膳食补充硒对代谢疾病患者炎症标志物的影响：一项随机对照试验的系统评价和荟萃分析
The effects of dietary selenium supplementation on inflammatory markers among patients with metabolic diseases: a systematic review and meta-analysis of randomized controlled trials.
作者信息
Djalalinia Shirin, Hasani Motahareh, Asayesh Hamid, Ejtahed Hanieh-Sadat, Malmir Hanieh, Kasaeian Amir, Zarei Maryam, Baygi Fereshteh, Rastad Hadith, Mahdavi Gorabi Armita, Qorbani Mostafa
机构信息
Development of Research & Technology Center, Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran.
Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran Universityof Medical Sciences, Tehran, Iran.
出版信息
J Diabetes Metab Disord. 2021 Jun 9;20(1):1051-1062. doi: 10.1007/s40200-021-00821-3. eCollection 2021 Jun.
PURPOSE
Selenium (Se) is a trace element having significant effects on human metabolism. Recent studies suggest that Se supplementation have a pivotal effect on the inflammatory markers. Therefore, the aim of this study was to assess the effect of Se supplementation on plasma inflammatory markers including C-reactive protein (CRP) and high-sensitivity C-reactive protein (hs-CRP) and nitric oxide (NO) as a stress oxidative index, among patients with metabolic diseases.
METHODS
To assess the effects of Se on the inflammatory markers, following the PRISMA-P guidelines, we systematically searched ISI/WOS, PubMed/MEDLINE, and Scopus for studies that assessed the effect of Se supplementation on the inflammatory markers. Data extraction was performed by two independent investigators. Using the random effects or fixed-effects model depending on the results of heterogeneity tests was used to estimate the pooled standardized mean difference (SMD). Heterogeneity between studies was assessed using Cochran's Q test and I index.
RESULTS
The initial search revealed 3,320 papers. After screening process and considering inclusion criteria, 7 publications were eligible for inclusion in the meta-analysis. The meta-analysis results showed that Se supplementation did not significantly affect CRP and hs-CRP concentrations (mean difference (MD) = -0.15; 95% CI: -0.55- 0.23; P = 0.43). Subgroup analysis of CRP type showed that Se supplementation significantly decreased hs-CRP level (pooled SMD = -0.44; 95% CI: -0.67-0.21). Moreover, no significant change was observed in NO level by continuing to take Se supplementation, (pooled SMD: 0.003, 95%CI: -0.26, 0.26).
CONCLUSIONS
This study revealed that Se supplementation would have desirable effects on cardio-metabolic indicators through affecting the levels of inflammatory markers. Given the importance of concerns, more attention should be given to more prospective studies with longer follow-up.
目的
硒（Se）是一种对人体新陈代谢有显著影响的微量元素。近期研究表明，补充硒对炎症标志物有关键作用。因此，本研究旨在评估补充硒对代谢疾病患者血浆炎症标志物的影响，这些标志物包括C反应蛋白（CRP）、高敏C反应蛋白（hs-CRP）以及作为应激氧化指标的一氧化氮（NO）。
方法
为评估硒对炎症标志物的影响，我们遵循PRISMA-P指南，系统检索了ISI/WOS、PubMed/MEDLINE和Scopus，以查找评估补充硒对炎症标志物影响的研究。数据提取由两名独立研究人员进行。根据异质性检验结果，使用随机效应或固定效应模型来估计合并标准化均值差（SMD）。采用Cochran's Q检验和I指数评估研究间的异质性。
结果
初步检索共得到3320篇论文。经过筛选并考虑纳入标准后，有7篇出版物符合纳入荟萃分析的条件。荟萃分析结果显示，补充硒对CRP和hs-CRP浓度无显著影响（均值差（MD）=-0.15；95%置信区间：-0.55 - 0.23；P = 0.43）。CRP类型的亚组分析表明，补充硒显著降低了hs-CRP水平（合并SMD = -0.44；95%置信区间：-0.67 - 0.21）。此外，持续补充硒后，NO水平未观察到显著变化（合并SMD：0.003，95%置信区间：-0.26，0.26）。
结论
本研究表明，补充硒可能通过影响炎症标志物水平对心脏代谢指标产生有益影响。鉴于问题的重要性，应更加关注随访时间更长的前瞻性研究。
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