The Role of Circulating Secreted Frizzled-Related Protein 4 (SFRP4) in Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis.
Zoya Khan, Mohd Ashif Khan, Nilanjan Saha
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In 30 seconds
This systematic review and meta-analysis examined whether circulating secreted frizzled-related protein 4 (SFRP4) levels differ between adults with type 2 diabetes mellitus (T2DM) and healthy controls. Twelve observational studies were reviewed; nine studies, including 631 people with T2DM and 467 controls, contributed to the meta-analysis. Circulating SFRP4 was higher in T2DM (SMD = 1.70, 95% CI: 0.47-2.94; p = 0.0131). The result was supported by sensitivity analyses, but substantial heterogeneity across studies limits the precision of the pooled estimate.
Key findings
- Across nine studies, circulating SFRP4 was higher in T2DM than in controls (SMD = 1.70, 95% CI: 0.47-2.94; p = 0.0131).
- The meta-analysis included 631 individuals with T2DM and 467 controls.
- Between-study heterogeneity was substantial (I 2 = 96.7%), although sensitivity analyses supported the robustness of the findings.
Why it matters
The findings link higher circulating SFRP4 with T2DM and support further investigation of this protein as a research biomarker. However, the observational evidence establishes an association, not causation or clinical predictive value. The marked heterogeneity also means the pooled difference may not translate consistently across populations or study settings.
What to keep in mind
The meta-analysis was based on observational studies and showed substantial heterogeneity (I 2 = 96.7%). The abstract notes that prospective studies are needed to assess predictive value beyond established glycemic biomarkers.