Abstract
Background
Epidemiological studies evaluating the association between zinc level and the risk of preeclampsia have produced inconsistent results. We therefore conducted a meta-analysis to summarize the evidence for them.
Methods
Pertinent studies were identified by a search in PubMed and Web of Knowledge up to April 2015. Standardized mean difference (SMD) was performed to combine the results. Random-effect model was used. Publication bias was estimated using Egger’s regression asymmetry test.
Results
Thirteen articles (11 case–control studies and 2 cross-sectional studies) involving 445 preeclampsia cases and 568 healthy controls were included in this meta-analysis. Our pooled results suggested that preeclampsia patients had a lower zinc level as compared with healthy, pregnant controls (summary SMD = −0.61, 95 % CI = −0.74, −0.48, I 2 = 88.5 %). The association was also significant in Asia (SMD = −0.73, 95 % CI = −0.88, −0.58), but not in Europe. No publication biases were found.
Conclusions
Our analysis indicated that zinc level in preeclampsia patients was significantly lower than that of healthy, pregnant women, especially among the Asian population.
Similar content being viewed by others
References
Walker JJ (2000) Pre-eclampsia. Lancet 356:1260–1265
Sibai BM, Stella CL (2009) Diagnosis and management of atypical preeclampsia-eclampsia. Am J Obstet Gynecol 200(481):e481–e487
Ghulmiyyah L, Sibai B (2012) Maternal mortality from preeclampsia/eclampsia. Semin Perinatol 36:56–59
Kumru S, Aydin S, Simsek M, Sahin K, Yaman M, Ay G (2003) Comparison of serum copper, zinc, calcium, and magnesium levels in preeclamptic and healthy pregnant women. Biol Trace Elem Res 94:105–112
Kalinderis M, Papanikolaou A, Kalinderi K, Vyzantiadis TA, Ioakimidou A, Tarlatzis BC (2015) Serum levels of leptin and IP-10 in preeclampsia compared to controls. Arch Gynecol Obstet 292:343–347
DerSimonian R, Laird N (1986) Meta-analysis in clinical trials. Control Clin Trials 7:177–188
Higgins JP, Thompson SG (2002) Quantifying heterogeneity in a meta-analysis. Stat Med 21:1539–1558
Higgins JP, Thompson SG, Deeks JJ, Altman DG (2003) Measuring inconsistency in meta-analyses. BMJ 327:557–560
Higgins JP, Thompson SG (2004) Controlling the risk of spurious findings from meta-regression. Stat Med 23:1663–1682
Egger M, Davey Smith G, Schneider M, Minder C (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ 315:629–634
Tobias A (1999) Assessing the influence of a single study in the meta-analysis estimate. Stata Tech Bull 47:15–17
Adam B, Malatyalioglu E, Alvur M, Talu C (2001) Magnesium, zinc and iron levels in pre-eclampsia. J Matern Fetal Med 10:246–250
Ahsan T, Banu S, Nahar Q, Ahsan M, Khan MN, Islam SN (2013) Serum trace elements levels in preeclampsia and eclampsia: correlation with the pregnancy disorder. Biol Trace Elem Res 152:327–332
Araujo Brito J, do Nascimento Marreiro D, Moita Neto JM, Michelle Costa e Silva D, de Goncalves Sousa Almondes K, Valadares Neto Jde D, do Nascimento Nogueira N (2013) Enzyme activity of superoxide dismutase and zincemia in women with preeclampsia. Nutr Hosp 28:486–490
Atamer Y, Kocyigit Y, Yokus B, Atamer A, Erden AC (2005) Lipid peroxidation, antioxidant defense, status of trace metals and leptin levels in preeclampsia. Eur J Obstet Gynecol Reprod Biol 119:60–66
Borella P, Szilagyi A, Than G, Csaba I, Giardino A, Facchinetti F (1990) Maternal plasma concentrations of magnesium, calcium, zinc and copper in normal and pathological pregnancies. Sci Total Environ 99:67–76
Fenzl V, Flegar-Mestric Z, Perkov S, Andrisic L, Tatzber F, Zarkovic N, Duic Z (2013) Trace elements and oxidative stress in hypertensive disorders of pregnancy. Arch Gynecol Obstet 287:19–24
Farzin L, Sajadi F (2012) Comparison of serum trace element levels in patients with or without pre-eclampsia. J Res Med Sci 17:938–941
Gupta S, Jain NP, Avasthi K, Wander GS (2014) Plasma and erythrocyte zinc in pre-eclampsia and its correlation with foetal outcome. J Assoc Physicians India 62:306–310
Ilhan N, Ilhan N, Simsek M (2002) The changes of trace elements, malondialdehyde levels and superoxide dismutase activities in pregnancy with or without preeclampsia. Clin Biochem 35:393–397
Jain S, Sharma P, Kulshreshtha S, Mohan G, Singh S (2010) The role of calcium, magnesium, and zinc in pre-eclampsia. Biol Trace Elem Res 133:162–170
Kolusari A, Kurdoglu M, Yildizhan R, Adali E, Edirne T, Cebi A, Demir H, Yoruk IH (2008) Catalase activity, serum trace element and heavy metal concentrations, and vitamin A, D and E levels in pre-eclampsia. J Int Med Res 36:1335–1341
Rafeeinia A, Tabandeh A, Khajeniazi S, Marjani AJ (2014) Serum copper, zinc and lipid peroxidation in pregnant women with preeclampsia in gorgan. Open Biochem J 8:83–88
Sarwar MS, Ahmed S, Ullah MS, Kabir H, Rahman GK, Hasnat A, Islam MS (2013) Comparative study of serum zinc, copper, manganese, and iron in preeclamptic pregnant women. Biol Trace Elem Res 154:14–20
English FA, Kenny LC, McCarthy FP (2015) Risk factors and effective management of preeclampsia. Integr Blood Press Control 8:7–12
Huppertz B, Kingdom JC (2004) Apoptosis in the trophoblast–role of apoptosis in placental morphogenesis. J Soc Gynecol Investig 11:353–362
Raijmakers MT, Dechend R, Poston L (2004) Oxidative stress and preeclampsia: rationale for antioxidant clinical trials. Hypertension 44:374–380
Redman CW, Sargent IL (2005) Latest advances in understanding preeclampsia. Science 308:1592–1594
Sun JY, Jing MY, Weng XY, Fu LJ, Xu ZR, Zi NT, Wang JF (2005) Effects of dietary zinc levels on the activities of enzymes, weights of organs, and the concentrations of zinc and copper in growing rats. Biol Trace Elem Res 107:153–165
Munafo MR, Flint J (2004) Meta-analysis of genetic association studies. Trends Genet 20:439–444
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
None.
Rights and permissions
About this article
Cite this article
Zhu, Q., Zhang, L., Chen, X. et al. Association between zinc level and the risk of preeclampsia: a meta-analysis. Arch Gynecol Obstet 293, 377–382 (2016). https://doi.org/10.1007/s00404-015-3883-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00404-015-3883-y