Center for Reproductive Medicine, Department of Obstetrics and Gynaecology, NanFang Hospital, Southern Medical University, Guangzhou, China.
The First School of Clinical Medicine, Southern Medical University, Guangzhou, China.
Front Endocrinol (Lausanne). 2023 Aug 29;14:1216507. doi: 10.3389/fendo.2023.1216507. eCollection 2023.
This study aimed to evaluate the association between blood heavy metal (zinc (Zn), copper (Cu), lead (Pb), and cadmium (Cd)) concentrations and spontaneous abortion (SA) and recurrent pregnancy loss (RPL) and explore the possible endocrine dysfunction associated with it.
A literature search was performed in the PubMed, Embase, Cochrane Library, and Web of Science databases up to April 2023. The overall effects were expressed as the standard mean difference (SMD). Subgroup analysis was performed according to the type of abortion (SA or RPL). Stata 16.0 was utilized for data analysis.
Based on the integrated findings, abortion women showed significantly lower Zn (SMD = -1.05, 95% CI: -1.74 to -0.36, = 0.003) and Cu concentrations (SMD = -1.42, 95% CI: -1.97 to -0.87, 0.001) and higher Pb (SMD = 1.47, 95% CI: 0.89-2.05, 0.001) and Cd concentrations (SMD = 1.15, 95% CI: 0.45-1.85, = 0.001) than normal pregnant women. Subgroup analysis showed that Zn and Cu deficiency and Cd and Pb exposure were significantly (0.05) associated with RPL, whereas Cu deficiency and Cd and Pb exposure were significantly (0.05) associated with SA.
Zn and Cu deficiencies and Pb and Cd exposure were associated with abortion. Endocrine dysfunction, such as insulin resistance, vitamin D insufficiency, and abnormal thyroid and sex hormone concentrations, is thought to be involved in heavy metal-related abortion.
本研究旨在评估血液重金属（锌（Zn）、铜（Cu）、铅（Pb）和镉（Cd））浓度与自然流产（SA）和复发性妊娠丢失（RPL）之间的关联，并探讨其可能与内分泌功能障碍相关。
检索 PubMed、Embase、Cochrane Library 和 Web of Science 数据库，截至 2023 年 4 月。采用标准均数差（SMD）表示总效应。根据流产类型（SA 或 RPL）进行亚组分析。采用 Stata 16.0 进行数据分析。
综合研究结果显示，流产女性的 Zn（SMD=-1.05，95%CI：-1.74 至-0.36， = 0.003）和 Cu 浓度（SMD=-1.42，95%CI：-1.97 至-0.87， 0.001）显著降低，Pb（SMD=1.47，95%CI：0.89-2.05， 0.001）和 Cd 浓度（SMD=1.15，95%CI：0.45-1.85， 0.001）显著升高。亚组分析显示，Zn 和 Cu 缺乏以及 Cd 和 Pb 暴露与 RPL 显著相关（0.05），而 Cu 缺乏以及 Cd 和 Pb 暴露与 SA 显著相关（0.05）。
Zn 和 Cu 缺乏以及 Pb 和 Cd 暴露与流产有关。内分泌功能障碍，如胰岛素抵抗、维生素 D 不足以及甲状腺和性激素浓度异常，可能与重金属相关的流产有关。
