Diabetes Metab J.  2019 Aug;43(4):447-460. 10.4093/dmj.2018.0123.

Association between Serum Selenium Level and the Presence of Diabetes Mellitus: A Meta-Analysis of Observational Studies

• Kim J
• Chung HS
• Choi MK
• Roh YK
• Yoo HJ
• Park JH
• Kim DS
• Yu JM
• Moon S

• KMID: 2455668
• DOI: http://doi.org/10.4093/dmj.2018.0123

Abstract

BACKGROUND
Epidemiological studies have suggested an association between selenium (Se) and diabetes mellitus (DM). However, different studies have reported conflicting results. Therefore, we performed a comprehensive meta-analysis to clarify the impact of Se on DM.
METHODS
We searched the PubMed database for studies on the association between Se and DM from inception to June 2018.
RESULTS
Twenty articles evaluating 47,930 participants were included in the analysis. The meta-analysis found that high levels of Se were significantly associated with the presence of DM (pooled odds ratios [ORs], 1.88; 95% confidence interval [CI], 1.44 to 2.45). However, significant heterogeneity was found (I2 =82%). Subgroup analyses were performed based on the Se measurement methods used in each study. A significant association was found between high Se levels and the presence of DM in the studies that used blood (OR, 2.17; 95% CI, 1.60 to 2.93; I2 =77%), diet (OR, 1.61; 95% CI, 1.10 to 2.36; I2 =0%), and urine (OR, 1.49; 95% CI, 1.02 to 2.17; I2 =0%) as samples to estimate Se levels, but not in studies on nails (OR, 1.24; 95% CI, 0.52 to 2.98; I2 =91%). Because of significant heterogeneity in the studies with blood, we conducted a sensitivity analysis and tested the publication bias. The results were consistent after adjustment based on the sensitivity analysis as well as the trim and fill analysis for publication bias.
CONCLUSION
This meta-analysis demonstrates that high levels of Se are associated with the presence of DM. Further prospective and randomized controlled trials are warranted to elucidate the link better.

Keyword

Antioxidants; Diabetes mellitus; Selenium; Trace elements

MeSH Terms

Antioxidants
Diabetes Mellitus*
Diet
Epidemiologic Studies
Odds Ratio
Population Characteristics
Prospective Studies
Publication Bias
Selenium*
Trace Elements
Antioxidants
Selenium
Trace Elements

Figure

• 

  Fig. 1 Representation of the search strategy. DM, diabetes mellitus.

• 

  Fig. 2 Forest plots summarizing the odds ratio (OR) of the association between Se levels and the presence of diabetes mellitus. CI, confidence interval.

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