孕期铁调素及其与母体铁和炎症标志物、母体体重结局以及后代神经发育结局的相关性：一项系统评价和荟萃分析。

Hepcidin across pregnancy and its correlation with maternal markers of iron and inflammation, maternal body weight outcomes, and offspring neurodevelopmental outcomes: a systematic review and meta-analysis.

作者信息

Ssewanyana Derrick, Borque Stephane L, Lye Stephen J, Matthews Stephen G

机构信息

Departments of Physiology (Drs Ssewanyana, Lye, and Matthews).

Medicine (Drs Ssewanyana, Lye, and Matthews), University of Toronto, Toronto, Canada.

出版信息

AJOG Glob Rep. 2023 May 11;3(3):100222. doi: 10.1016/j.xagr.2023.100222. eCollection 2023 Aug.

DOI:10.1016/j.xagr.2023.100222

PMID:37645642

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10461250/

Abstract

OBJECTIVE

This study evaluated the correlation between maternal hepcidin and other biomarkers of iron status, markers of inflammation, and maternal body weight during pregnancy, as well as neurodevelopment in the offspring.

DATA SOURCES

PubMed, Web of Science, Scopus, and Embase were searched from inception until March 2022.

STUDY ELIGIBILITY CRITERIA

Studies conducted among pregnant women without apparent pregnancy complications were included. Eligible studies reported correlation coefficients between maternal hepcidin and any outcomes of maternal biomarkers of iron status or inflammatory load during pregnancy, prenatal maternal body weight, and offspring neurodevelopment. Studies without correlation data were eligible if they quantitatively reported volumes of both maternal hepcidin and any marker of iron status and/or inflammatory load during gestation.

METHODS

Pooled correlation coefficients between maternal hepcidin and outcomes of interest were calculated using the Fisher -to-Z transformation. Both fixed-effects and DerSimonian and Laird random-effects models were used to calculate pooled correlation coefficient. When meta-analysis was not feasible, results were descriptively synthesized.

RESULTS

Forty-six studies with 6624 participants were eligible. Hepcidin was significantly correlated with hemoglobin in the third trimester (=0.21; 95% confidence interval, 0.1-0.32); ferritin in the first (=0.31; 95% confidence interval, 0.01-0.61) and third trimester (=0.35; 95% confidence interval, 0.23-0.48); soluble transferrin receptor in the second trimester (=-0.27; 95% confidence interval, -0.4 to -0.14); total iron-binding capacity in the second trimester (=0.37; 95% confidence interval, 0.24-0.50); and serum iron in the third trimester (=0.11; 95% confidence interval, 0.02-0.19). Hepcidin was significantly correlated with the inflammatory marker interleukin-6 in the third trimester (=0.26; 95% confidence interval, 0.17-0.34) and C-reactive protein in the second (=0.16; 95% confidence interval, 0.03-0.30) and third trimester (=0.28; 95% confidence interval, 0.04-0.52). Four out of 5 studies reported weak-to-moderate positive correlation between hepcidin and body mass index. Hepcidin levels varied across body mass index categories. No single study reported the relationship between maternal hepcidin and neurodevelopment in offspring.

CONCLUSION

Hepcidin weakly to moderately correlates with biomarkers of iron and inflammation in pregnancy.

摘要

目的

本研究评估了孕期母亲铁调素与其他铁状态生物标志物、炎症标志物、母亲体重以及后代神经发育之间的相关性。

数据来源

检索了PubMed、科学网、Scopus和Embase数据库，检索时间从建库至2022年3月。

研究纳入标准

纳入在无明显妊娠并发症的孕妇中开展的研究。符合条件的研究报告了母亲铁调素与孕期母亲铁状态生物标志物或炎症负荷的任何结果、产前母亲体重以及后代神经发育之间的相关系数。如果研究定量报告了孕期母亲铁调素和任何铁状态及/或炎症负荷标志物的含量，但没有相关数据，也符合纳入标准。

方法

采用Fisher - Z变换计算母亲铁调素与感兴趣结果之间的合并相关系数。使用固定效应模型和DerSimonian和Laird随机效应模型计算合并相关系数。当无法进行荟萃分析时，对结果进行描述性综合分析。

结果

46项研究符合条件，共6624名参与者。铁调素与孕晚期血红蛋白显著相关（r = 0.21；95%置信区间，0.1 - 0.32）；与孕早期铁蛋白显著相关（r = 0.31；95%置信区间，0.01 - 0.61）以及孕晚期铁蛋白显著相关（r = 0.35；95%置信区间，0.23 - 0.48）；与孕中期可溶性转铁蛋白受体显著相关（r = -0.27；95%置信区间，-0.4至-0.14）；与孕中期总铁结合力显著相关（r = 0.37；95%置信区间，0.24 - 0.50）；与孕晚期血清铁显著相关（r = 0.11；95%置信区间，0.02 - 0.19）。铁调素与孕晚期炎症标志物白细胞介素-6显著相关（r = 0.26；95%置信区间，0.17 - 0.34），与孕中期（r = 0.16；95%置信区间，0.03 - 0.30）和孕晚期（r = 0.28；95%置信区间，0.04 - 0.52）的C反应蛋白显著相关。5项研究中有4项报告铁调素与体重指数之间存在弱至中度正相关。铁调素水平在不同体重指数类别中有所不同。没有一项研究报告母亲铁调素与后代神经发育之间的关系。