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| Association between Serum Selenium Level and the Presence of Diabetes Mellitus: A Meta-Analysis of Observational Studies |
Juno Kim ,1 Hye Soo Chung,2 Min-Kyu Choi,1 Yong Kyun Roh,1 Hyung Joon Yoo,3 Jung Hwan Park,4 Dong Sun Kim,4 Jae Myung Yu, 2 and Shinje Moon2,5 |
| 1Department of Family Medicine, Hallym University College of Medicine, Chuncheon, Korea. |
| 2Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea. |
| 3Division of Internal Medicine, CM Hospital, Seoul, Korea. |
| 4Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea. |
| 5Department of Internal Medicine, Graduate School, Hanyang University College of Medicine, Seoul, Korea. |
Corresponding author: Shinje Moon. Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University College of Medicine, 1 Singil-ro, Yeongdeungpo-gu, Seoul 07441, Korea. Email: sinjei1129@gmail.com Corresponding author: Jae Myung Yu. Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University College of Medicine, 1 Singil-ro, Yeongdeungpo-gu, Seoul 07441, Korea. Email: jaemyungyu@hallym.or.kr
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Received July 10, 2018; Accepted October 28, 2018.
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This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Abstract
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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.
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Keywords:
Antioxidants; Diabetes mellitus; Selenium; Trace elements
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