Trace Element Status and Hypothyroidism: A Systematic Review and Meta-analysis

Sepide Talebi; Ehsan Ghaedi; Erfan Sadeghi; Hamed Mohammadi; Amir Hadi; Cain C.T. Clark; Gholamreza Askari

doi:10.1007/s12011-019-01963-5

Trace Element Status and Hypothyroidism: A Systematic Review and Meta-analysis

Sepide Talebi
, Ehsan Ghaedi
, Erfan Sadeghi
, Hamed Mohammadi
, Amir Hadi
, Cain C.T. Clark
, Gholamreza Askari

Research output: Contribution to journal › Review article › peer-review

55 Citations (Scopus)

410 Downloads (Pure)

Abstract

The relationship between thyroid hormones metabolism and trace element levels has biological plausibility; however, previous reports that compared trace element levels in patients with hypothyroidism and healthy individuals yielded conflicting results. Therefore, the aim of this meta-analysis was to investigate the association between selected trace elements (i.e., selenium (Se), zinc (Zn), iron (Fe), manganese (Mn), copper (Cu), lead (Pb)), and magnesium (Mg) concentrations in patients with hypothyroidism and healthy controls. Electronic databases, including PubMed, Scopus, Embase, and Science Direct, were searched systematically until September 2019. Thirty-two observational studies were included in the final analyses. Hedges’ g tests were used to estimate effect sizes, as trace element concentrations were reported using different measurement units across the studies. Selenium (Hedges’ g = − 0.52; 95% CI = [− 1.05, − 0.002]; P = 0.049) and Zn (Hedges’ g = − 0.86; 95% CI = [− 1.66, − 0.06]; P = 0.035) concentrations were significantly lower, whereas Pb concentrations were significantly higher (Hedges’ g = 0.34; 95% CI = [0.10, 0.59]; P = 0.006) in patients with hypothyroidism compared with healthy controls. There were no differences in the concentrations of Fe, Cu, Mn, and Mg between the groups. Patients with hypothyroidism exhibited lower Se and Zn and increased Pb concentrations compared with healthy controls. High-quality studies with larger sample sizes are required to explicate the link between trace element status and hypothyroidism.

Original language	English
Pages (from-to)	1-14
Journal	Biological Trace Element Research
Volume	197
Issue number	1
Early online date	10 Dec 2019
DOIs	https://doi.org/10.1007/s12011-019-01963-5
Publication status	Published - Sept 2020

Bibliographical note

Copyright © and Moral Rights are retained by the author(s) and/ or other copyright owners. A copy can be downloaded for personal non-commercial research or study, without prior permission or charge. This item cannot be reproduced or quoted extensively from without first obtaining permission in writing from the copyright holder(s). The content must not be changed in any way or sold commercially in any format or medium without the formal permission of the copyright holders.

Funding

This research was financially supported by the student research committee of Isfahan University of Medical Sciences [grant number IR.MUI.RESEARCH.REC.1397.433].

Funders	Funder number
Isfahan University of Medical Sciences	IR.MUI.RESEARCH.REC.1397.433
Isfahan University of Medical Sciences

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Hypothyroidism
Meta-analysis
Systematic review
Trace elements

ASJC Scopus subject areas

Endocrinology, Diabetes and Metabolism
Biochemistry
Clinical Biochemistry
Biochemistry, medical
Inorganic Chemistry

Access to Document

10.1007/s12011-019-01963-5

Post-PrintAccepted author manuscript, 326 KB

Cite this

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title = "Trace Element Status and Hypothyroidism: A Systematic Review and Meta-analysis",

abstract = "The relationship between thyroid hormones metabolism and trace element levels has biological plausibility; however, previous reports that compared trace element levels in patients with hypothyroidism and healthy individuals yielded conflicting results. Therefore, the aim of this meta-analysis was to investigate the association between selected trace elements (i.e., selenium (Se), zinc (Zn), iron (Fe), manganese (Mn), copper (Cu), lead (Pb)), and magnesium (Mg) concentrations in patients with hypothyroidism and healthy controls. Electronic databases, including PubMed, Scopus, Embase, and Science Direct, were searched systematically until September 2019. Thirty-two observational studies were included in the final analyses. Hedges{\textquoteright} g tests were used to estimate effect sizes, as trace element concentrations were reported using different measurement units across the studies. Selenium (Hedges{\textquoteright} g = − 0.52; 95\% CI = [− 1.05, − 0.002]; P = 0.049) and Zn (Hedges{\textquoteright} g = − 0.86; 95\% CI = [− 1.66, − 0.06]; P = 0.035) concentrations were significantly lower, whereas Pb concentrations were significantly higher (Hedges{\textquoteright} g = 0.34; 95\% CI = [0.10, 0.59]; P = 0.006) in patients with hypothyroidism compared with healthy controls. There were no differences in the concentrations of Fe, Cu, Mn, and Mg between the groups. Patients with hypothyroidism exhibited lower Se and Zn and increased Pb concentrations compared with healthy controls. High-quality studies with larger sample sizes are required to explicate the link between trace element status and hypothyroidism.",

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note = "Copyright {\textcopyright} and Moral Rights are retained by the author(s) and/ or other copyright owners. A copy can be downloaded for personal non-commercial research or study, without prior permission or charge. This item cannot be reproduced or quoted extensively from without first obtaining permission in writing from the copyright holder(s). The content must not be changed in any way or sold commercially in any format or medium without the formal permission of the copyright holders. ",

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AU - Sadeghi, Erfan

AU - Mohammadi, Hamed

AU - Hadi, Amir

AU - Clark, Cain C.T.

AU - Askari, Gholamreza

N1 - Copyright © and Moral Rights are retained by the author(s) and/ or other copyright owners. A copy can be downloaded for personal non-commercial research or study, without prior permission or charge. This item cannot be reproduced or quoted extensively from without first obtaining permission in writing from the copyright holder(s). The content must not be changed in any way or sold commercially in any format or medium without the formal permission of the copyright holders.

PY - 2020/9

Y1 - 2020/9

N2 - The relationship between thyroid hormones metabolism and trace element levels has biological plausibility; however, previous reports that compared trace element levels in patients with hypothyroidism and healthy individuals yielded conflicting results. Therefore, the aim of this meta-analysis was to investigate the association between selected trace elements (i.e., selenium (Se), zinc (Zn), iron (Fe), manganese (Mn), copper (Cu), lead (Pb)), and magnesium (Mg) concentrations in patients with hypothyroidism and healthy controls. Electronic databases, including PubMed, Scopus, Embase, and Science Direct, were searched systematically until September 2019. Thirty-two observational studies were included in the final analyses. Hedges’ g tests were used to estimate effect sizes, as trace element concentrations were reported using different measurement units across the studies. Selenium (Hedges’ g = − 0.52; 95% CI = [− 1.05, − 0.002]; P = 0.049) and Zn (Hedges’ g = − 0.86; 95% CI = [− 1.66, − 0.06]; P = 0.035) concentrations were significantly lower, whereas Pb concentrations were significantly higher (Hedges’ g = 0.34; 95% CI = [0.10, 0.59]; P = 0.006) in patients with hypothyroidism compared with healthy controls. There were no differences in the concentrations of Fe, Cu, Mn, and Mg between the groups. Patients with hypothyroidism exhibited lower Se and Zn and increased Pb concentrations compared with healthy controls. High-quality studies with larger sample sizes are required to explicate the link between trace element status and hypothyroidism.

AB - The relationship between thyroid hormones metabolism and trace element levels has biological plausibility; however, previous reports that compared trace element levels in patients with hypothyroidism and healthy individuals yielded conflicting results. Therefore, the aim of this meta-analysis was to investigate the association between selected trace elements (i.e., selenium (Se), zinc (Zn), iron (Fe), manganese (Mn), copper (Cu), lead (Pb)), and magnesium (Mg) concentrations in patients with hypothyroidism and healthy controls. Electronic databases, including PubMed, Scopus, Embase, and Science Direct, were searched systematically until September 2019. Thirty-two observational studies were included in the final analyses. Hedges’ g tests were used to estimate effect sizes, as trace element concentrations were reported using different measurement units across the studies. Selenium (Hedges’ g = − 0.52; 95% CI = [− 1.05, − 0.002]; P = 0.049) and Zn (Hedges’ g = − 0.86; 95% CI = [− 1.66, − 0.06]; P = 0.035) concentrations were significantly lower, whereas Pb concentrations were significantly higher (Hedges’ g = 0.34; 95% CI = [0.10, 0.59]; P = 0.006) in patients with hypothyroidism compared with healthy controls. There were no differences in the concentrations of Fe, Cu, Mn, and Mg between the groups. Patients with hypothyroidism exhibited lower Se and Zn and increased Pb concentrations compared with healthy controls. High-quality studies with larger sample sizes are required to explicate the link between trace element status and hypothyroidism.

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KW - Meta-analysis

KW - Systematic review

KW - Trace elements

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DO - 10.1007/s12011-019-01963-5

M3 - Review article

C2 - 31820354

AN - SCOPUS:85076768544

SN - 0163-4984

VL - 197

SP - 1

EP - 14

JO - Biological Trace Element Research

JF - Biological Trace Element Research

IS - 1

ER -

Trace Element Status and Hypothyroidism: A Systematic Review and Meta-analysis

Abstract

Bibliographical note

Funding

UN SDGs

Keywords

ASJC Scopus subject areas

Access to Document

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