Selenium and coronary heart disease: a meta-analysis
Selenium and coronary heart disease: a meta-analysis
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DOI：
10.1093/ajcn/84.4.762
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发表时间：
2006-10-01
影响因子：
7.1
通讯作者：
Guallar, Eliseo
中科院分区：
文献类型：
--
作者：
Flores-Mateo, Gemma;Navas-Acien, Ana;Guallar, Eliseo
背景资料：据推测，低硒浓度与心血管疾病风险增加有关，硒补充剂可预防冠心病。目的：目的是对观察性研究中硒生物标志物与冠心病终点的关联以及随机试验中硒补充剂预防冠心病终点的疗效进行荟萃分析。设计：检索MEDLINE和科克伦图书馆数据库中1966年至2005年进行的研究。相对风险汇总使用逆方差加权随机效应model.Results：25个观察性研究（14个队列和11个病例对照研究），测量血液或趾甲硒浓度和6个随机试验，评估含硒补充剂符合我们的纳入标准。队列研究中最高和最低硒浓度类别比较的合并相对风险为0.85（95%CI：0.74，0.99），病例对照研究中为0.43（0.29，0.66）。在观察性研究中，硒浓度增加50%与冠心病风险降低24%（7%，38%）相关。在随机试验中，含硒补充剂与安慰剂比较的合并相对危险度为0.89（0.68，1.17）。结论：观察性研究中硒浓度与冠心病风险呈负相关。由于观察性研究为其他抗氧化剂提供了误导性的证据，这种关联的有效性尚不确定。很少有随机试验讨论了硒补充剂的心血管功效，他们的发现仍然不确定。需要来自正在进行的大型试验的证据来确定低硒浓度作为心血管疾病的危险因素。目前，硒补充剂不应被推荐用于预防心血管疾病。
Background: It is hypothesized that low selenium concentrations are associated with an increased risk of cardiovascular disease and that selenium supplements prevent coronary heart disease.Objective: The objective was to perform a meta-analysis on the association of selenium biomarkers with coronary heart disease end-points in observational studies and on the efficacy of selenium supplements in preventing coronary heart disease endpoints in randomized trials.Design: The MEDLINE and the Cochrane Library databases were searched for studies conducted from 1966 through 2005. Relative risks were pooled by using an inverse-variance weighted random-effects model.Results: Twenty-five observational studies (14 cohort and 11 case-control studies) that measured blood or toenail selenium concentrations and 6 randomized trials that evaluated supplements containing selenium met our inclusion criteria. The pooled relative risk in a comparison of the highest with the lowest selenium concentration categories was 0.85 (95% CI: 0.74, 0.99) in cohort studies and 0.43 (0.29, 0.66) in case-control studies. In observational studies, a 50% increase in selenium concentrations was associated with a 24% (7%, 38%) reduction in coronary heart disease risk. In randomized trials, the pooled relative risk in a comparison of supplements containing selenium with placebo was 0.89 (0.68, 1.17).Conclusions: Selenium concentrations were inversely associated with coronary heart disease risk in observational studies. Because observational studies have provided misleading evidence for other antioxidants, the validity of this association is uncertain. Few randomized trials have addressed the cardiovascular efficacy of selenium supplementation, and their findings are still inconclusive. Evidence from large ongoing trials is needed to establish low selenium concentrations as a cardiovascular disease risk factor. Currently, selenium supplements should not be recommended for cardiovascular disease prevention.