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炎症性肠病中的硒缺乏:一项全面的荟萃分析。

Selenium deficiency in inflammatory bowel disease: A comprehensive meta-analysis.

作者信息

Liu Sishuo, Lin Tingting, Wang Wenguang, Jing Fangyuan, Sheng Jinghao

机构信息

Institute of Environmental Medicine and Department of General Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China.

Liangzhu Laboratory, Zhejiang University, Hangzhou, 311121, China.

出版信息

Heliyon. 2024 Nov 5;10(22):e40139. doi: 10.1016/j.heliyon.2024.e40139. eCollection 2024 Nov 30.

Abstract

BACKGROUND

Micronutrient deficiencies, particularly selenium, are common in Inflammatory Bowel Diseases and may influence disease progression and severity. Various studies have investigated blood selenium levels in patients with inflammatory bowel disease, but these studies have shown considerable heterogeneity and are generally limited by small sample sizes. Therefore, this study aims to clarify the selenium status in patients with inflammatory bowel disease compared to controls and to explore the potential of selenium supplementation as a therapeutic option.

METHOD

A comprehensive search of online databases from January 1980 to December 2023 was conducted, focusing on studies related to selenium levels in patients with inflammatory bowel disease. The relationship between blood selenium concentrations in inflammatory bowel disease patients and controls was pooled using a random-effects model.

RESULTS

From the 1853 references screened, 20 studies were selected based on the inclusion criteria, involving 1792 inflammatory bowel disease patients (including both Crohn's disease and ulcerative colitis cases) and 1648 controls. The meta-analysis demonstrated that inflammatory bowel disease patients have significantly lower selenium levels compared to the control group. This trend was consistent across subgroups differentiated by study characteristics such as design, geographical location, selenium detection methods, types of samples analyzed, and age categories of participants, with particularly notable deficiencies observed in patients with Crohn's disease. The robustness of these findings was supported by sensitivity analysis, and tests for publication bias indicated no significant skewing of results.

CONCLUSION

The analysis confirms that inflammatory bowel disease patients, especially those with Crohn's disease, have significantly lower levels of selenium compared to controls, suggesting that that selenium supplementation may serve as a valuable adjunct to the therapeutic regimen for managing inflammatory bowel disease, particularly in patients identified with selenium insufficiency.

摘要

背景

微量营养素缺乏,尤其是硒缺乏,在炎症性肠病中很常见,可能会影响疾病的进展和严重程度。多项研究调查了炎症性肠病患者的血硒水平,但这些研究显示出相当大的异质性,并且通常受样本量小的限制。因此,本研究旨在阐明炎症性肠病患者与对照组相比的硒状态,并探索补充硒作为一种治疗选择的潜力。

方法

对1980年1月至2023年12月的在线数据库进行了全面检索,重点关注与炎症性肠病患者硒水平相关的研究。使用随机效应模型汇总炎症性肠病患者和对照组的血硒浓度之间的关系。

结果

从筛选的1853篇参考文献中,根据纳入标准选择了20项研究,涉及1792例炎症性肠病患者(包括克罗恩病和溃疡性结肠炎病例)和1648名对照组。荟萃分析表明,与对照组相比,炎症性肠病患者的硒水平显著降低。在按研究特征(如设计、地理位置、硒检测方法、分析的样本类型和参与者年龄类别)区分的亚组中,这一趋势是一致的,在克罗恩病患者中观察到尤为明显的缺乏。敏感性分析支持了这些发现的稳健性,发表偏倚检验表明结果没有显著偏倚。

结论

分析证实,与对照组相比,炎症性肠病患者,尤其是克罗恩病患者的硒水平显著较低,这表明补充硒可能是治疗炎症性肠病治疗方案的有价值辅助手段,特别是在确定有硒缺乏的患者中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a402/11583699/441475856719/gr1.jpg

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