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Review
. 2024 Jun 29;24(1):141.
doi: 10.1007/s10238-024-01413-0.

The potential role of serum amyloid A as biomarker of rheumatic diseases: a systematic review and meta-analysis

Angelo Zinellu  1 , Arduino A Mangoni  2   3
Affiliations
Review

The potential role of serum amyloid A as biomarker of rheumatic diseases: a systematic review and meta-analysis

Angelo Zinellu et al. Clin Exp Med. .

Abstract

The identification of novel, robust biomarkers for the diagnosis of rheumatic diseases (RDs) and the presence of active disease might facilitate early treatment and the achievement of favourable long-term outcomes. We conducted a systematic review and meta-analysis of studies investigating the acute phase reactant, serum amyloid A (SAA), in RD patients and healthy controls to appraise its potential as diagnostic biomarker. We searched PubMed, Scopus, and Web of Science from inception to 10 April 2024 for relevant studies. We evaluated the risk of bias and the certainty of evidence using the JBI Critical Appraisal Checklist and GRADE, respectively (PROSPERO registration number: CRD42024537418). In 32 studies selected for analysis, SAA concentrations were significantly higher in RD patients compared to controls (SMD = 1.61, 95% CI 1.24-1.98, p < 0.001) and in RD patients with active disease compared to those in remission (SMD = 2.17, 95% CI 1.21-3.13, p < 0.001). Summary receiving characteristics curve analysis showed a good diagnostic accuracy of SAA for the presence of RDs (area under the curve = 0.81, 95% CI 0.78-0.84). The effect size of the differences in SAA concentrations between RD patients and controls was significantly associated with sex, body mass index, type of RD, and study country. Pending the conduct of prospective studies in different types of RDs, the results of this systematic review and meta-analysis suggest that SAA is a promising biomarker for the diagnosis of RDs and active disease.

Keywords: Active disease; Autoimmunity; Biomarkers; Diagnostic accuracy; Inflammation; Rheumatic diseases; Serum amyloid A.

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Conflict of interest statement

The authors have no relevant financial or non-financial interests to disclose.

Figures

Fig. 1
Fig. 1
PRISMA 2020 flow diagram
Fig. 2
Fig. 2
Forest plot of studies reporting serum amyloid A concentrations in patients with rheumatic diseases and healthy controls
Fig. 3
Fig. 3
Sensitivity analysis of the association between serum amyloid A concentrations and rheumatic diseases
Fig. 4
Fig. 4
Funnel plot of studies investigating the association between serum amyloid A concentrations and rheumatic diseases
Fig. 5
Fig. 5
Funnel plot of studies investigating the association between serum amyloid A concentrations and rheumatic diseases after “trimming and filling”. Dummy studies and genuine studies are represented by enclosed circles and free circles, respectively
Fig. 6
Fig. 6
Bubble plot reporting the univariate meta-regression analysis between the effect size and male to female ratio (A) and body mass index (B)
Fig. 7
Fig. 7
Forest plot of studies reporting serum amyloid A concentrations in patients with rheumatic diseases and healthy controls according to disease type
Fig. 8
Fig. 8
Forest plot of studies reporting serum amyloid A concentrations in patients with rheumatic diseases and healthy controls according to geographical area
Fig. 9
Fig. 9
Forest plot of the pooled estimates of sensitivity and specificity of serum amyloid A concentrations for the presence of rheumatic diseases
Fig. 10
Fig. 10
SROC curve with 95% confidence region and prediction region of serum amyloid A concentrations for the presence of rheumatic diseases
Fig. 11
Fig. 11
Fagan’s nomogram of serum amyloid A concentrations for the presence of rheumatic diseases
Fig. 12
Fig. 12
Forest plot of studies reporting serum amyloid A concentrations in patients with rheumatic diseases with active disease and patients in remission
Fig. 13
Fig. 13
Sensitivity analysis of the association between serum amyloid A concentrations and the presence of active disease
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References

    1. McGonagle D, McDermott MF. A proposed classification of the immunological diseases. PLoS Med. 2006;3(8): e297. 10.1371/journal.pmed.0030297. - PMC - PubMed
    1. Moutsopoulos HM. Autoimmune rheumatic diseases: one or many diseases? J Transl Autoimmun. 2021;4: 100129. 10.1016/j.jtauto.2021.100129. - PMC - PubMed
    1. Chauhan R, Raina V, Nandi SP. Prevalence of autoimmune diseases and its challenges in diagnosis. Crit Rev Immunol. 2019;39(3):189–201. 10.1615/CritRevImmunol.2019031798. - PubMed
    1. Lenti MV, Rossi CM, Melazzini F, et al. Seronegative autoimmune diseases: a challenging diagnosis. Autoimmun Rev. 2022;21(9): 103143. 10.1016/j.autrev.2022.103143. - PubMed
    1. Siddle HJ, Bradley SH, Anderson AM, Mankia K, Emery P, Richards SH. Opportunities and challenges in early diagnosis of rheumatoid arthritis in general practice. Br J Gen Pract. 2023;73(729):152–4. 10.3399/bjgp23X732321. - PMC - PubMed

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