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

• Published in: Diabetes & metabolism journal Vol. 43; no. 4; pp. 447 - 460
• Main Authors: Kim, Juno, Chung, Hye Soo, Choi, Min-Kyu, Roh, Yong Kyun, Yoo, Hyung Joon, Park, Jung Hwan, Kim, Dong Sun, Yu, Jae Myung, Moon, Shinje
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Diabetes Association / Daehan Dangnyobyeong Hakoe 01.08.2019; Korean Diabetes Association; 대한당뇨병학회
• Subjects: Adult; Aged; antioxidants; Bias; Databases, Factual; Diabetes; diabetes mellitus; Diabetes Mellitus - blood; Diabetes Mellitus - epidemiology; Diabetes Mellitus - urine; Female; Humans; Insulin resistance; Investigations; Kinases; Male; Meta-analysis; Middle Aged; Nails - chemistry; Observational studies; Observational Studies as Topic; Odds Ratio; Original; Oxidative stress; Publication Bias; Selenium; Selenium - blood; Selenium - urine; Sensitivity analysis; trace elements; 내과학; Antioxidants; Trace elements; Selenium; Diabetes mellitus
• ISSN: 2233-6079; 2233-6087
• DOI: 10.4093/dmj.2018.0123

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. We searched the PubMed database for studies on the association between Se and DM from inception to June 2018. 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 ( ²=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; ²=77%), diet (OR, 1.61; 95% CI, 1.10 to 2.36; ²=0%), and urine (OR, 1.49; 95% CI, 1.02 to 2.17; ²=0%) as samples to estimate Se levels, but not in studies on nails (OR, 1.24; 95% CI, 0.52 to 2.98; ²=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. 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.