Selenium Status in Patients with Chronic Liver Disease: A Systematic Review and Meta-Analysis.

Yaduan Lin,Ting Liu,Binbin Xie,Fanchen He,Jiang He,Shaoyan Lian,Chaoqun Liu

doi:10.3390/nu14050952

Yaduan Lin, Ting Liu + Show 5 more

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https://doi.org/10.3390/nu14050952

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Abstract

Background: The potential role of selenium in preventing chronic liver diseases remains controversial. This meta-analysis aimed to summarize the available evidence from observational studies and intervention trials that had evaluated the associations between body selenium status and chronic liver diseases. Methods: We comprehensively searched MEDLINE, Embase, Web of Science, and Cochrane Library from inception to April 2021. The study protocol was registered at PROSPERO (CRD42020210144). Relative risks (RR) for the highest versus the lowest level of selenium and standard mean differences (SMD) with 95% confidence intervals (CI) were pooled using random-effects models. Heterogeneity and publication bias were evaluated using the I2 statistic and Egger’s regression test, respectively. Results: There were 50 studies with 9875 cases and 12975 population controls in the final analysis. Patients with hepatitis (SMD = −1.78, 95% CI: −2.22 to −1.34), liver cirrhosis (SMD = −2.06, 95% CI: −2.48 to −1.63), and liver cancer (SMD = −2.71, 95% CI: −3.31 to −2.11) had significantly lower selenium levels than controls, whereas there was no significant difference in patients with fatty liver diseases (SMD = 1.06, 95% CI: −1.78 to 3.89). Moreover, the meta-analysis showed that a higher selenium level was significantly associated with a 41% decrease in the incidence of significant advanced chronic liver diseases (RR = 0.59, 95% CI: 0.49 to 0.72). Conclusion: Our meta-analysis suggested that both body selenium status and selenium intake were negatively associated with hepatitis, cirrhosis, and liver cancer. However, the associations for fatty liver diseases were conflicting and need to be established in prospective trials.

Highlights

Selenium has been recognized as an essential trace element in humans for decades, which exerts its biological functions in antioxidant defense, redox signaling, thyroid hormone metabolism, and immune response through various selenoproteins [1]
We found an adverse association between body selenium status and chronic liver diseases (SMD = −1.70, 95% confidence intervals (CI): −2.30 to −1.11, n = 137), but the heterogeneity was high (I2 = 99.5%, p < 0.001)
We found that fatty liver disease patients had an equivalent level of selenium to healthy controls (SMD = 1.06, 95% CI: −1.78 to 3.89, n = 11), whereas patients with hepatitis (SMD = −1.78, 95% CI: −2.22 to −1.34, n = 44), liver cirrhosis (SMD = −2.06, 95% CI: −2.48 to −1.63, n = 57), and liver cancer (SMD = −2.71, 95% CI: −3.31 to −2.11, n = 25) had a lower selenium level than healthy controls, regardless of the baseline of selenium level in the body

Summary

Introduction

Selenium has been recognized as an essential trace element in humans for decades, which exerts its biological functions in antioxidant defense, redox signaling, thyroid hormone metabolism, and immune response through various selenoproteins [1]. The potential role of selenium in preventing chronic liver diseases remains controversial This meta-analysis aimed to summarize the available evidence from observational studies and intervention trials that had evaluated the associations between body selenium status and chronic liver diseases. Patients with hepatitis (SMD = −1.78, 95% CI: −2.22 to −1.34), liver cirrhosis (SMD = −2.06, 95% CI: −2.48 to −1.63), and liver cancer (SMD = −2.71, 95% CI: −3.31 to −2.11) had significantly lower selenium levels than controls, whereas there was no significant difference in patients with fatty liver diseases (SMD = 1.06, 95% CI: −1.78 to 3.89). The meta-analysis showed that a higher selenium level was significantly associated with a 41% decrease in the incidence of significant advanced chronic liver diseases (RR = 0.59, 95% CI: 0.49 to 0.72). Conclusion: Our meta-analysis suggested that both body selenium status and selenium intake were negatively associated with hepatitis, cirrhosis, and liver cancer. The associations for fatty liver diseases were conflicting and need to be established in prospective trials

Methods

Results

Discussion

Conclusion