P-268 Metal exposure and risk of Parkinson’s disease: systematic review and meta-analyses
Bibliographic record
Abstract
<h3>Introduction</h3> Parkinson’s disease (PD) is the second most common neurodegenerative disorder. Metal exposure has been suggested as a possible environmental risk factor by many epidemiological studies, but results have been inconsistent. Additionally, existing reviews on metal exposure and PD risk lack careful screening for study design and quality, especially on the exposure assessment. <h3>Objectives</h3> We aimed to synthesize the literature on metal exposure and PD risk by examining the quality of the overall study and exposure assessment method. <h3>Methods</h3> We conducted a systematic review on observational studies of metal levels from biological matrices, and dietary and occupational/environmental sources among PD patients and controls. We searched the PubMed/MEDLINE, EMBASE and Cochrane databases up to July 2020. Metal species included manganese, iron, copper, lead, mercury, aluminum, calcium, selenium, zinc, magnesium, cadmium, chromium and nickel, and the outcome was idiopathic PD. We applied an adapted Newcastle-Ottawa Scale (NOS) and a previously established exposure assessment rating to evaluate each individual study. We then performed meta-analyses with random-effects model. <h3>Results</h3> 80 case-control studies were included, of which 69 were graded as low or moderate quality. The majority of case-control studies were hospital-based and applied biomonitoring approaches to quantify metal levels after disease diagnosis. Studies on copper, iron, manganese and zinc were most prevalent. Meta-analyses showed no significant PD risk for these metals and heterogeneity among studies was substantial. Furthermore, 5 cohort studies were retained, but the population source, metal exposure and follow-up period were heterogeneous. <h3>Conclusion</h3> The level of evidence on metal exposure and PD risk is limited and no consensus can be drawn from the literature. Reverse causality cannot be ruled out by existing biomonitoring studies. Studies assessing metal levels before disease onset are needed to improve our understanding of the role of metals in the etiology of PD.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".