The Relationship between S100A9 Protein Levels and Diabetic Retinopathy among Type 2 Diabetes Patients: A Meta-Analysis

INTRODUCTION: The global prevalence of type 2 diabetes is increasing, significantly affecting individuals' quality of life. While traditional symptomatic treatments have demonstrated some therapeutic benefits, their efficacy remains limited. This study aims to evaluate the relationship between S100A9 protein levels and diabetic retinopathy in patients with type 2 diabetes through a meta- analysis. METHODS: A comprehensive review of studies was conducted using databases, such as MEDLINE, EMBASE, CENTRAL, and ClinicalTrials.gov, with the search terms ("S100A9" OR "S100a9" OR "s100a9") and ("diabetic retinopathy" OR "DR"), up to March 20th, 2024. Review Manager 5.4 was used to synthesize the findings, assess publication bias, and perform sensitivity analyses. RESULTS: Five studies were included, comprising 194 patients with diabetes in the experimental group and 111 participants without diabetes in the control group. Comparison of S100A9 protein levels between patients with type 2 diabetes and non-diabetic controls revealed significant differences, indicating elevated S100A9 levels in patients with type 2 diabetes. DISCUSSION: These findings suggest that increased S100A9 protein levels may contribute to the development of type 2 diabetes and its complications, including diabetic retinopathy. Upregulation of S100A9 could serve as a potential biomarker for early diagnosis and a target for therapeutic intervention. However, limitations of this study include the small sample size and variability in methodologies across the included studies. CONCLUSION: Elevated S100A9 protein levels are associated with type 2 diabetes and its complications, highlighting its potential as a biomarker and therapeutic target. Further research is needed to validate these findings and assess the clinical utility of targeting S100A9 in type 2 diabetes management.