Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, 210009, China.
Biol Trace Elem Res. 2022 Nov;200(11):4615-4631. doi: 10.1007/s12011-021-03070-w. Epub 2022 Jan 10.
It has been reported that heavy metals have adverse effects on the immune system. However, the relationship between heavy metal exposure and allergic outcomes remains unclear. This systematic review was conducted to examine whether heavy metal exposure is associated with allergic outcomes during childhood. We performed a systematic search of all relevant articles in Web of Science, EMBASE, and PubMed, from inception through to November 2020. We used odds ratio (OR) and the standard mean differences (SMDs) with 95% confidence intervals (CIs) to present estimates from individual studies. In addition, random-effects meta-analysis was used to pool the data. We also conducted the meta-regression and subgroup analysis to explore potential sources of heterogeneity. After duplicate removal, we finally included 35 articles in the systematic review and meta-analysis from an initial 11,181 articles. The overall results showed that copper (Cu) was associated with asthma (pooled SMD = 1.50, 95% CI = 0.13-2.86); in the subgroup analysis, the results indicated that lead (Pb) was associated with asthma (pooled OR = 6.27, 95% CI = 2.24-17.56), and Cu and Pb were connected with atopic dermatitis (SMD = - 1.05, 95% CI = - 1.45 to - 0.65; SMD = 5.68, 95% CI = 5.05-6.32), respectively. Mercury (Hg) was associated with atopic dermatitis (pooled OR = 1.13, 95% CI = 1.04-1.22) and wheeze (OR = 1.20, 95% CI = 1.05-1.37). The meta-analysis results indicate that Cu might be connected with childhood asthma, but not with other allergic diseases; Hg and Pb may have no association with allergic diseases during childhood. Given some limits observed in the current studies, more prospective cohort studies are still needed to verify our findings. Review registration: PROSPERO CRD42020222167.
据报道，重金属对免疫系统有不良影响。然而，重金属暴露与过敏结果之间的关系尚不清楚。本系统评价旨在研究儿童时期重金属暴露是否与过敏结果有关。我们对 Web of Science、EMBASE 和 PubMed 中的所有相关文章进行了系统检索，检索时间从建库至 2020 年 11 月。我们使用比值比（OR）和标准均数差（SMD）及其 95%置信区间（CI）来呈现来自单个研究的估计值。此外，我们还进行了随机效应荟萃分析来汇总数据。我们还进行了荟萃回归和亚组分析，以探讨潜在的异质性来源。在重复项删除后，我们最终从最初的 11181 篇文章中纳入了 35 篇文章进行系统评价和荟萃分析。总体结果表明，铜（Cu）与哮喘有关（汇总 SMD=1.50，95%CI=0.13-2.86）；在亚组分析中，结果表明铅（Pb）与哮喘有关（汇总 OR=6.27，95%CI=2.24-17.56），Cu 和 Pb 与特应性皮炎有关（SMD=-1.05，95%CI=-1.45 至-0.65；SMD=5.68，95%CI=5.05-6.32）。汞（Hg）与特应性皮炎（汇总 OR=1.13，95%CI=1.04-1.22）和喘息（OR=1.20，95%CI=1.05-1.37）有关。荟萃分析结果表明，Cu 可能与儿童哮喘有关，但与其他过敏性疾病无关；Hg 和 Pb 可能与儿童时期的过敏性疾病无关。鉴于目前研究中观察到的一些局限性，仍需要更多的前瞻性队列研究来验证我们的研究结果。综述注册：PROSPERO CRD42020222167。
