Association between circulating plasma CTRP3 levels and acute ischemic stroke: a systematic review and meta-analysis

Background: C1q tumor necrosis factor (TNF)-related protein 3 (CTRP3) is a novel adipokine that has been shown to exert neuroprotective effects in acute cerebral infarction. However, conflicting results have emerged regarding the circulating levels of CTRP3 between patients with acute ischemic stroke and healthy individuals. This meta-analysis aims to investigate the association between circulating CTRP3 levels and acute ischemic stroke. Objective: The objective of this meta-analysis is to re-evaluate the relationship between circulating CTRP3 levels and acute ischemic stroke. Methods: We conducted a comprehensive search across PubMed, Web of Science, Embase, Cochrane Library, CNKI, VIP, Wanfang Data, and CBM to identify relevant studies up to February 2025 and 110 articles were found. After screening the titles, abstracts, and full texts, a total of 14 articles were ultimately included in this meta-analysis. Due to high heterogeneity, we conducted subgroup analyses stratified by patient characteristics, clinical and biochemical parameters, carotid intima-media thickness, IL-6 levels, CTRP9 levels, smoking, hypertension, and diabetes. Publication bias was evaluated using Egger's regression test, Begg's correlation analysis, and funnel plot visualizations. Results: < 0.00001). Subgroup analysis revealed that the observed heterogeneity could be attributed to patient age and body mass index (BMI). The year of publication, clinical biochemical parameters, carotid intima-media thickness, IL-6, CTRP9, smoking, hypertension, and diabetes categorization were not sources of heterogeneity. Conclusion: The meta-analysis confirmed that circulating levels of CTRP3 were significantly lower in patients with acute ischemic stroke compared with control group. This association may be modulated by patient age and BMI.