背景:疟疾,严重的健康威胁,显著影响总抗氧化剂状态(TAS)水平,导致相当大的氧化应激。本系统综述和荟萃分析旨在描述疟疾患者和健康对照之间TAS水平的差异。并评估疾病严重程度和寄生虫密度之间的相关性。
方法:系统评价在国际前瞻性系统评价注册中心(PROSPERO)注册,注册号为CRD42023448761。在Embase等数据库中进行了全面的文献检索,MEDLINE,日志@Ovid,PubMed,Scopus,ProQuest,和谷歌学者确定报告疟疾患者TAS水平数据的研究。对纳入研究的数据进行了定性和定量分析。使用随机效应模型汇总疟疾患者和对照组之间的TAS水平差异,用对冲作为效应大小度量。
结果:在1796条确定的记录中,20项研究符合纳入标准。这些研究的定性综合显示,与非疟疾病例相比,疟疾患者的TAS水平显着下降。荟萃分析结果显示,与非疟疾病例相比,疟疾患者的TAS水平显着降低(P<0.01,Hedges\'g:-2.75,95%CI-3.72至-1.78,I2:98.16%,13项研究),提示这些患者氧化应激升高。亚组分析显示,TAS水平变化受地理区域的显著影响,年龄组,疟原虫物种,和测量TAS的方法。值得注意的是,在严重疟疾病例和寄生虫密度高的病例中,TAS水平明显较低,表明氧化应激和疾病严重程度之间的潜在关系。
结论:本研究强调了TAS作为疟疾疾病风险和严重程度的生物标志物的潜在效用。与对照组相比,疟疾患者的TAS水平显着降低意味着氧化应激增加。进一步精心设计,有必要进行大规模研究来验证这些发现,并阐明TAS与疟疾之间的复杂机制.
BACKGROUND: Malaria, a severe health threat, significantly affects total antioxidant status (TAS) levels, leading to considerable oxidative stress. This systematic review and meta-analysis aimed to delineate differences in TAS levels between malaria patients and healthy controls, and assess correlations between disease severity and parasite density.
METHODS: The systematic review was registered with the International Prospective Register of Systematic Reviews (PROSPERO) under registration number CRD42023448761. A comprehensive literature search was conducted in databases such as Embase, MEDLINE, Journals@Ovid, PubMed, Scopus, ProQuest, and Google Scholar to identify studies reporting data on TAS levels in malaria patients. Data from the included studies were analysed both qualitatively and quantitatively. Differences in TAS levels between malaria patients and controls were pooled using a random effects model, with Hedges\' g as the effect size measure.
RESULTS: Of 1796 identified records, 20 studies met the inclusion criteria. The qualitative synthesis of these studies revealed a marked decrease in TAS levels in patients with malaria compared to non-malaria cases. The meta-analysis results showed a significant decrease in TAS levels in patients with malaria compared to non-malaria cases (P < 0.01, Hedges\' g: - 2.75, 95% CI - 3.72 to -1.78, I2: 98.16%, 13 studies), suggesting elevated oxidative stress in these patients. Subgroup analyses revealed that TAS level variations were significantly influenced by geographical region, age group, Plasmodium species, and method for measuring TAS. Notably, TAS levels were significantly lower in severe malaria cases and those with high parasite density, indicating a potential relationship between oxidative stress and disease severity.
CONCLUSIONS: This study highlights the potential utility of TAS as a biomarker for disease risk and severity in malaria. The significant decrease in TAS levels in malaria patients compared to controls implies increased oxidative stress. Further well-designed, large-scale studies are warranted to validate these findings and elucidate the intricate mechanisms linking TAS and malaria.