Kooshki Alireza, Farmani Reyhane, Amirabadizadeh Alireza, Mehrpour Omid, Sanjari Mohammad Javad, Nakhaee Samaneh
Student Research Committee, Birjand University of Medical Sciences, Birjand, Iran.
Research Institute for Endocrine Sciences, Student Research Committee, Endocrine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
PLoS One. 2024 Dec 6;19(12):e0313851. doi: 10.1371/journal.pone.0313851. eCollection 2024.
The role of trace elements and toxic metals on human health has been extensively discussed concerning disease pathogenesis and risk factors of diseases. In this systematic review and meta-analysis, we aimed to investigate arsenic (As), cadmium (Cd), lead (Pb), iron (Fe), zinc (Zn), and magnesium (Mg) levels in individuals with multiple sclerosis (MS) and healthy controls. We searched different databases/search engines for this systematic review and meta-analysis, including Web of Science, PubMed, Scopus, and Google Scholar, until June 27, 2024. Out of 5466 studies identified, 65 met our eligibility criteria and were included in the systematic review. For the meta-analysis, 58 studies with 10420 participants (5316 multiple sclerosis patients and 5104 healthy controls) had adequate data for inclusion. Results from the pooled data, analyzed using a random-effects model, revealed higher levels of As (Hedge's g = 4.00 μg/l, 95% CI = 2.03 to 5.98, P <0.001; I2 = 97.69%, P<0.001) and Cd (Hedge's g = 1.20 μg/l, 95% CI = 0.13 to 2.27, P = 0.028; I2 = 97.99%, P<0.001) in multiple sclerosis patients compared to healthy ones. However, no significant differences were observed in the concentrations of Zn, Fe, Mg, and Pb between the two groups. This study identified elevated As and Cd levels in MS patients, indicating the need for targeted interventions and public health guidelines for toxic metal exposure. Limiting exposure to contaminated environments and maintaining essential element levels through natural resources or supplements is essential, as there may be a possible relationship between multiple sclerosis and the concentrations of these elements in humans.
关于微量元素和有毒金属对人类健康的作用，已围绕疾病发病机制和疾病风险因素展开了广泛讨论。在本系统评价和荟萃分析中，我们旨在调查多发性硬化症（MS）患者和健康对照者体内的砷（As）、镉（Cd）、铅（Pb）、铁（Fe）、锌（Zn）和镁（Mg）水平。我们为此系统评价和荟萃分析检索了不同的数据库/搜索引擎，包括科学网、PubMed、Scopus和谷歌学术，检索截至2024年6月27日。在识别出的5466项研究中，65项符合我们的纳入标准并被纳入系统评价。对于荟萃分析，58项研究（共10420名参与者，其中5316名多发性硬化症患者和5104名健康对照者）有足够的数据可供纳入。使用随机效应模型分析汇总数据的结果显示，与健康对照者相比，多发性硬化症患者体内的As水平更高（Hedge's g = 4.00 μg/l，95% CI = 2.03至5.98，P <0.001；I2 = 97.69%，P<0.001），Cd水平也更高（Hedge's g = 1.20 μg/l，95% CI = 0.13至2.27，P = 0.028；I2 = 97.99%，P<0.001）。然而，两组之间的Zn、Fe、Mg和Pb浓度未观察到显著差异。本研究确定了MS患者体内As和Cd水平升高，这表明需要针对有毒金属暴露制定有针对性的干预措施和公共卫生指南。限制暴露于受污染环境，并通过自然资源或补充剂维持必需元素水平至关重要，因为多发性硬化症与人体中这些元素的浓度之间可能存在某种关系。
