Department of Nutrition, School of Medicine, Jinan University, Guangzhou 510632, China.
Institute of Land and Sea Transport Systems, Faculty of Mechanical Engineering and Transport Systems, Technical University of Berlin, 10623 Berlin, Germany.
Nutrients. 2022 Feb 23;14(5):952. doi: 10.3390/nu14050952.
The potential role of selenium in preventing chronic liver diseases remains controversial. This meta-analysis aimed to summarize the available evidence from observational studies and intervention trials that had evaluated the associations between body selenium status and chronic liver diseases.
We comprehensively searched MEDLINE, Embase, Web of Science, and Cochrane Library from inception to April 2021. The study protocol was registered at PROSPERO (CRD42020210144). Relative risks (RR) for the highest versus the lowest level of selenium and standard mean differences (SMD) with 95% confidence intervals (CI) were pooled using random-effects models. Heterogeneity and publication bias were evaluated using the statistic and Egger's regression test, respectively.
There were 50 studies with 9875 cases and 12975 population controls in the final analysis. Patients with hepatitis (SMD = -1.78, 95% CI: -2.22 to -1.34), liver cirrhosis (SMD = -2.06, 95% CI: -2.48 to -1.63), and liver cancer (SMD = -2.71, 95% CI: -3.31 to -2.11) had significantly lower selenium levels than controls, whereas there was no significant difference in patients with fatty liver diseases (SMD = 1.06, 95% CI: -1.78 to 3.89). Moreover, the meta-analysis showed that a higher selenium level was significantly associated with a 41% decrease in the incidence of significant advanced chronic liver diseases (RR = 0.59, 95% CI: 0.49 to 0.72).
Our meta-analysis suggested that both body selenium status and selenium intake were negatively associated with hepatitis, cirrhosis, and liver cancer. However, the associations for fatty liver diseases were conflicting and need to be established in prospective trials.
硒在预防慢性肝病中的作用仍存在争议。本荟萃分析旨在总结观察性研究和干预试验的现有证据，这些研究评估了体内硒状态与慢性肝病之间的关系。
我们全面检索了 MEDLINE、Embase、Web of Science 和 Cochrane Library 从成立到 2021 年 4 月的文献。研究方案在 PROSPERO（CRD42020210144）注册。使用随机效应模型汇总最高与最低硒水平的相对风险（RR）和 95%置信区间（CI）的标准均数差（SMD）。使用 Q 统计量和 Egger 回归检验评估异质性和发表偏倚。
最终分析纳入了 50 项研究，共 9875 例病例和 12975 例人群对照。与对照组相比，肝炎（SMD = -1.78，95%CI：-2.22 至-1.34）、肝硬化（SMD = -2.06，95%CI：-2.48 至-1.63）和肝癌（SMD = -2.71，95%CI：-3.31 至-2.11）患者的硒水平显著降低，而脂肪肝（SMD = 1.06，95%CI：-1.78 至 3.89）患者之间无显著差异。此外，荟萃分析表明，较高的硒水平与显著进展性慢性肝病的发病率降低 41%显著相关（RR = 0.59，95%CI：0.49 至 0.72）。
本荟萃分析表明，体内硒状态和硒摄入与肝炎、肝硬化和肝癌均呈负相关。然而，脂肪肝的相关性存在争议，需要在前瞻性试验中进一步证实。
