engleski

Micro and macronutrient profile in Down syndrome children and adolescents: systematic review and meta-analysis

Background: Down syndrome (DS), an expression of complete or partial trisomy of chromosome 21, is the most common genetic disorder known to date. Nowadays, there is a great deal of clinical interest in the question of whether children with DS benefit from nutritional supplementation to improve their development, cognitive decline, and overall health, especially if started early in childhood. To date, the relevant scientific literature has not been systematically reviewed and organized. Therefore, our aim was to provide a systematic review and meta-analysis of the micro- and macronutrient profile in DS children and adolescents. Methods: This study was conducted in accordance with PRISMA guidelines. We identified all relevant case-control studies published by January 1, 2021, by searching the PubMed and Scopus databases for original English-language articles analyzing the micro- and macronutrient profile of individuals with DS. After a comprehensive analysis, 40 studies were included in the qualitative synthesis and 31 in the quantitative synthesis (meta- analysis). MetaAnalysis software, version 3.0 (Biostat, Inc., Englewood, NJ, USA) was employed for the meta-analysis. Results: Significant results (p≤0.05) were obtained for zinc, selenium, copper, vitamin B12, sodium and calcium. Serum, plasma, and whole blood analyses showed lower zinc levels in DS compared with controls (SMDserum[95%CI]=-2.32[-3.22, -1.41] ; SMDplasma[95%C I]=-1.29[-2.26, -0.31] ; SMDblood[95%CI]=-1.59[-2.29, -0.89]). Similarly, plasma and blood selenium concentrations were significantly lower in DS (SMDplasma[95%CI]=-1.39[-2.26, -0.51] ; SMDblood[95%C I]=-1.86[-2.59, -1.13]. Intraerythrocyte copper and serum B12 were higher in DS (SMDCu[95%CI]=3.33[2.19, 4.46] ; SMDB12[95%CI]=0.89[0 .01, 1.77). Finally, salivary sodium and calcium were slightly elevated (SMDNa[95%CI]=1.06[0.29, 1.82] ; SMDCa[95%CI]=0.49[0. 16, 0.83], whereas blood calcium was lower in DS children/adolescents compared to controls (SMDCa[95%CI]=-0.77[-1.34, -0.21]). Conclusion: This study provides the first field overview of micro- and macronutrient profiles in DS children and adolescents. Additionally, the evidence-based foundation for future dietary interventions has also been established.

adolescents, Down syndrome, children, macronutrients, micronutrients, meta-analysis

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