Association of circulatory chemerin levels with the severity of pre-eclampsia: A systematic review and bootstrapped meta-analysis

Abstract

Introduction This study presents a systematic review and meta-analysis to investigate the association between circulating chemerin levels and the severity of preeclampsia (PE). Material and Methods A thorough search was conducted across multiple databases, including PubMed/MEDLINE, SCOPUS, and the Cochrane Library, up to March 31, 2024, focusing on observational studies that compared chemerin levels in patients with severe versus mild PE. Two independent reviewers extracted mean and standard deviation (SD) values of chemerin levels from these studies. The quality and risk of bias of the included studies were assessed using the Newcastle–Ottawa Scale. Standardized mean differences (SMD) with 95% confidence intervals (CI) were calculated to evaluate the difference in chemerin levels between severe and mild PE groups. Sensitivity analyses were performed to address heterogeneity and ensure the reliability of the findings. Additionally, a bootstrapped meta-analysis with 1,000 and 10,000 simulations was conducted to further validate the results. Results Six observational studies were included in the analysis. The findings revealed that patients with severe PE had significantly higher chemerin levels compared to those with mild PE (SMD 1.55, 95% CI 0.67–2.43, p < 0.0001). The bootstrapped meta-analysis supported the accuracy of these findings (SMD = 1.54, CI = 0.74–2.38). No publication bias was identified using Begg’s and Egger’s tests, and the sensitivity analysis confirmed the robustness of the results. Conclusion This meta-analysis provides compelling evidence that chemerin levels are significantly elevated in patients with severe PE compared to those with mild PE. Further research is warranted to investigate the potential of circulating chemerin as a diagnostic marker for PE severity.