Association between zinc level and the risk of preeclampsia: a meta-analysis

Zhu, Qi; Zhang, Lingli; Chen, Xiaobo; Zhou, Jun; Liu, Jiangyue; Chen, Jianhua

doi:10.1007/s00404-015-3883-y

Cited by 29 publications

(18 citation statements)

References 24 publications

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“…With respect to essential metals, we observed a reduction, albeit imprecise, in the risk of preeclampsia associated with an increase in urinary Se. This observation is consistent with the literature, which suggests that essential metals, including Se, may reduce the risk of preeclampsia [16, 17]. In contrast, urinary Cu and Se were associated with lower circulating PlGF levels.…”

Section: Discussionsupporting

confidence: 92%

“…Previous studies have reported associations between toxic metals, such as cadmium (Cd) and lead (Pb), and an increased risk of preeclampsia [10–15]. Alternatively, higher exposure to essential metals, such as selenium (Se) and zinc (Zn), within a recommended range, have been routinely associated with a decreased risk of preeclampsia [16, 17]. Possible mechanisms for these associations include that toxic metals may impair trophoblast invasiveness [18–21], generate placental oxidative stress [22], or lead to maternal immunologic abnormalities [23], whereas essential metals have antioxidant properties that may reduce the effect of toxic exposures and promote normal placentation [24].…”

Section: Introductionmentioning

confidence: 99%

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Urinary trace metals, maternal circulating angiogenic biomarkers, and preeclampsia: a single-contaminant and mixture-based approach

et al. 2019

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Background Exposures to toxic metals and deficiencies in essential metals disrupt placentation and may contribute to preeclampsia. However, effects of exposure to combinations of metals remain unknown. Objective We investigated the relationship between urinary trace metals, circulating angiogenic biomarkers, and preeclampsia using the LIFECODES birth cohort. Methods Urine samples collected during pregnancy were analyzed for 17 trace metals and plasma samples were analyzed for soluble fms-like tyrosine-1 (sFlt-1) and placental growth factor (PlGF). Cox proportional hazard models were used to estimate the hazard ratios (HR) of preeclampsia associated with urinary trace metals. Linear regression models were used to estimate the relationship between urinary trace metals and angiogenic biomarkers. Principal components analysis (PCA) was used to identify groups of metals and interactions between principal components (PCs) loaded by toxic and essential metals were examined. Results In single-contaminant models, several toxic and essential metals were associated with lower PlGF and higher sFlt-1/PlGF ratio. Detection of urinary chromium was associated with preeclampsia: HR (95% Confidence Interval [CI]) = 3.48 (1.02, 11.8) and an IQR-increase in urinary selenium was associated with reduced risk of preeclampsia (HR: 0.28, 95% CI: 0.08, 0.94). Using PCA, 3 PCs were identified, characterized by essential metals (PC1), toxic metals (PC2), and seafood-associated metals (PC3). PC1 and PC2 were associated with lower PlGF levels, but not preeclampsia risk in the overall cohort. Conclusions Trace urinary metals may be associated with adverse profiles of angiogenic biomarkers and preeclampsia. Electronic supplementary material The online version of this article (10.1186/s12940-019-0503-5) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Urinary trace metals, maternal circulating angiogenic biomarkers, and preeclampsia: a single-contaminant and mixture-based approach

et al. 2019

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“…In the present study, "serum zinc concentration was found to decrease significantly in the preeclamptic group compared to normotensive pregnant women. Our results are consistent with earlier reports" 6,10,14 . Zn is an important trace element in metabolism, growth, development, and reproduction.…”

Section: Graph I: Serum Zinc Levels Of Control and Cases Groups Discussionsupporting

confidence: 94%

Association of Serum Zinc level with Pre Eclampsia

2017

J Liaquat Uni Med Health Sci

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BACKGROUND: Pre eclampsia is the commonest obstetrical complication in pregnant women. The etiology of pre eclampsia has yet not been clearly understood. It has a worldwide prevalence of 2-10% of pregnancies and one of the major causes of increase in maternal and perinatal morbidity and mortality. Zinc plays an important role in the course and eventual outcome of human pregnancy and is essential for normal embryogenesis and fetal growth. Zinc deficiency in pregnancy is thought to be associated with pre-eclampsia. OBJECTIVE: The aim of this study was to investigate the serum zinc level in pre-eclampsia. PATIENTS AND METHODS: This Hospital based study conducted at Gynecology Department of Indus Medical Collage, Tando Muhammad Khan, Sindh from October 2015 to March 2016 with the Permission of Head of the Department and Principal of Institute. The study groups consist of 40 consecutive diagnosed cases of pre eclampsia and 40 women with normal pregnancies. The serum zinc level of the subjects under this study was determined using Atomic Absorption Spectrophotometer. RESULTS: The results of our study showed that serum Zinc level among the pre-eclamptic and was statistically significantly low as compared to normotensive pregnant women. CONCLUSION: The findings of current work are statistically significant to establish that concentration of serum zinc among preeclamptic subjects is lower than in the normotensive women during pregnancy.

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“…Of the 2444 citations identified, 126 systematic reviews were included in this review. Figure provides details of the review identification and selection process.…”

Section: Resultsmentioning

confidence: 99%

Prediction of pre‐eclampsia: review of reviews

Townsend

Khalil

Premakumar

et al. 2019

Ultrasound in Obstet & Gyne

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Objective Primary studies and systematic reviews provide estimates of varying accuracy for different factors in the prediction of pre‐eclampsia. The aim of this study was to review published systematic reviews to collate evidence on the ability of available tests to predict pre‐eclampsia, to identify high‐value avenues for future research and to minimize future research waste in this field. Methods MEDLINE, EMBASE and The Cochrane Library including DARE (Database of Abstracts of Reviews of Effects) databases, from database inception to March 2017, and bibliographies of relevant articles were searched, without language restrictions, for systematic reviews and meta‐analyses on the prediction of pre‐eclampsia. The quality of the included reviews was assessed using the AMSTAR tool and a modified version of the QUIPS tool. We evaluated the comprehensiveness of search, sample size, tests and outcomes evaluated, data synthesis methods, predictive ability estimates, risk of bias related to the population studied, measurement of predictors and outcomes, study attrition and adjustment for confounding. Results From 2444 citations identified, 126 reviews were included, reporting on over 90 predictors and 52 prediction models for pre‐eclampsia. Around a third (n = 37 (29.4%)) of all reviews investigated solely biochemical markers for predicting pre‐eclampsia, 31 (24.6%) investigated genetic associations with pre‐eclampsia, 46 (36.5%) reported on clinical characteristics, four (3.2%) evaluated only ultrasound markers and six (4.8%) studied a combination of tests; two (1.6%) additional reviews evaluated primary studies investigating any screening test for pre‐eclampsia. Reviews included between two and 265 primary studies, including up to 25 356 688 women in the largest review. Only approximately half (n = 67 (53.2%)) of the reviews assessed the quality of the included studies. There was a high risk of bias in many of the included reviews, particularly in relation to population representativeness and study attrition. Over 80% (n = 106 (84.1%)) summarized the findings using meta‐analysis. Thirty‐two (25.4%) studies lacked a formal statement on funding. The predictors with the best test performance were body mass index (BMI) > 35 kg/m2, with a specificity of 92% (95% CI, 89–95%) and a sensitivity of 21% (95% CI, 12–31%); BMI > 25 kg/m2, with a specificity of 73% (95% CI, 64–83%) and a sensitivity of 47% (95% CI, 33–61%); first‐trimester uterine artery pulsatility index or resistance index > 90th centile (specificity 93% (95% CI, 90–96%) and sensitivity 26% (95% CI, 23–31%)); placental growth factor (specificity 89% (95% CI, 89–89%) and sensitivity 65% (95% CI, 63–67%)); and placental protein 13 (specificity 88% (95% CI, 87–89%) and sensitivity 37% (95% CI, 33–41%)). No single marker had a test performance suitable for routine clinical use. Models combining markers showed promise, but none had undergone external validation. Conclusions This review of reviews calls into question the need for further aggregate meta‐analy...

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Association between zinc level and the risk of preeclampsia: a meta-analysis

Abstract: Our analysis indicated that zinc level in preeclampsia patients was significantly lower than that of healthy, pregnant women, especially among the Asian population.

Cited by 29 publications

References 24 publications

Urinary trace metals, maternal circulating angiogenic biomarkers, and preeclampsia: a single-contaminant and mixture-based approach

Urinary trace metals, maternal circulating angiogenic biomarkers, and preeclampsia: a single-contaminant and mixture-based approach

Association of Serum Zinc level with Pre Eclampsia

Prediction of pre‐eclampsia: review of reviews

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