ZINC CONCENTRATION AND THYROID CANCER: A REVIEW AND META-ANALYSIS STUDY.
literature review, zinc, trace elements, thyroid gland neoplasms
Thyroid Cancer (TC) is the most common group of endocrine tumors and its incidence has increased rapidly over the last four decades. Investigations related to metal imbalance have become important due to the sensitivity of the thyroid gland to them. Studies reveal that some metals play a fundamental role in several physiological processes in the body, while the deficiency of essential trace elements is associated with carcinogenic evolution. In this context, Zinc (Zn) stands out, essential for the action of the thyroid hormone and with a potential relationship with the pathogenesis of TC. This dissertation aims to contribute to the discussion on the association between low serum concentrations of Zn and the occurrence of TC through a systematic review and meta-analysis of the most recent scientific evidence. The search was performed in PubMed/MEDLINE, Scopus, Embase, LILACS and Web of Science databases for observational studies investigating changes in Zn concentration serum and the occurrence of TC in adults, published until December 2024. No language or publication period restrictions were imposed. The primary outcome was low serum Zn concentration and the occurrence of TC. Three independent reviewers have selected the studies and extracted data from the original publications. The risk of bias was assessed using the Newcastle-Ottawa Scale. Data analysis was performed using the R software (V.4.3.1) and, to assess heterogeneity, we have calculated the I2 statistic and the results were based on random-effect models. Altogether, 12 studies (n = 8 case-control and n = 4 cross-sectional) were included, with a total number of subjects participating in the studies ranging from 50 to 523. The overall risk of bias of the included studies have ranged from moderate to high. Serum Zn were not significantly lower in patients with TC compared to healthy controls (average difference: -251.77; 95% confidence interval: -699.09, 195.54; I2 = 100%, very low certainty). To elucidate the role of serum Zn in the prevention of TC, further investigations, including rigorously designed observational studies with representative samples and improved control of potential confounding variables are indispensable.