title: Significance of increased leptin expression in osteoarthritis patients.
abstract: OBJECTIVE
  Alterations in leptin expression contributes to the progression of various diseases, including cancers. This meta-analysis investigated the clinical significance of leptin levels in osteoarthritis (OA) patients, with the goal of building a leptin-based diagnostic criterion for OA.
  
  
  METHODS
  Multiple scientific databases in English and Chinese languages, such as the Cochrane Library Database, CINAHL, Chinese Biomedical (CBM), EMBASE, PubMed, and Web of Science, were exhaustively searched, without any language restrictions, to identify high-quality studies relevant to leptin and OA. Version 12.0 STATA software was used for data analysis. We used odds ratios (OR) and 95% confidence intervals (CI) to test the correlation between serum leptin levels and OA progression.
  
  
  RESULTS
  A total of 11 clinical studies were finally selected for their high quality and relevance to the topic in this meta-analysis. The 11 case-control studies contained a combined total of 3,625 subjects. The meta-analysis results showed that leptin expression was significantly increased in OA patients, compared with the controls (SMD = 0.87, 95%CI: 0.72-1.02, P < 0.001), and there was also a strong association between leptin expression levels and gender (SMD = 8.55, 95%CI: 4.74-12.35, P < 0.001). In ethnicity-stratified subgroup analysis, all the study populations, irrespective of ethnicity, showed remarkably high leptin expression levels in females and in OA patients (all P < 0.05), compared to their respective counterparts.
  
  
  CONCLUSIONS
  The present study revealed that increased leptin expression levels are associated with disease severity in OA patients, especially among the female OA patients. Based on our results, we propose that leptin level may be a useful biomarker for the assessment of the clinical status in OA patients.
authors.affiliation: Department of Orthopedics, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510000, P.R. China.
authors.forename: Ping
authors.initials: P
authors.lastname: Zhang
authors.affiliation: Department of Orthopedics, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510000, P.R. China.
authors.forename: Zhi-Hong
authors.initials: ZH
authors.lastname: Zhong
authors.affiliation: Department of Orthopedics, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510000, P.R. China.
authors.forename: Hao-Tao
authors.initials: HT
authors.lastname: Yu
authors.affiliation: Department of Orthopedics, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510000, P.R. China.
authors.forename: Bin
authors.initials: B
authors.lastname: Liu
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D020738:Leptin / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000378:metabolism*; D017594:Publication Bias
chemical_list: D020738:Leptin