Ventriglia Mariacarla, Brewer George J, Simonelli Ilaria, Mariani Stefania, Siotto Mariacristina, Bucossi Serena, Squitti Rosanna
Fatebenefratelli Foundation for Health Research and Education, AFaR Division, "San Giovanni Calibita" Fatebenefratelli Hospital, Rome, Italy.
Department of Human Genetics, University of Michigan Medical School, Ann Arbor, MI, USA.
J Alzheimers Dis. 2015;46(1):75-87. doi: 10.3233/JAD-141296.
To evaluate whether zinc levels in serum, plasma, and cerebrospinal fluid are altered in Alzheimer's disease (AD), we performed meta-analyses of 27 studies on the topic published from 1983 to 2014. The subjects' sample obtained by merging studies was a pooled total of 777 AD subjects and 1,728 controls for serum zinc studies, 287 AD subjects and 166 controls for plasma zinc, and of 292 AD subjects and 179 controls for CSF zinc. The main result of this meta-analysis is the very high heterogeneity among the studies either in demographic terms or in methodological approaches. Although we considered these effects in our analyses, the heterogeneity persisted and it has to be taken into account in the interpretation of the results. Our meta-analysis indicated that serum zinc appears significantly decreased in AD patients compared with healthy controls, and this result is confirmed when serum and plasma studies were analyzed together. If we considered the age-matched studies, the meta-analysis carried out on only six studies showed no significant difference in zinc levels between AD and healthy controls (SMD =-0.55, 95% CI (-1.18; 0.09); p = 0.094; I2 = 91%). In the light of these findings, we speculated about the possibility that the decreases observed could indicate a possible dietary zinc deficiency and we suggested that the possible involvement of zinc alterations in AD may have an interplay with copper metabolism.
为评估阿尔茨海默病（AD）患者血清、血浆和脑脊液中的锌水平是否发生改变，我们对1983年至2014年发表的27项关于该主题的研究进行了荟萃分析。通过合并研究获得的受试者样本中，血清锌研究共有777例AD受试者和1728例对照，血浆锌研究有287例AD受试者和166例对照，脑脊液锌研究有292例AD受试者和179例对照。该荟萃分析的主要结果是，无论是在人口统计学方面还是在方法学方法上，各研究之间均存在非常高的异质性。尽管我们在分析中考虑了这些影响，但异质性仍然存在，在解释结果时必须予以考虑。我们的荟萃分析表明，与健康对照相比，AD患者的血清锌水平显著降低，当将血清和血浆研究一起分析时，这一结果得到了证实。如果我们考虑年龄匹配的研究，仅对六项研究进行的荟萃分析显示，AD患者和健康对照之间的锌水平没有显著差异（标准化均数差=-0.55，95%可信区间（-1.18；0.09）；p=0.094；I²=91%）。鉴于这些发现，我们推测观察到的降低可能表明存在饮食锌缺乏的可能性，并建议锌改变在AD中的可能参与可能与铜代谢相互作用。
