Serum resistin levels rise progressively with worsening severity of coronary heart disease and acute myocardial infarction in this meta-analysis
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Key Takeaway
Serum resistin rises with coronary disease severity, but high heterogeneity limits its standalone diagnostic utility.
This network meta-analysis evaluated serum resistin levels across varying severities of coronary heart disease, acute coronary syndrome, and acute myocardial infarction. The study compared these levels against healthy controls to determine if resistin serves as a reliable biomarker for disease progression.
The results demonstrated a clear, progressive increase in serum resistin as disease severity escalated. Subjects with stable coronary heart disease showed a standardized mean difference of 0.77 compared to healthy individuals. This effect intensified significantly in acute coronary syndrome, reaching a standardized mean difference of 1.88, and peaked at 4.68 for acute myocardial infarction.
Despite these consistent trends, the analysis identified substantial heterogeneity with an I-squared value of 95.8%. Evidence of publication bias further complicates the interpretation of these findings. Consequently, the authors caution that resistin is not suitable for standalone diagnosis but may offer utility within multi-biomarker models for risk stratification.
The certainty of the evidence remains uncertain due to the high heterogeneity and potential inflation of observed effect sizes. Clinicians should interpret these results with caution, recognizing that association does not imply causation in this observational context.
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View Original Abstract ↓
ObjectiveTo systematically quantify the graded relationship between serum resistin levels and the severity of coronary heart disease (CHD) using a network meta-analysis, thereby evaluating its potential as a biological marker of disease progression.MethodsWe conducted a comprehensive search of major international and Chinese databases up to December 2025. A random-effects network meta-analysis was performed to calculate standardized mean differences (SMD) and Surface Under the Cumulative Ranking (SUCRA) values. Subgroup, sensitivity, and Trim-and-Fill analyses were conducted to investigate heterogeneity and publication bias.ResultsA total of 26 studies (n = 9,169 subjects) were included. The network meta-analysis (5,450 individuals) demonstrated a progressive, stepwise increase in serum resistin levels across the disease spectrum: from healthy controls (CHD-), to stable CHD (SMD = 0.77, 95% CI: 0.38–1.15), to acute coronary syndrome (ACS; SMD = 1.88, 95% CI: 1.22–2.54), and culminating in acute myocardial infarction (AMI; SMD = 4.68, 95% CI: 3.92–5.43), all compared to controls. SUCRA rankings confirmed this clear hierarchy (AMI > ACS > stable CHD > CHD-). However, substantial heterogeneity (I²=95.8%) and evidence of publication bias were detected.ConclusionSerum resistin levels show a clear, graded association with CHD severity, positioning resistin as a potent biological correlate of the underlying inflammatory burden. However, due to significant heterogeneity and publication bias that likely inflate the observed effect sizes, resistin is not suitable as a standalone diagnostic tool. Its potential clinical utility may lie as an adjunctive marker in multi-biomarker models for risk stratification, a role that requires validation in large-scale prospective studies using standardized assays.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, PROSPERO CRD420261397089.
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