Circulating beta 2 and alpha 1 microglobulins predict progression of nephropathy in diabetic patients: a meta-analysis of prospective cohort studies

Aims To study the association of circulating beta 2 (B2M) and alpha 1 microglobulins (A1M) with diabetic nephropathy (DN) progression, a meta-analysis was performed on the prospective cohort studies. Methods Up to October 2021, a comprehensive search of the PubMed, EMBASE, Scopus, Web of Science, and Cochrane Library databases was performed. The primary outcome (progression of DN) was defined as a decrease in eGFR or the occurrence of end stage renal disease or DN-related mortality. Eligible studies were included in a pooled analysis that used either fixed-effect or random-effect models to compensate for variation in measurement standards between studies. The funnel plot and Egger's test were used to assess publication bias. Results The meta-analysis included 4398 people from 9 prospective trials (8 cohorts) for B2M and 3110 people from 4 prospective trials (3 cohorts) for MM. Diabetic individuals with higher B2M levels had an increased risk for DN (relative risk [RR]: 1.81, 95% confidence interval [CI]: 1.56-2.09). Likewise, higher AIM was associated with augmented probability of DN (RR: 1.96, 95% CI: 1.46-2.62). The funnel plot and Egger's tests indicated no publication bias for MM. Additionally, to compensate for putative publication bias for B2M, using trim and fill analysis, four studies were filled for this marker and the results remained significant (RR: 1.62, 95% CI: 1.37-1.92). Conclusions The elevated serum levels of B2M and A1M could be considered as potential predictors of DN progression in diabetic patients.

Automated summary

This study conducted a meta-analysis to investigate the association between circulating beta 2 and alpha 1 microglobulins and the progression of diabetic nephropathy. The results showed that elevated levels of B2M and A1M were associated with an increased risk of DN in diabetic patients, suggesting that they could be potential predictors of DN progression.