Urinary nerve growth factor: a biomarker for overactive bladder in children? A meta-analysis and trail sequential analysis

Abstract

Purpose

Based on previously two meta-analyses, urinary nerve growth factor (NGF) has emerged as one potentially noninvasive biomarker for overactive bladder (OAB) in adults. We performed this systematic review to explore if NGF is a biomarker for OAB in children.

Methods

A literature search was conducted in PubMed, Embase, Web of science and Cochrane Library. Copies of all relevant articles were retrieved for quality assessment and data abstraction by two reviewers. Primary outcome was pooled standardized mean difference (SMD) for NGF/Cr (NGF normalized to urine creatinine) level between OAB group and controls.

Results

Three case–control studies published from 2012 to 2017 were included with 99 patients and 61 controls. Children with OAB had a significant higher baseline urinary NGF/Cr level compared to controls (SMD 1.75, 95% CI 0.47–3.03, P < 0.01). After treatment, the level of NGF/Cr decreased significantly compared to baseline level at third month and sixth month time points (SMD 0.51, 95% CI = 0.14–0.88, P = 0.007 and SMD 0.68, 95% CI = 0.30–1.05, P = 0.0004). We calculated the required information size to 1306 patients for comparison of urinary NGF/Cr level between OAB and controls by trail sequential analysis (TSA).

Conclusions

Based on this systematic review, NGF/Cr may be a noninvasive biomarker for OAB in children in the future. But based on TSA, more original studies are needed to clarify the role of NGF/Cr in the biomarker effect.

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