The Role of Adiponectin in Diabetic Peripheral Neuropathy: A Systematic Review and Meta-Analysis.

Abstract

<h4>Background</h4>Diabetic peripheral neuropathy (DPN) is a prevalent microvascular consequence of diabetes with a complex etiology. Adiponectin, an adipokine with anti-inflammatory and neuroprotective properties, has been implicated in DPN, but its significance remains unclear due to conflicting findings. The objective of this systematic review is to assess the association between circulating adiponectin levels and the risk of DPN in individuals with diabetes.<h4>Methods</h4>We did a systematic literature search in PubMed, Scopus, and CINAHL for studies investigating adiponectin levels in diabetes patients with and without DPN. A meta-analysis was done to evaluate the pooled mean difference in adiponectin levels between patients and controls. Study quality was rated using the Joanna Briggs Institute's critical appraisal tool.<h4>Results</h4>The systematic review comprised 13 studies with 3,337 participants. Meta-analysis of 4 studies (920 participants) indicated no significant difference in adiponectin levels between DPN patients (n=418) and controls (n=502) (pooled mean difference 0.01, 95% CI: -0.24 to 0.26, p=0.94), with strong heterogeneity (I²=59%). Subgroup analyses were not possible due to inadequate data. Risk of bias was generally low, with 7 studies graded as good quality.<h4>Conclusions</h4>Our findings imply that circulating adiponectin levels are not linked with the risk of DPN in diabetes. However, the substantial heterogeneity among studies underscores the need for more well-designed prospective studies to explain the role of adiponectin in DPN etiology.