Sadeq A Al-Maweri1,2, Esam Halboub3,4, Hesham Mohammed Al-Sharani5,6, Anas Shamala7, Ahlam Al-Kamel7, Mohammed Al-Wesabi7, Abdullkhaleg Albashari8, Amani Al-Sharani7, Saleem Abdulrab9. 1. Department of Oral Medicine and Diagnostic Sciences, AlFarabi Colleges of Dentistry and Nursing, Riyadh, Saudi Arabia. Sadali05@hotmail.com. 2. Department of Oral Medicine, Oral Pathology and Oral Radiology, Faculty of Dentistry, Sana'a University, Sana'a, Yemen. Sadali05@hotmail.com. 3. Department of Oral Medicine, Oral Pathology and Oral Radiology, Faculty of Dentistry, Sana'a University, Sana'a, Yemen. 4. Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jizan, Saudi Arabia. 5. Department of Oral and Maxillofacial Surgery, College of Dentistry, Ibb University, Ibb, Yemen. 6. Department of Maxillofacial Surgery, School of Stomatology, Harbin Medical University, Harbin, China. 7. Department of Preventive and Biomedical Science, Faculty of Dentistry, University of Science and Technology, Sana'a, Yemen. 8. School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China. 9. Madinat Khalifa Health Center, Primary Health Care Corporation, Doha, Qatar.
Abstract
OBJECTIVES: The present meta-analysis sought to investigate the potential association between zinc levels and recurrent aphthous stomatitis (RAS). METHODS: A comprehensive search of online databases (PubMed, Scopus, Web of Science, and China National Knowledge Infrastructure (CNKI)) was conducted to identify all English and Chinese studies published up to August 2020. All case-control studies that assessed plasma/serum zinc levels were eligible for inclusion. Data were analyzed using Comprehensive Meta-Analysis software version 2.2.046 (Biostat, Englewood, NJ, USA). Trial sequential analysis (TSA) was conducted with the trial sequential analysis program. RESULTS: Nineteen case-control studies, involving 1079 RAS cases and 965 controls, were included in the meta-analysis. The pooled results of 19 studies showed that zinc level was significantly lower in RAS patients than in healthy controls (weighted difference in means = - 21.092, 95% CI - 26.695 to - 15.490, I2 = 95.375%, P < 0.001). Upon subgroup analysis by geographic distribution of the sample (Chinese vs. others), the association remained significant in each individual subgroup, although the association was more pronounced among Chinese populations. TSA indicated that the current studies surpassed the required information size, confirming that the differences were reliable. CONCLUSION: The results suggest a significant association between low serum zinc levels and the occurrence of RAS. Although TSA confirmed a solid conclusion, conducting large-scale studies with the highest standards of quality is encouraged. CLINICAL RELEVANCE: Determining zinc levels should be considered in diagnosis, management, and prevention of RAS.
OBJECTIVES: The present meta-analysis sought to investigate the potential association between zinc levels and recurrent aphthous stomatitis (RAS). METHODS: A comprehensive search of online databases (PubMed, Scopus, Web of Science, and China National Knowledge Infrastructure (CNKI)) was conducted to identify all English and Chinese studies published up to August 2020. All case-control studies that assessed plasma/serum zinc levels were eligible for inclusion. Data were analyzed using Comprehensive Meta-Analysis software version 2.2.046 (Biostat, Englewood, NJ, USA). Trial sequential analysis (TSA) was conducted with the trial sequential analysis program. RESULTS: Nineteen case-control studies, involving 1079 RAS cases and 965 controls, were included in the meta-analysis. The pooled results of 19 studies showed that zinc level was significantly lower in RAS patients than in healthy controls (weighted difference in means = - 21.092, 95% CI - 26.695 to - 15.490, I2 = 95.375%, P < 0.001). Upon subgroup analysis by geographic distribution of the sample (Chinese vs. others), the association remained significant in each individual subgroup, although the association was more pronounced among Chinese populations. TSA indicated that the current studies surpassed the required information size, confirming that the differences were reliable. CONCLUSION: The results suggest a significant association between low serum zinc levels and the occurrence of RAS. Although TSA confirmed a solid conclusion, conducting large-scale studies with the highest standards of quality is encouraged. CLINICAL RELEVANCE: Determining zinc levels should be considered in diagnosis, management, and prevention of RAS.
Authors: Sadeq Ali Al-Maweri; Esam Halboub; Sajna Ashraf; Ahmed Y Alqutaibi; Nashwan Mohammed Qaid; Kamila Yahya; Mohammed Nasser Alhajj Journal: BMC Oral Health Date: 2020-08-24 Impact factor: 2.757