采用系统评价和荟萃分析综合评价妊娠期锰(Mn)水平与子痫前期(PE)的关系。通过搜索Medline检索相关的观察性研究,WebofScience,Embase,和Cochrane图书馆从数据库开始到2023年5月25日。使用包含异质性的随机效应模型进行汇集结果。这项荟萃分析纳入了18项观察性研究,其中包括1113名女性PE和5480名血压正常的孕妇。汇总结果显示,与正常血压对照相比,女性PE患者的血锰浓度显著降低(标准化平均差:-0.36,95%置信区间:-0.50~-0.22,p<0.001;I2=67%).亚组分析显示,结果受研究国家(非洲,亚洲人,或西方),采血时间(之前,at,或在诊断为PE之后),对照组的平均血锰水平,或校正的混杂因素数量(亚组分析p均>0.05),而测量血液Mn水平的方法可能会影响结果(亚组差异p<0.001)。最后,3项研究的汇总结果显示,高水平的血锰与PE的低风险相关,且连续分析了血锰(风险比[RR]:0.71,95%CI:0.59~0.85,p<0.001;I2=0%)和分类变量(RR:0.50,95%CI:0.30~0.82,p=0.006;I2=32%).总之,孕妇血锰水平低可能与PE有关。
A systematic
review and meta-analysis was performed to comprehensively evaluate the association between manganese (Mn) level and preeclampsia (PE) during pregnancy. Relevant observational studies were retrieved by searching Medline, Web of Science, Embase, and Cochrane Library from database inception to May 25, 2023. Pooling results was performed using a random-effects model incorporating heterogeneity. This meta-analysis incorporated 18 observational studies, which included 1113 women with PE and 5480 normotensive pregnant women. Pooled results showed that compared to normotensive control, women with PE had significantly lower blood Mn concentration (standardized mean difference: -0.36, 95% confidence interval: -0.50 to -0.22, p < 0.001; I2 = 67%). Subgroup analysis showed that the results were not significantly affected by study country (African, Asian, or Western), timing of blood sampling (before, at, or after the diagnosis of PE), mean blood Mn level of controls, or numbers of confounding factors adjusted (p for subgroup analysis all > 0.05), while methods for measuring blood Mn levels might affect the results (p for subgroup difference < 0.001). Finally, pooled results of three studies showed that a high level of blood Mn was related to a low risk of PE with blood Mn analyzed in continuous (risk ratio [RR]: 0.71, 95% CI: 0.59 to 0.85, p < 0.001; I2 = 0%) and categorized variables (RR: 0.50, 95% CI: 0.30 to 0.82, p = 0.006; I2 = 32%). In conclusion, a low blood level of Mn may be associated with PE in pregnant women.