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Table 1 Characteristics of studies evaluating endocan levels in diabetic patients

From: Endocan in prediabetes, diabetes, and diabetes-related complications: a systematic review and meta-analysis

Author

Year

Design

Location

Specimen

Population

DM type

Special population

N total

Age

% Male

Main Findings

Anik et al.

2020

Cross-sectional

Turkey

Serum

Children with T1DM and age-, gender-, and pubertal stage distribution-matched healthy children

T1DM

No

128

12.0 ± 3.7

47.6

Serum levels of endocan were higher in T1DM children than in healthy ones (P < 0.01) and there was a significant positive correlation between endocan and serum HbA1c (r = 0.296, P = 0.01).

Arman et al.

2015

Prospective cohort

Turkey

Serum

Patients diagnosed with T2DM and healthy controls

T2DM

No

83

55.4 ± 10.2

42.2

Serum endocan was significantly higher in patients with T2DM than in healthy controls (1.56 ± 0.99 ng/ml vs. 0.72 ± 0.1 ng/ml, P < 0.001). After 3 months of treatment, there was a significant reduction in HbA1c (10.7 ± 2.28% vs. 7.57 ± 1.17%, P < 0.0001) and endocan levels (1.55 ± 0.99 ng/ml vs. 1.07 ± 0.71 ng/ml, P < 0.0001). However, endocan levels were still higher than healthy controls (1.07 ± 0.71 ng/ml vs. 0.72 ± 0.1 ng/ml, P < 0.001).

Arman et al.

2022

Cross-sectional

Turkey

Serum

Patients with diabetes and healthy participants

Pre-DM

No

84

48.8 ± 9.1

31.0

Endocan was lower in prediabetes patients than in healthy patients (P = 0.042) and there was a negative correlation between fasting insulin and levels of endocan (r=-0.320, P = 0.001).

Balamir et al.

2017

Cross-sectional

Turkey

Serum

Patients in the 18 to 65 age groups under constant follow-up in a clinic with T2DM diagnosis and healthy controls

T2DM

No

176

54.3 ± 9.9

35.8

Median serum endocan was higher in T2DM patients and endothelial damage than those in T2DM patients without endothelial damage (475.15 pg/ml vs. 216.37 pg/ml, P < 0.001, respectively).

Bilir et al.

2016

Cross-sectional

Turkey

Serum

Diabetic patients with or without DPN and healthy controls

T2DM

No

152

57.7 ± 8.4

46.7

Diabetic patients (with or without DPN) had higher endocan than healthy controls (P < 0.001). Endocan levels were found to be significantly higher in diabetic patients with DPN than those without DPN (P = 0.001). When grouping patients according to treatment, those who received insulin had higher endocan levels than those who received oral antidiabetic medications (P = 0.004).

Bingol et al.

2016

Prospective cohort

Turkey

Serum

Subjects with suspicion of OSA

DM

OSA

63

49.6 ± 9.5

52.4

Serum levels of endocan seem to be higher in OSA patients with diabetes than those without it, but the difference is not significant (1.48 ± 0.86 vs. 1.19 ± 0.3 ng/ml, P = 0.489).

Bozkurt et al.

2020

Cross-sectional

Turkey

Serum

Patients with DM who were admitted to the Department of Ophthalmology and control patients without any systemic disease

T2DM

No

100

61.9 ± 8.3

50.0

Serum endocan levels increase with the stage of diabetic retinopathy and it was found to be an independent predictor showing the stage.

Celik et al.

2022

Cross-sectional

Turkey

Plasma

Patients who underwent Phacoemulsification surgery in an ophthalmology clinic and controls without any medical problems

T2DM

No

120

71.2 ± 5.2

54.2

Blood endocan was higher in patients with DM and cataracts, DRP and cataracts, and patients with cataracts than in healthy individuals.

Chang et al.

2021

Prospective cohort

Taiwan

Plasma

Patients with T2DM and regular visitors of the outpatient department of the Division of Endocrinology and Metabolism

DM

No

312

62.3 ± 11.9

68.0

It was found that plasma endocan levels were not related to the occurrence of renal events in patients with diabetes.

Chen et al.

2022

Cross-sectional

China

Serum

Patients with DKD

DM

DKD

183

58.0 ± 8.5

68.3

Serum endocan levels were negatively correlated with HbA1c (r = -0.21, P < 0.01) and estimated GFR (r = -0.206, P < 0.01) and positively correlated with 24 h urine protein (r = 0.219, P < 0.01).

Cikrikcioglu et al.

2016

Cross-sectional

Turkey

Serum

Patients with T2DM attending to an internal medicine outpatient clinic

T2DM

No

137

56.4 ± 8.4

30.6

Serum endocan levels were negatively correlated with the urine albumin-creatinine ratio (r = 0.282, P = 0.001). Patients with or without retinopathy and with or without neuropathy were comparable in terms of serum endocan levels. There was no correlation between serum endocan and diabetes duration, BMI, eGFR, HbA1c, and fasting glucose.

Dallio et al.

2017

Cross-sectional

Italy

Serum

Consecutive NAFLD patients with or without T2DM and healthy subjects

DM

NAFLD

81

56.6 ± 11.2

53.0

In patients with NAFLD, diabetic patients had significantly higher endocan compared to non-diabetic ones (1.56 ± 0.81 ng/ml vs. 0.72 ± 0.58 ng/ml, P = 0.001).

Ekiz-Bilir et al.

2019

Cross-sectional

Turkey

Serum

Diabetic patients admitted to hospital and healthy controls who were admitted to internal medicine out-patient clinics for a routine medical assessment

T2DM

No

131

56.1 ± 7.8

53.4

Serum endocan levels were higher in diabetic patients with nephropathy than those with normoalbuminuria (P = 0.011) and both groups had higher serum endocan levels compared with healthy individuals (P < 0.001 and P = 0.001, respectively).

Elkamshoushi et al.

2018

Cross-sectional

Egypt

Serum

Patients with ED who were recruited from Andrology Outpatient Clinic and healthy controls

T2DM

ED

45

41.8 ± 4.8

100

Serum endocan levels in ED patients with DM were significantly higher than patients without DM (P = 0.013) and both groups showed significantly higher levels than healthy individuals (P < 0.001 and P = 0.001, respectively).

Kim et al.

2020

Prospective cohort

Korea

Plasma

Patients with ESRD on hemodialysis

DM

ESRD

354

62.1 ± 12.7

NR

In patients with ESRD, patients with lower endocan levels had a higher rate of DM (64.6%) compared to the higher endocan group (47.2%) (P = 0.001).

Klisic et al.

2020

Cross-sectional

Montenegro

Serum

Patients with prediabetes and T2DM patients, compared with healthy controls

T2DM

No

278

61.5 ± 3.2

39.2

T2DM patients had significantly higher endocan compared to healthy individuals and there was no significant difference between T2DM and prediabetic patients. It was found that a rise in endocan levels by one level increases the probability of a higher HbA1c by three times (OR 3.69, 95% CI 1.84 to 7.01, P < 0.001).

Klisic et al. (2)

2020

Case-control

Montenegro

Serum

Patients with T2DM and diabetes-free participants

T2DM

No

106

61.8 ± 10.0

44.3

Serum endocan levels were higher in diabetic patients in comparison to healthy individuals (P = 0.005).

Kose et al.

2015

Cross-sectional

Turkey

Serum

Patients who were diagnosed as having ACS, control group (age- and sex-matched)

DM

ACS

83

56.0 ± 10.6

78.3

Endocan levels were higher in diabetic patients with ACS than non-diabetic patients with ACS (1.02 ± 0.33 ng/ml vs. 0.81 ± 0.21 ng/ml, P = 0.016). Both groups showed a significant difference compared with controls (0.86 ± 0.25 ng/ml vs. 0.75 ± 0.13 ng/ml, P = 0.014).

Kosir et al.

2019

Prospective cohort

Slovenia

Plasma

Consecutive chronic HF patients

DM

HF

120

71.0 ± 11.0

64.0

Plasma endocan levels had no significant difference between diabetic and non-diabetic heart failure patients (P > 0.05).

Lv et al.

2017

Cross-sectional

China

Serum

Patients with T2DM and gender-matched and age-matched healthy subjects

T2DM

No

97

50.3 ± 9.8

58.6

Endocan was significantly higher in diabetic patients with subclinical atherosclerosis than diabetic patients than healthy controls (P < 0.05 for all comparisons).

Moin et al.

2022

Case-control

Bahrain

Plasma

Subjects with T2DM and nondiabetic control Caucasian subjects, all aged 40–70 years

T2DM

No

46

62.0 ± 9.0

50.0

Plasma endocan levels were lower in T2DM patients than healthy controls (P < 0.05).

Qiu et al.

2016

Cross-sectional

China

Serum

Patients with T2DM and normotensive control participants

T2DM

No

105

63.1 ± 10.0

55.2

Endocan peripheral levels were significantly higher in T2DM patients with STEMI than T2DM without STEMI and it was significantly higher in both groups compared with controls.

Singh et al.

2022

Prospective cohort

India

Serum

Diabetic patients with dengue fever and non-diabetic patients with dengue fever

DM

Dengue fever

40

56.5 ± 3.0

NR

Endocan circulatory levels were significantly higher in dengue fever and diabetes than those with dengue fever without diabetes (P < 0.0001).

Zuwala-Jagiello et al.

2019

Retrospective cohort

Poland

Serum

Patients treated for liver cirrhosis and control serum samples were collected from age- and gender-matched healthy subjects in whom liver diseases were ruled out

T2DM

Cirrhosis

330

NR

54.2

Serum concentrations of endocan were significantly higher in cirrhosis patients compared with healthy individuals (P < 0.001) and cirrhotic patients with diabetes had higher endocan blood levels than cirrhotic non-diabetic patients (P < 0.01).

  1. Data are presented as mean ± standard deviation, median [interquartile range], median [range], or percentage. DM: diabetes mellitus; T1DM: type 1 diabetes mellitus; T2DM: type 2 diabetes mellitus; DPS: diabetes peripheral neuropathy; OSA: obstructive sleep apnea; NAFLD: non-alcoholic fatty liver disease; DKD: diabetic kidney disease; ED: erectile dysfunction; ESRD: end-stage renal disease; ACS: acute coronary syndrome; NR: not reported; DRP: diabetic retinopathy; GFR: glomerular filtration rate; BMI: body mass index; OR: odds ratio; CI: confidence interval; HF: heart failure; STEMI: ST-elevated myocardial infarction