Circulating endocan and preeclampsia: a meta-analysis

Xia Lan, Zhaoming Liu, Xia Lan, Zhaoming Liu

Abstract

Background: Endocan, a novel protein involved in inflammation and endothelial dysfunction, has been suggested to be related to preeclampsia, although the results of previous studies were not consistent. The aim of the study was to evaluate the potential difference of circulating endocan in women with preeclampsia and those with normal pregnancy.

Methods: Matched case-control studies evaluating the difference of circulating endocan between women with preeclampsia and those with normal pregnancy were identified via systematic search of PubMed and Embase databases. A random-effect model or a fixed-effect model was used to pool the results according to the heterogeneity. Subgroup analysis was performed to evaluate whether the timing of preeclampsia onset affected the outcome.

Results: Overall, eight matched case-control studies, including 451 women with preeclampsia and 442 women with normal pregnancy were included. Significant heterogeneity was detected among the included studies (P for Cochrane's Q test = 0.006, I2 = 65%). Meta-analysis with a random-effect model showed that women with preeclampsia had significantly higher circulating level of endocan compared with women with normal pregnancy (standardized mean difference = 0.37, 95% confidence interval: 0.13-0.62, P = 0.003). Subsequent subgroup analyses showed that the difference of circulating endocan between women with early onset preeclampsia and those with normal pregnancy was not statistically different from that between women with late-onset preeclampsia and those with normal pregnancy (P for subgroup difference = 0.81).

Conclusions: Women with preeclampsia have higher circulating endocan than those with normal pregnancy.

Keywords: endocan; meta-analysis; preeclampsia.

Conflict of interest statement

The authors declare that there are no competing interests associated with the manuscript.

© 2020 The Author(s).

Figures

Figure 1. Flowchart of database search
Figure 1. Flowchart of database search
Figure 2. Forest plots for the meta-analysis
Figure 2. Forest plots for the meta-analysis
Forest plots for the meta-analysis comparing circulating endocan between women with preeclampsia and those with normal pregnancy; (A) main analyses; and (B) stratified analyses by the timing of preeclampsia onset; PE, preeclampsia. For each figure, mean and SD indicate the mean values and SD of circulating endocan (μg/ml) in women from each group, and total indicate the total number of women in each group.
Figure 3. Funnel plots for the meta-analysis
Figure 3. Funnel plots for the meta-analysis
Funnel plots for the meta-analysis comparing circulating endocan between women with preeclampsia and those with normal pregnancy. Each box in the figure indicates an included study of the meta-analysis, and the plots were constructed by the effect size for each study (SMD) and its standard error (SE). The plots were symmetrical on visual inspection, suggesting low risk of publication bias for this meta-analysis.

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