Diagnostic accuracy of urinary AD7c-NTP for Alzheimer’s disease and mild cognitive impairment: A Systematic review and Meta- analysis

Background Studies have shown that urinary AD7c-NTP levels are elevated in patients with Alzheimer Disease (AD) and mild cognitive impairment (MCI), suggesting its potential as a novel diagnostic biomarker. However, more comprehensive studies are still required to validate its diagnostic potential for AD and MCI. Methods We systematically reviewed studies reporting urinary AD7c-NTP concentrations in patients with Alzheimer Disease, mild cognitive impairment, and healthy controls. Twelve electronic databases were comprehensively searched for studies evaluating the diagnostic accuracy of urinary AD7c-NTP for detecting AD or MCI from their inception to November 7, 2024. The pooled sensitivity, specificity, and the diagnostic odds ratio were calculated using a hierarchical summary receiver operating characteristic model. Results In the comparative analysis of AD and the controls (26 studys, 4,237 participants), the pooled sensitivity was 0.87 (95%CI:0.84–0.90, I ²  = 69.91, p  < 0.1) and the pooled specificity was 0.87 (95%CI:0.84–0.89, I²=73.16, p  < 0.1). In the comparative analysis of MCI and the controls (11 studys, 1,293 participants), the pooled sensitivity was 0.79 (95%CI:0.70–0.85, I²=80.00, p < 0.1) and the pooled specificity was 0.84 (95%CI:0.78–0.88, I²=64.41, p  < 0.1). Conclusion Our study showed that urinary AD7c-NTP had good diagnostic value for Alzheimer Disease and mild cognitive impairment. However, analysis of studies related to mild cognitive impairment revealed model instability, suggesting the need for further research to identify factors that may influence urinary AD7c-NTP levels. (INPLASY registration number: INPLASY202530048).