Kong Fei-Juan, Ma Lei-Lei, Chen Shu-Ping, Li Ge, Zhou Jia-Qiang
Department of Anesthesiology, Hangzhou First People's Hospital, Nanjing Medical University, No. 261 Huansha Road, Hangzhou, 310006, People's Republic of China.
Department of Critical Care Medicine, Zhejiang Provincial People's Hospital, Hangzhou, China.
Nutr J. 2016 Oct 28;15(1):94. doi: 10.1186/s12937-016-0211-8.
The association between serum selenium level and gestational diabetes mellitus (GDM) is controversial. The aim of our study was to systematically review available literature linking selenium to GDM for a comprehensive understanding of the relationship between serum selenium level and GDM in human.
PubMed, The Cochrane Library and Medline were searched for studies published up to August 2016. Manual searches of references of the relevant original studies were carried out. Pooled estimates were measured using the fixed or random effect model. Overall effect was reported in a standard mean difference (SMD). All data were analyzed with Review Manager 5.3 and Stata 12.0.
Of 44 references reviewed, seven studies involving 569 patients met our inclusion criteria and contributed to meta-analysis. All the studies were used to evaluate the relationship between serum selenium level and GDM. Selenium level was significantly lower in women with GDM than those without GDM (SMD = -1.17; 95 % CI: -1.98 to -0.35, P = 0.005). Subgroup analysis showed that such trend was consistent within the non-Caucasian population (Asia: SMD = -2.82; 95 % CI: -5.21 to -0.43, P = 0.02; Africa: SMD = -0.56; 95 % CI: -1.07 to -0.05, P = 0.03) and in the third trimester (SMD = -1.78; 95 % CI: -3.04 to -0.52, P = 0.006), but not within the Caucasian population (Europe: SMD = -0.6; 95 % CI: -1.98 to 0.78, P = 0.39) or in the second trimester (SMD = -0.68; 95 % CI: -1.6 to 0.25, P = 0.15).
The available evidences suggested that serum selenium level was lower in women with GDM than those with normal glucose tolerance, especially within the non-Caucasian population and in the third trimester. However, well-designed prospective studies are needed to understand dynamic associations between selenium status and GDM risk.
血清硒水平与妊娠期糖尿病（GDM）之间的关联存在争议。我们研究的目的是系统回顾将硒与GDM联系起来的现有文献，以全面了解人类血清硒水平与GDM之间的关系。
检索了PubMed、Cochrane图书馆和Medline中截至2016年8月发表的研究。对手动检索相关原始研究的参考文献进行了检索。采用固定或随机效应模型测量合并估计值。总体效应以标准平均差（SMD）报告。所有数据均使用Review Manager 5.3和Stata 12.0进行分析。
在审查的44篇参考文献中，7项涉及569例患者的研究符合我们的纳入标准并纳入荟萃分析。所有研究均用于评估血清硒水平与GDM之间的关系。GDM女性的硒水平显著低于非GDM女性（SMD = -1.17；95%CI：-1.98至-0.35，P = 0.005）。亚组分析表明，这种趋势在非白种人群（亚洲：SMD = -2.82；95%CI：-5.21至-0.43，P = 0.02；非洲：SMD = -0.56；95%CI：-1.07至-0.05，P = 0.03）和孕晚期（SMD = -1.78；95%CI：-3.04至-0.52，P = 0.006）中一致，但在白种人群（欧洲：SMD = -0.6；95%CI：-1.98至0.78，P = 0.39）或孕中期（SMD = -0.68；95%CI：-1.6至0.25，P = 0.15）中不一致。
现有证据表明，GDM女性的血清硒水平低于糖耐量正常的女性，尤其是在非白种人群和孕晚期。然而，需要设计良好的前瞻性研究来了解硒状态与GDM风险之间的动态关联。
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