The association of serum zinc and copper with hypertension: A meta-analysis

Abstract

Objective: The association of serum zinc (Zn), copper (Cu) with the risk of hypertension (HT) remains controversial. Therefore, we conducted a meta-analysis to explore the relationships.

Methods: We searched relevant literatures on PubMed and Web of Science up to September 2018. Pooled standard mean difference (SMD) with corresponding 95% confidence interval (CI) was calculated by random effects model.I² was used to evaluate heterogeneity among studies.

Results: 25 articles of serum Zn and 22 articles of serum Cu were included in meta-analysis. HT patients had lower serum Zn [SMD (95%CI): -0.612(-0.951, -0.274), z = 3.54, P_{for z} <0.001; I² = 97.0%, P_forI² <0.001], whereas no significant difference of serum Cu was shown between HT patients and controls [SMD (95%CI): 0.153(-0.101, 0.407)]. Also, male HT patients had lower serum Zn [SMD (95%CI): -1.443(-2.868, -0.017), z = 1.98, P_{for z} = 0.047; I² = 98.8%, P_forI² <0.001]. In subgroup analysis, a lower serum Zn was observed in HT patients in studies conducted in Europe [-1.066(-1.759, -0.374)], in case-control studies [-0.718(-1.294, -0.142)], in matched case-control studies [-0.939(-1.646, -0.233)] and studies involving treated patients [-1.416(-2.195, -0.638)]. Meanwhile, a higher serum Cu was found in HT patients in studies conducted in Africa [1.96(1.402, 2.518)], and in matched case-control studies [0.655(0.204, 1.107)].

Conclusion: The present meta-analysis indicates that serum Zn level in HT patients was significantly lower than that in controls, while no significantly different serum Cu level was found between HT patients and controls. Future studies are needed to confirm these results in future research.

Keywords: Copper; Hypertension; Meta-analysis; Zinc.