Abstract：
BACKGROUND: The assessment of zinc status is difficult but essential for the identification of zinc deficiency and evaluation of interventions to improve zinc status.
OBJECTIVE: The purpose of this systematic review (SR) and meta-analysis was to update the previously published SR of biomarkers of zinc status, conducted by the European Micronutrient Recommendations Aligned (EURRECA) network in 2009, to answer the question: Which putative measures (biomarkers) of zinc status appropriately reflect a change in zinc intake of at least 2 weeks?
METHODS: A structured search strategy was used to identify articles published between January 2007 and September 2022 from MEDLINE (Ovid), Embase (Ovid), Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials (CENTRAL). Relevant articles were identified using previously defined eligibility criteria.
METHODS: Data were extracted and combined with data from the previous SR.
METHODS: A random-effects model was used to calculate pooled mean differences using STATA (StataCorp). The risk of bias and the certainty of evidence for all outcomes were assessed. Additional data on 7 of the 32 previously reported biomarkers were identified, along with data on an additional 40 putative biomarkers from studies published since 2007. Pooled data analysis confirmed that, in healthy participants, both plasma/serum zinc concentration and urinary zinc excretion responded to changes in zinc intake (plasma/serum: mean effect [95% CI], controlled studies: 2.17 µmol/L [1.73, 2.61]; P < .005, I2 = 97.8; before-and-after studies: 2.87 µmol/L [2.45, 3.30]; P < .005, I2 = 98.1%; urine zinc: 0.39 mmol/mol creatinine [0.17, 0.62]; P < .005, I2 = 81.2; 3.09 µmol/day [0.16, 6.02]; P = .039, I2 = 94.3).
CONCLUSIONS: The updated analyses support the conclusion that plasma/serum and urinary zinc respond to changes in zinc intake in studies of healthy participants. Several additional putative biomarkers were identified, but more studies are needed to assess the sensitivity and reliability.
BACKGROUND: PROSPERO no. CRD42020219843.
OBJECTIVE: The purpose of this systematic review (SR) and meta-analysis was to update the previously published SR of biomarkers of zinc status, conducted by the European Micronutrient Recommendations Aligned (EURRECA) network in 2009, to answer the question: Which putative measures (biomarkers) of zinc status appropriately reflect a change in zinc intake of at least 2 weeks?
METHODS: A structured search strategy was used to identify articles published between January 2007 and September 2022 from MEDLINE (Ovid), Embase (Ovid), Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials (CENTRAL). Relevant articles were identified using previously defined eligibility criteria.
METHODS: Data were extracted and combined with data from the previous SR.
METHODS: A random-effects model was used to calculate pooled mean differences using STATA (StataCorp). The risk of bias and the certainty of evidence for all outcomes were assessed. Additional data on 7 of the 32 previously reported biomarkers were identified, along with data on an additional 40 putative biomarkers from studies published since 2007. Pooled data analysis confirmed that, in healthy participants, both plasma/serum zinc concentration and urinary zinc excretion responded to changes in zinc intake (plasma/serum: mean effect [95% CI], controlled studies: 2.17 µmol/L [1.73, 2.61]; P < .005, I2 = 97.8; before-and-after studies: 2.87 µmol/L [2.45, 3.30]; P < .005, I2 = 98.1%; urine zinc: 0.39 mmol/mol creatinine [0.17, 0.62]; P < .005, I2 = 81.2; 3.09 µmol/day [0.16, 6.02]; P = .039, I2 = 94.3).
CONCLUSIONS: The updated analyses support the conclusion that plasma/serum and urinary zinc respond to changes in zinc intake in studies of healthy participants. Several additional putative biomarkers were identified, but more studies are needed to assess the sensitivity and reliability.
BACKGROUND: PROSPERO no. CRD42020219843.
摘要：
背景：锌状态的评估是困难的，但对于识别锌缺乏和评估改善锌状态的干预措施至关重要。
目的：本系统综述（SR）和荟萃分析的目的是更新先前发表的锌状态生物标志物的SR，由欧洲微量营养素推荐联盟（EURRECA）网络于2009年进行，以回答以下问题：哪些锌状态的推定措施（生物标志物）适当地反映了至少2周的锌摄入量变化？
方法：使用结构化搜索策略来识别MEDLINE（Ovid）在2007年1月至2022年9月之间发表的文章，Embase(Ovid),Cochrane系统评价数据库，和Cochrane中央控制试验登记册（CENTRAL）。使用先前定义的资格标准确定了相关文章。
方法：提取数据并与先前SR的数据组合。
方法：使用随机效应模型来计算使用STATA（StataCorp）的合并均值差异。评估所有结果的偏倚风险和证据的确定性。确定了先前报道的32种生物标志物中的7种的其他数据，以及自2007年以来发表的40项推定的生物标志物的数据。汇总数据分析证实，在健康的参与者中，血浆/血清锌浓度和尿锌排泄均对锌摄入量的变化有反应（血浆/血清：平均效应[95%CI]，对照研究：2.17µmol/L[1.73，2.61]；P<.005，I2=97.8；前后研究：2.87µmol/L[2.45，3.30]；P<.005，I2=98.1％；尿锌：0.39mmol/mol肌酐[0.17，0.62]；P<.005，I2=81.2；3.09µmol/day[0.16]。
结论：更新的分析支持以下结论：在健康参与者的研究中，血浆/血清和尿锌对锌摄入量的变化有反应。确定了一些其他推定的生物标志物，但需要更多的研究来评估敏感性和可靠性。
背景：PROSPEROno.CRD42020219843。
目的：本系统综述（SR）和荟萃分析的目的是更新先前发表的锌状态生物标志物的SR，由欧洲微量营养素推荐联盟（EURRECA）网络于2009年进行，以回答以下问题：哪些锌状态的推定措施（生物标志物）适当地反映了至少2周的锌摄入量变化？
方法：使用结构化搜索策略来识别MEDLINE（Ovid）在2007年1月至2022年9月之间发表的文章，Embase(Ovid),Cochrane系统评价数据库，和Cochrane中央控制试验登记册（CENTRAL）。使用先前定义的资格标准确定了相关文章。
方法：提取数据并与先前SR的数据组合。
方法：使用随机效应模型来计算使用STATA（StataCorp）的合并均值差异。评估所有结果的偏倚风险和证据的确定性。确定了先前报道的32种生物标志物中的7种的其他数据，以及自2007年以来发表的40项推定的生物标志物的数据。汇总数据分析证实，在健康的参与者中，血浆/血清锌浓度和尿锌排泄均对锌摄入量的变化有反应（血浆/血清：平均效应[95%CI]，对照研究：2.17µmol/L[1.73，2.61]；P<.005，I2=97.8；前后研究：2.87µmol/L[2.45，3.30]；P<.005，I2=98.1％；尿锌：0.39mmol/mol肌酐[0.17，0.62]；P<.005，I2=81.2；3.09µmol/day[0.16]。
结论：更新的分析支持以下结论：在健康参与者的研究中，血浆/血清和尿锌对锌摄入量的变化有反应。确定了一些其他推定的生物标志物，但需要更多的研究来评估敏感性和可靠性。
背景：PROSPEROno.CRD42020219843。
