The Relationship between Serum Zinc Level and Preeclampsia: A Meta-Analysis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Literature Search and Selection
2.2. Inclusion and Exclusion Criteria
2.3. Data Extraction
2.4. Statistical Analysis
3. Results
3.1. Characteristics of Studies
Author [Ref.] (Year) | Country Continent | Study Design | Group | n | Mean Level of Serum Zinc (μmol/L) | SD (μmol/L) | p | Sample Type | Fasting | Age (Years, Mean ± SD) | Gestational Age (Weeks, Mean ± SD) | Match of Potential Confounders |
---|---|---|---|---|---|---|---|---|---|---|---|---|
Sarwar, M.S.; [11] (2013) | Bangladesh (Asia) | case-control study | Control PE | 58 50 | 15.08 11.85 | 3.54 5.38 | p < 0.001 | serum | 8 h fasting condition | 25.76 ± 0.73 25.46 ± 0.85 | 36.79 ± 0.27 35.32 ± 0.37 | matching for gestational period |
Rafeeinia, A.; [17] (2014) | Iran (Asia) | cross-sectional study | Control total PE control mild PE sever PE | 50 50 50 35 15 | 11.23 10.92 11.08 10.62 12.00 | 5.08 4.00 0.62 0.62 1.23 | p = 0.76 p = 0.71 | serum | overnight fast | 27.10 ± 4.6 26.50 ± 3.9 27.18 ± 4.6 27.0 ± 4.1 25.40 ± 3.5 | 31.50 ± 3.60 30.80 ± 3.30 26.41 ± 5.0 23.82 ± 4.60 28.02 ± 7.90 | |
Fenzl, V.; [24] (2013) | Croatia (Europe) | cross-sectional study | Control PE | 37 30 | 8.85 9.23 | 1.43 1.43 | NS | serum | overnight fast | 30.8 31.2 | 37.42 36.55 | |
Farzin, L.; [13] (2012) | Iran (Asia) | cross-sectional study | Control PE | 60 60 | 15.48 11.77 | 3.10 2.71 | p < 0.001 | serum | yes | 26.66 ± 3.72 27.43 ± 3.91 | 35.27 ± 1.20 35.48 ± 1.14 | matched for age, gestational age, anthropometrics and socioeconomic status |
Adam, B.; [29] (2001) | Turkey (Asia) | cross-sectional study | Control PE | 20 20 | 5.25 4.82 | 0.68 0.72 | NS | plasma | no | 27 ± 6.8 29 ± 8 | 37 ± 3.9 35 ± 4 | matched for age, gestational age |
Ilhan, N.; [12] (2002) | Turkey (Asia) | cross-sectional study | Control PE | 30 21 | 19.26 12.76 | 3.73 4.45 | p < 0.001 | plasma | overnight fast | 19–31 | 31–38 | |
Kolusari, A.; [28] (2008) | Turkey (Asia) | cross-sectional study | Control PE | 48 47 | 0.20 0.16 | 0.06 0.07 | NS | serum | overnight fast | 27.92 ± 4.25 27.91 ± 5.21 | 35.41 ± 1.62 34.87 ± 2.34 | |
Atamer, Y.; [27] (2005) | Turkey (Asia) | cross-sectional study | Control PE | 28 32 | 16.71 12.18 | 3.06 2.77 | NS | serum | overnight fast | 25.85 ± 3.36 27.00 ± 3.89 | 36.53 ± 3.15 35.68 ± 2.94 | |
Borella, P.; [30] (1990) | Italy (Europe) | cross-sectional study | Control PE | 35 24 | 9.60 10.49 | 2.29 2.28 | NS | plasma | yes | 29–40 | ||
Akhtar, S.; [31] (2011) | Bangladesh (Asia) | cross-sectional study | Control PE | 30 60 | 17.74 13.88 | 1.03 2.42 | p < 0.001 | serum | no | 25.20 ± 4.85 25.11 ± 5.66 | 31.53 ± 3.90 32.35 ± 3.53 | ageand gestational period matched |
Akinloye, O.; [23] (2010) | Nigeria (Africa) | cross-sectional study | Control PE | 40 49 | 9.40 8.60 | 0.80 1.40 | p < 0.05 | serum | no | age-matched | ||
Ahsan, T.; [25] (2013) | Bangladesh (Asia) | cross-sectional study | Control PE | 27 44 | 15.00 16.00 | 2.00 2.00 | p = 0.560 | serum | no | 24.11 ± 4.93 26.05 ± 5.41 | 36.23 ± 2.64 35.60 ± 3.85 | demographically well matched |
Rathore, S.; [26] (2011) | India (Asia) | cross-sectional study | Control PE | 47 14 | 8.85 7.57 | 3.32 2.74 | NS | serum | no | 19–35 | age-matched | |
Ugwuja, E.I.; [32] (2010) | Nigeria (Africa) | cross-sectional study | Control PE | 40 40 | 10.87 9.97 | 10.30 9.74 | p = 0.686 | plasma | no | 27.55 ± 4.23 29.45 ± 3.70 | 21.40 ± 3.22 | matched for age, gestational age, parity, anthropometrics andsocioeconomic status |
Gupta, S.; [33] (2014) | India (Asia) | case-control study | Control mild PE sever PE | 75 47 18 | 10.63 10.46 9.28 | 1.82 2.05 1.63 | NS p < 0.01 | plasma | no | |||
Araujo Brito, J.; [34] (2013) | Brazil (America) | case-control study | Control mild PE sever PE | 50 20 24 | 7.43 7.69 5.97 | 1.28 1.45 1.26 | NS p < 0.05 | plasma | fasting for at least 12 h | 24.13 ± 6.43 27.00 ± 6.59 | 39.17 ± 1.76 36.30 ± 3.01 | |
Jain, S.; [35] (2010) | India (Asia) | cross-sectional study | Control mild PE sever PE | 50 25 25 | 15.64 12.72 12.04 | 2.40 1.70 1.40 | p < 0.05 p < 0.05 | serum | no | 23.92 ± 3.42 23.04 ± 3.76 22.96 ± 3.81 | 33.62 ± 7.83 34.92 ± 3.54 35.08 ± 3.60 | age-matched |
3.2. Serum or Plasma Zinc Level and PE
Subgroup | Number of Studies | SMD (95% CI) | Test of SMD = 0 | Heterogeneity | Article Included | ||
---|---|---|---|---|---|---|---|
Z | p for Z | I2 | p for I2 | ||||
Continent | |||||||
Asia Europe Africa | 10 2 2 | −0.812 (−1.263, −0.362) 0.323 (−0.033, 0.678) −0.389 (−0.971, 0.194) | 3.54 1.78 1.31 | 0.0001 0.075 0.191 | 88.4 0.0 72.2 | 0.0001 0.734 0.058 | [11,12,13,17,25,26,27,28,29,31] [24,30] [23,32] |
Sample type | |||||||
plasma serum | 4 10 | −0.460 (−1.246, 0.325) −0.637 (−1.080, −0.195) | 1.15 2.82 | 0.251 0.005 | 87.7 89.4 | 0.0001 0.0001 | [12,29,30,32] [11,13,17,23,24,25,26,27,28,31] |
Fasting status | |||||||
yes no | 8 6 | −0.636 (−1.131, −0.141) −0.522 (−1.159, 0.115) | 2.52 1.61 | 0.012 0.108 | 89.2 89.4 | 0.0001 0.0001 | [11,12,13,17,24,27,28,30] [23,25,26,29,31,32] |
Individual age match | |||||||
yes no | 7 7 | −0.634 (−1.213, −0.056) −0.540 (−1.060, −0.019) | 2.15 2.03 | 0.032 0.042 | 89.9 88.2 | 0.0001 0.0001 | [13,23,25,26,29,31,32] [11,12,17,24,27,28,30] |
Individual gestational age match | |||||||
yes no | 6 8 | −0.678 (−1.325, −0.030) −0.516 (−0.983, −0.050) | 2.05 2.17 | 0.040 0.030 | 91.5 86.0 | 0.0001 0.0001 | [11,13,25,29,31,32] [12,17,23,24,26,27,28,30] |
3.3. Meta-Regression
3.4. Influence Analysis and Small-Study Effect Evaluation
4. Discussion
5. Conclusions
Supplementary Files
Supplementary File 1Acknowledgments
Author Contributions
Conflicts of Interest
References
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Ma, Y.; Shen, X.; Zhang, D. The Relationship between Serum Zinc Level and Preeclampsia: A Meta-Analysis. Nutrients 2015, 7, 7806-7820. https://doi.org/10.3390/nu7095366
Ma Y, Shen X, Zhang D. The Relationship between Serum Zinc Level and Preeclampsia: A Meta-Analysis. Nutrients. 2015; 7(9):7806-7820. https://doi.org/10.3390/nu7095366
Chicago/Turabian StyleMa, Yue, Xiaoli Shen, and Dongfeng Zhang. 2015. "The Relationship between Serum Zinc Level and Preeclampsia: A Meta-Analysis" Nutrients 7, no. 9: 7806-7820. https://doi.org/10.3390/nu7095366