. [15] | 838 (400/438) | 62.90 | 2.80 ± 1.09 | NA | NA | 406 (194/212) | 63.00 | 2.80 ± 1.05 | NA | 1.00 |
Luo Y. et al. [16] | 178 (107/71) | 53.00 | 2.70 ± 0.90 | NA | NA | 234 (126/108) | 59.00 | 2.60 ± 0.90 | NA | 0.43 |
Ren Z. et al. [17] | 385 (191/194) | 66.40 | 2.50 ± 0.80 | 133.00 ± 18.00 | 0.46 | 402 (204/198) | 63.80 | 2.60 ± 0.80 | 132.00 ± 18.00 | 0.15 |
Andersen S. et al. [44] | 1178 (693/485) | 60.90 | 3.42 ± 0.12 | 148.00 ± 21.00 | <0.05 | 78 (42/36) | 60.60 | 3.10 | 150.50 ± 14.23 | <0.05 |
Anastasi T. et al. [45] | 274 (143/131) | 63.30 | 3.34 ± 1.40 | 141.20 ± 19.70 | <0.01 | 107 (77/30) | 66.10 | 3.00 ± 1.10 | 150.40 ± 22.90 | 0.02 |
Xu T. et al. [46] | 397 (111/286) | 62.34 | 3.07 ± 0.90 | 137.14 ± 19.72 | 0.27 | 160 (50/90) | 62.38 | 3.13 ± 1.07 | 135.04 ± 21.36 | 0.50 |
Zhu T. et al. [52] | 32 (16/16) | 54.38 | 2.64 ± 0.76 | 126.96 ± 11.30 | NA | 32 (15/17) | 56.00 | 2.94 ± 1.23 | 128.97 ± 11.97 | NA |
Deng W. et al. [51] | 80 (43/37) | 60.68 | 2.71 ± 0.63 | 127.86 ± 16.36 | 0.08 | 122 (72/49) | 60.69 | 2.76 ± 0.70 | 132.64 ± 20.26 | 0.92 |
Thainá R. et al. [50] | 258 (101/157) | 66.00 | 2.94 ± 1.01 | 142.00 ± 22.00 | 0.07 | 168 (61/107) | 70.00 | 3.04 ± 0.99 | 146.00 ± 23.00 | 0.36 |
Miric D. et al. [35] | 51 (20/31) | 61.50 | 3.88 ± 1.32 | NA | NA | 29 (13/16) | 62.90 | 4.01 ± 1.45 | NA | NA |
Hussain G. et al. [42] | 22 (10/12) | 51.90 | 2.29 ± 0.34 | 132.82 ± 10.63 | NA | 64 (28/36) | 54.68 | 2.50 ± 0.59 | 140.00 ± 39.14 | <0.05 |
Li L. et al. [43] | 2246 (1148/1098) | 57.00 | 3.10 ± 1.19 | 135.70 ± 18.85 | <0.01 | 1113 (459/654) | 62.30 | 3.09 ± 1.12 | 139.27 ± 19.15 | 0.82 |
Pai Y. et al. [36] | 2223 (1280/943) | 61.90 | 2.64 ± 0.81 | NA | NA | 624 (381/243) | 71.40 | 2.51 ± 0.80 | NA | 0.02 |
Xu F. et al. [48] | 45 (21/24) | 58.70 | 2.70 ± 0.80 | 139.00 ± 18.00 | 0.19 | 45 (25/20) | 59.80 | 2.30 ± 0.60 | 134.00 ± 18.00 | 0.01 |
Wang H. et al. [37] | 78 (34/44) | 60.59 | 3.03 ± 0.68 | NA | NA | 129 (54/75) | 61.53 | 2.96 ± 0.88 | NA | NA |
Wang H. et al. [40] | 150 (73/77) | 60.80 | 3.60 ± 2.20 | 135.00 ± 19.70 | NA | 101 (51/50) | 61.80 | 3.00 ± 1.90 | 127.00 ± 16.50 | NA |
Pai Y. et al. [39] | 351 (186/165) | 72.50 | 2.54 ± 0.72 | 133.20 ± 15.00 | 0.15 | 275 (147/128) | 73.50 | 2.49 ± 0.73 | 131.25 ± 14.90 | 0.93 |
Mao F. et al. [22] | 686 (398/288) | 57.73 | NA | 127.81 ± 13.10 | 0 | 264 (157/107) | 63.78 | NA | 131.82 ± 15.33 | NA |
Hoque S. et al. [33] | 304 (NA) | 49.68 | NA | 127.12 ± 12.62 | 0.20 | 96 (NA) | 51.93 | NA | 129.33 ± 14.66 | NA |
Meta-analysis results
Association of serum LDL level with DPN
Subgroup analyses | N (%) | T2DM with DPN* | T2DM without DPN | SMD (95% CI) * | Heterogeneity | ||
---|---|---|---|---|---|---|---|
Mean + SD | Mean + SD | P-value** | I-squared | ||||
Ethnicity | America | 3 (8.3) | 2.54 + 1.02 | 2.61 + 0.85 | 0.07 (−0.24–0.37) | <0.001 | 84.92 |
Asia | 29 (80.6) | 2.75 + 0.96 | 2.82 + 0.88 | 0.07 (0.01–0.12) | <0.001 | 78.97 | |
Europe | 4 (11.2) | 3.21 + 0.90 | 3.37 + 0.95 | 0.16 (− 0.06–0.38) | 0.03 | 66.96 | |
Study type | Case control | 11 (30.6) | 2.87 + 1.11 | 2.90 + 1.02 | 0.03 (− 0.05–0.11) | 0.12 | 34.80 |
Cohort | 3 (8.3) | 2.82 + 0.60 | 2.98 + 0.62 | 0.16 (− 0.05–0.37) | <0.001 | 84.15 | |
Cross-sectional | 22 (61.1) | 2.71 + 0.89 | 2.78 + 0.83 | 0.07 (0.01–0.13) | <0.001 | 80.52 | |
Total (Random Effect Model) | 36 (100) | 2.78 + 0.98 | 2.86 + 0.91 | 0.08 (0.03–0.13) | <0.001 | 88.10 |
Association of SBP level with DPN
Subgroup analyses | N (%) | T2DM with DPN* | T2DM without DPN | SMD (95% CI) | Heterogeneity | ||
---|---|---|---|---|---|---|---|
Mean + SD | Mean + SD | P-value** | I-squared | ||||
Ethnicity | Asia | 26 | 134.64 + 18.81 | 132.26 + 16.55 | −2.38 (−3.81 - -0.95) | <0.001 | 85.70 |
Europe | 2 | 150.27 + 11.45 | 144.66 + 9.85 | −5.61 (−12.66–1.45) | 0.03 | 78.38 | |
America | 1 | 146.00 + 23.00 | 142.00 + 22.00 | −4.00 (−8.35–0.35) | NA | NA | |
Study type | Case control | 6 | 134.52 + 18.59 | 133.58 + 17.99 | −0.94 (− 5.49–3.61) | <0.001 | 91.33 |
Cohort | 2 | 148.07 + 21.20 | 145.00 + 20.10 | −3.07 (−6.25–0.11) | 0.54 | 0.00 | |
Cross-sectional | 21 | 135.57 + 18.67 | 132.51 + 16.43 | −3.06 (− 4.55 - -1.57) | <0.001 | 83.99 | |
Total (Random Effect Model) | 29 (100) | 141.08 + 19.10 | 138.45 + 18.50 | −2.63 (− 4.00 - -1.27) | <0.001 | 84.88 |