Department of Gynecology and Obstetrics, The 960th Hospital of the People's Liberation Army of China, 25 Shifan Road, Jinan, 250031, China.
Department of Medical Information, The 960th Hospital of the People's Liberation Army of China, Jinan, 250031, China.
Biol Trace Elem Res. 2024 May;202(5):1843-1855. doi: 10.1007/s12011-023-03796-9. Epub 2023 Aug 23.
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; I = 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; I = 0%) and categorized variables (RR: 0.50, 95% CI: 0.30 to 0.82, p = 0.006; I = 32%). In conclusion, a low blood level of Mn may be associated with PE in pregnant women.
一项系统评价和荟萃分析全面评估了怀孕期间锰（Mn）水平与子痫前期（PE）之间的关联。通过检索 Medline、Web of Science、Embase 和 Cochrane Library，从数据库建立到 2023 年 5 月 25 日，检索了相关观察性研究。使用包含异质性的随机效应模型进行汇总结果。这项荟萃分析纳入了 18 项观察性研究，其中包括 1113 名患有 PE 的女性和 5480 名正常血压孕妇。汇总结果显示，与正常血压对照组相比，患有 PE 的女性血液 Mn 浓度明显较低（标准化均数差：-0.36，95%置信区间：-0.50 至 -0.22，p < 0.001；I = 67%）。亚组分析表明，研究国家（非洲、亚洲或西方）、采血时间（在 PE 诊断之前、之时或之后）、对照组平均血液 Mn 水平或调整的混杂因素数量（p 均 > 0.05）对结果无显著影响，而血液 Mn 水平的测量方法可能会影响结果（p 为亚组差异 < 0.001）。最后，三项研究的汇总结果表明，血液 Mn 水平较高与 PE 风险较低相关，以连续变量（风险比 [RR]：0.71，95%置信区间：0.59 至 0.85，p < 0.001；I = 0%）和分类变量（RR：0.50，95%置信区间：0.30 至 0.82，p = 0.006；I = 32%）进行分析。总之，孕妇血液 Mn 水平较低可能与 PE 相关。
