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Meta-Analysis
. 2012;7(1):e29003.
doi: 10.1371/journal.pone.0029003. Epub 2012 Jan 3.

The characteristics of blood glucose and WBC counts in peripheral blood of cases of hand foot and mouth disease in China: a systematic review

Yuyun Li  1 , Runan Zhu, Yuan Qian, Jie Deng
Affiliations
Meta-Analysis

The characteristics of blood glucose and WBC counts in peripheral blood of cases of hand foot and mouth disease in China: a systematic review

Yuyun Li et al. PLoS One. 2012.

Abstract

Background: Outbreaks of Hand Foot and Mouth Disease (HFMD) have occurred in many parts of the world especially in China. We aimed to summarize the characteristics of the levels of blood glucose and white blood cell (WBC) counts in cases of HFMD in Mainland China and Taiwan, using meta-analysis based on systematic review of published articles.

Methods: We systematically reviewed published studies, from the MEDLINE and WANFANG Data, about the levels of blood glucose and WBC counts in cases of HFMD until 15(th) June 2011, and quantitatively summarized the characteristics of them using meta-analysis.

Results: In total, 37 studies were included in this review. In Mainland China and Taiwan, generally, the average level of blood glucose, the prevalence of hyperglycemia, WBC counts and the prevalence of leukocytosis increased with the severity of the illness. There was no significant difference in the prevalence of leukocytosis between ANS (autonomic nervous system dysregulation)/PE (pulmonary edema) group and CNS (central nervous system) group, and in the average level of blood glucose between healthy controls and mild cases of HFMD. WBC counts in cases infected by EV71 were less than those in cases infected by CA16.

Conclusions: our analyses indicated that blood glucose and WBC counts increased with the severity of HFMD disease, which would help doctors to manage patients efficiently.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Flow diagram of study identification.
Figure 2
Figure 2. Meta-analysis of the level of blood glucose between healthy controls and mild cases of HFMD.
Each comparison was presented by the name of the first author and the year of the publication. The studies were shown by a point estimate of the MD and the accompanying 95%CI which were displayed on a logarithmic scale using a random effects model. The studies are sorted according to the weight which was obtained by contribution to the pooled MD estimate. Between-study heterogeneity was tested by the x2-based Q-statistic, and its impact was quantified by I2 which can range between 0 and 100%.
Figure 3
Figure 3. Meta-analysis of the level of blood glucose between mild cases and severe cases of HFMD.
Each comparison was presented by the name of the first author and the year of the publication. The studies were shown by a point estimate of the MD and the accompanying 95%CI which were displayed on a logarithmic scale using a random effects model. The studies are sorted according to the weight which was obtained by contribution to the pooled MD estimate. Between-study heterogeneity was tested by the x2-based Q-statistic, and its impact was quantified by I2 which can range between 0 and 100%.
Figure 4
Figure 4. Meta-analysis of the prevalence of hyperglycemia between mild cases and severe cases of HFMD.
Each comparison was presented by the name of the first author and the year of the publication. The studies were shown by a point estimate of the OR and the accompanying 95%CI which were displayed on a logarithmic scale using a random effects model. The studies are sorted according to the weight which was obtained by contribution to the pooled OR estimate. Between-study heterogeneity was tested by the x2-based Q-statistic, and its impact was quantified by I2 which can range between 0 and 100%.
Figure 5
Figure 5. Meta-analysis of WBC counts between mild cases and severe cases of HFMD.
Each comparison was presented by the name of the first author and the year of the publication. The studies were shown by a point estimate of the MD and the accompanying 95%CI which were displayed on a logarithmic scale using a random effects model. The studies are sorted according to the weight which was obtained by contribution to the pooled MD estimate. Between-study heterogeneity was tested by the x2-based Q-statistic, and its impact was quantified by I2 which can range between 0 and 100%.
Figure 6
Figure 6. Meta-analysis of the prevalence of leukocytosis between mild cases and severe cases of HFMD.
Each comparison was presented by the name of the first author and the year of the publication. The studies were shown by a point estimate of the OR and the accompanying 95%CI which were displayed on a logarithmic scale using a random effects model. The studies are sorted according to the weight which was obtained by contribution to the pooled OR estimate. Between-study heterogeneity was tested by the x2-based Q-statistic, and its impact was quantified by I2 which can range between 0 and 100%.
Figure 7
Figure 7. Meta-analysis of the level of blood glucose between CNS and ANS/PE.
Each comparison was presented by the name of the first author and the year of the publication. The studies were shown by a point estimate of the MD and the accompanying 95%CI which were displayed on a logarithmic scale using a random effects model. The studies are sorted according to the weight which was obtained by contribution to the pooled MD estimate. Between-study heterogeneity was tested by the x2-based Q-statistic, and its impact was quantified by I2 which can range between 0 and 100%.
Figure 8
Figure 8. Meta-analysis of the prevalence of hyperglycemia between CNS and ANS/PE.
Each comparison was presented by the name of the first author and the year of the publication. The studies were shown by a point estimate of the OR and the accompanying 95%CI which were displayed on a logarithmic scale using a random effects model. The studies are sorted according to the weight which was obtained by contribution to the pooled OR estimate. Between-study heterogeneity was tested by the x2-based Q-statistic, and its impact was quantified by I2 which can range between 0 and 100%.
Figure 9
Figure 9. Meta-analysis of WBC counts between CNS and ANS/PE.
Each comparison was presented by the name of the first author and the year of the publication. The studies were shown by a point estimate of the MD and the accompanying 95%CI which were displayed on a logarithmic scale using a random effects model. The studies are sorted according to the weight which was obtained by contribution to the pooled MD estimate. Between-study heterogeneity was tested by the x2-based Q-statistic, and its impact was quantified by I2 which can range between 0 and 100%.
Figure 10
Figure 10. Meta-analysis of the prevalence of leukocytosis between CNS and ANS/PE.
Each comparison was presented by the name of the first author and the year of the publication. The studies were shown by a point estimate of the OR and the accompanying 95%CI which were displayed on a logarithmic scale using a random effects model. The studies are sorted according to the weight which was obtained by contribution to the pooled OR estimate. Between-study heterogeneity was tested by the x2-based Q-statistic, and its impact was quantified by I2 which can range between 0 and 100%.
Figure 11
Figure 11. Meta-analysis of WBC counts between cases infected by EV71 and cases infected by CA16.
Each comparison was presented by the name of the first author and the year of the publication. The studies were shown by a point estimate of the MD and the accompanying 95%CI which were displayed on a logarithmic scale using a random effects model. The studies are sorted according to the weight which was obtained by contribution to the pooled MD estimate. Between-study heterogeneity was tested by the x2-based Q-statistic, and its impact was quantified by I2 which can range between 0 and 100%.
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