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Meta-Analysis
. 2014 Apr 9;9(4):e93900.
doi: 10.1371/journal.pone.0093900. eCollection 2014.

Pallidal index as biomarker of manganese brain accumulation and associated with manganese levels in blood: a meta-analysis

Shao-Jun Li  1 , Li Jiang  2 , Xue Fu  3 , Shuang Huang  1 , Yan-Ni Huang  1 , Xiang-Rong Li  4 , Jing-Wen Chen  1 , Yong Li  1 , Hai-Lan Luo  1 , Fang Wang  1 , Shi-Yan Ou  1 , Yue-Ming Jiang  1
Affiliations
Meta-Analysis

Pallidal index as biomarker of manganese brain accumulation and associated with manganese levels in blood: a meta-analysis

Shao-Jun Li et al. PLoS One. .

Abstract

Objective: The current study was designed to evaluate the sensitivity, feasibility, and effectiveness of the pallidal index (PI) serving as a biomarker of brain manganese (Mn) accumulation, which would be used as an early diagnosis criteria for Mn neurotoxicity.

Methods: The weighted mean difference (WMD) of the PI between control and Mn-exposed groups was estimated by using a random-effects or fixed-effects meta-analysis with 95% confidence interval (CI) performed by STATA software version 12.1. Moreover, the R package "metacor" was used to estimate correlation coefficients between PI and blood Mn (MnB).

Results: A total of eight studies with 281 occupationally Mn-exposed workers met the inclusion criteria. Results were pooled and performed with the Meta-analysis. Our data indicated that the PI of the exposed group was significantly higher than that of the control (WMD: 7.76; 95% CI: 4.86, 10.65; I2 = 85.7%, p<0.0001). A random effects model was used to perform meta-analysis. These findings were remarkably robust in the sensitivity analysis, and publication bias was shown in the included studies. Seven out of the eight studies reported the Pearson correlation (r) values. Significantly positive correlation between PI and MnB was observed (r = 0.42; 95% CI, 0.31, 0.52).

Conclusions: PI can be considered as a sensitive, feasible, effective and semi-quantitative index in evaluating brain Mn accumulation. MnB can also augment the evaluation of brain Mn accumulation levels in the near future. However, the results should be interpreted with caution.

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Conflict of interest statement

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

Figures

Figure 1
Figure 1. Results of search, selection and inclusion of studies in the review.
Figure 2
Figure 2. The forest plot of the PI in the experimental group comparing with the control group.
Figure 3
Figure 3. The forest plot of the PI–MnB relationship.
See this image and copyright information in PMC

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