Meta-Analysis
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Aug 21, 2023; 29(31): 4797-4808
Published online Aug 21, 2023. doi: 10.3748/wjg.v29.i31.4797
Circulating copeptin level and the clinical prognosis of patients with chronic liver disease
Hao-Qian Tan, Ming Zhao, Zan Huang, Yang Liu, Han Li, Long-Hui Ma, Jun-Ying Liu
Hao-Qian Tan, Department of Gastroenterology, Zhoukou Central Hospital Affiliated to Xinxiang Medical University, Zhoukou 466000, Henan Province, China
Ming Zhao, Yang Liu, Han Li, Jun-Ying Liu, Department of Gastroenterology, Zhoukou Central Hospital, Zhoukou 466000, Henan Province, China
Zan Huang, Long-Hui Ma, Department of Teaching and Research, Zhoukou Central Hospital, Zhoukou 466000, Henan Province, China
Author contributions: Tan HQ and Liu JY conceived and designed the study; Tan HQ, Zhao M, Huang Z, and Liu Y performed database search, data collection, and study quality evaluation; Tan HQ, Li H, and Ma LH performed statistical analysis; Tan HQ, Zhao M, Huang Z, and Liu JY interpreted the results; Tan HQ wrote the initial draft; all authors revised the manuscript, read and approved the final version of the manuscript.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jun-Ying Liu, MD, Director, Department of Gastroenterology, Zhoukou Central Hospital, No. 26 Renmin Road East Section, Chuanhui District, Zhoukou 466000, Henan Province, China. liujunying781025@163.com
Received: June 15, 2023
Peer-review started: June 15, 2023
First decision: July 14, 2023
Revised: July 21, 2023
Accepted: July 28, 2023
Article in press: July 28, 2023
Published online: August 21, 2023
ARTICLE HIGHLIGHTS
Research background

Patients with chronic liver disease (CLD) will develop various complications with the progression of the disease. Upregulated systemic arginine vasopressin (AVP) has been observed in patients with advanced CLD. However, measuring AVP is clinically challenging due to the short half-life. Copeptin is a C-terminus of AVP precursor, which may be of importance for prognostic prediction in patients with CLD.

Research motivation

Identifying biomarkers that predict the prognosis of patients with CLD is clinically important. Although there are pilot studies aiming to correlate copeptin with survival of patients with CLD, the results are not always consistent. In this regard, a systematic review with meta-analysis is particularly useful.

Research objectives

To investigate the correlation between serum copeptin and transplant-free survival (TFS) in patients with CLD with a systematic review and meta-analysis.

Research methods

Studies were obtained by search of PubMed, Embase, the Cochrane Library, and Web of Science. Two authors independently screened the studies, assessed the study quality with Newcastle-Ottawa Scale, and extracted the data. Risk ratios and corresponding 95% confidence intervals were used as the variables to indicate the association between serum concentration of copeptin and the survival of patients with CLD. The RevMan and Stata software were used for the statistical analyses.

Research results

This meta-analysis enrolled ten datasets involving 3133 patients, who were followed for 1 to 48 mo (mean: 12.5 mo). We found that a high level of serum copeptin was associated with a poor TFS, with a risk ratio of 1.82. Additionally, sensitivity analysis retrieved similar results by omitting one dataset at a time. The robustness of the finding was further evidenced by consistent results of subgroup analyses according to study country, study design, patient diagnosis, cutoff of copeptin, follow-up duration, and study quality score.

Research conclusions

High serum concentration of copeptin may be associated with a poor clinical prognosis in patients with CLD. These findings were not significantly affected by either of the included studies and were not influenced by multiple study characteristics within the subgroup analysis.

Research perspectives

In view of the standard methods for the measuring copeptin in clinical practice, as well as the finding of the meta-analysis, evaluating serum copeptin may be considered at the initial management of patients with CLD, which may provide prognostic significance.