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硒的作用:多发性硬化症补充剂的荟萃分析。

Shining a Light on Selenium: a Meta-analysis of Supplementation in Multiple Sclerosis.

机构信息

Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran.

School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Biol Trace Elem Res. 2024 Oct;202(10):4375-4386. doi: 10.1007/s12011-023-04026-y. Epub 2023 Dec 29.

Abstract

Multiple sclerosis (MS) is a chronic immune-mediated demyelinating disease of the central nervous system. Selenium is a trace element with significant antioxidant activity. This study aimed to seek evidence concerning selenium supplementation in MS. A systematic search was performed on PubMed, Web of Science, Scopus, and Embase databases to identify the studies assessing the consumption rate, efficacy, and safety of selenium and selenium-containing supplementations in MS patients. The meta-analysis was performed using the Comprehensive Meta-Analysis and the risk of bias was evaluated using the Joanna Briggs Institute's critical appraisal tools. A total of 9 studies were included, which consisted of six studies regarding the rate of selenium supplement consumption in MS patients, with a total sample size of 2381 patients. Based on the quantitative synthesis, 14.3% (95% CI, 12.8-16.0%; I, 3.58%) of MS patients had current selenium supplements usage, and 11.3% (95% CI, 7.6-16.6%; I, 81.40%) of patients had used selenium supplements previously. Although there is no evidence regarding supplementation with selenium alone, three RCT studies reported the safety of selenium-containing supplementation use in MS with improved inflammation and oxidative stress conditions. The findings of this study show that over 10% of patients with MS used selenium supplements, with no clinical significance supporting the benefits. There is a lack of evidence regarding the safety and efficacy of selenium supplements in MS patients. Due to the limited number of included studies and the lack of comprehensive and specific studies regarding selenium supplements in MS, the results must be interpreted with caution, and future clinical trials are required.

摘要

多发性硬化症(MS)是一种中枢神经系统的慢性免疫介导的脱髓鞘疾病。硒是一种具有显著抗氧化活性的微量元素。本研究旨在寻找关于 MS 患者补充硒的证据。我们在 PubMed、Web of Science、Scopus 和 Embase 数据库中进行了系统检索,以确定评估 MS 患者硒摄入量、疗效和安全性的研究。使用 Comprehensive Meta-Analysis 进行荟萃分析,并使用 Joanna Briggs 研究所的批判性评估工具评估偏倚风险。共纳入 9 项研究,其中包括 6 项关于 MS 患者硒补充剂消费率的研究,总样本量为 2381 例患者。基于定量综合分析,14.3%(95%CI,12.8-16.0%;I2=3.58%)的 MS 患者目前正在服用硒补充剂,11.3%(95%CI,7.6-16.6%;I2=81.40%)的患者曾服用过硒补充剂。尽管单独补充硒的证据不足,但三项 RCT 研究报告了含硒补充剂在 MS 中的安全性,可改善炎症和氧化应激状况。本研究结果表明,超过 10%的 MS 患者使用硒补充剂,但没有临床意义上的获益证据。目前缺乏关于 MS 患者硒补充剂安全性和疗效的证据。由于纳入研究数量有限,且缺乏关于 MS 患者硒补充剂的全面和具体研究,因此必须谨慎解释研究结果,需要开展未来的临床试验。

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