硒水平与慢性肾脏病关联的Meta分析

doi:10.19485/j.cnki.issn2096-5087.2023.08.006

Preventive Medicine

2023, Vol. 35

Issue (8): 669-676 DOI: 10.19485/j.cnki.issn2096-5087.2023.08.006

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Correlation between selenium and chronic kidney disease: a meta-analysis

LIU Wei, SONG Jie, CHEN Weiwei, YE Ding, MAO Yingying

School of Public Health, Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310053, China

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Abstract Objective To systematically evaluate the correlation between selenium in the body and the risk of chronic kidney disease (CKD), so as to provide insights into CKD prevention and control. Methods Publications pertaining to the correlation between selenium level and CKD were retrieved from electronic databases, including CNKI, WanFang Data, PubMed and Web of Science from inception until July 28, 2022. Meta-analysis was performed using the software Stata 16.0, and all measures were expressed with standardized mean difference (SMD) and its 95%CI. The source of heterogeneity was analyzed using subgroup analysis and meta-regression, and sensitivity analysis was performed using the leave-one-out method. In addition, the publication bias was evaluated with d funnel plot, Egger's test and Begg's test, and the robustness of the result was evaluated using the trim and filling method. Results A total of 2 990 publications were screened, and 63 eligible publications were included in the final analysis, including 18 cross-sectional studies, 40 case-control studies, 2 cohort studies and 3 randomized controlled trials (RCTs), which covered 5 099 CKD patients and 6 334 controls. Meta-analysis showed lower selenium levels in CKD patients than in controls (SMD=-1.828, 95%CI: -2.132 to -1.523, P<0.001). Subgroup analysis showed lower selenium levels among CKD patients than among controls from Asia, Europe and multiple continents (P<0.05), and lower selenium levels were detected in patients undergoing conservative treatment, hemodialysis and peritoneal dialysis than in controls (P<0.05), while the selenium levels were significantly lower in CKD patients than in controls in cross-sectional studies, case-control studies and RCTs (P<0.05). The selenium level was significantly lower among CKD patients than among controls regardless of the study year, sample size and score for quality of publications (P<0.05). Sensitivity analysis showed robustness of this meta-analysis. Publication bias was identified by funnel plot, Begg's test and Egger's test, and the robustness of the result was found using the trim-and-fill method. Conclusion There may be a possible correlation between selenium and the risk of CKD.

Key words： chronic kidney disease selenium correlation meta-analysis

Received: 17 April 2023 Revised: 10 June 2023 Published: 17 August 2023

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LIU Wei,SONG Jie,CHEN Weiwei, et al. Correlation between selenium and chronic kidney disease: a meta-analysis[J]. Preventive Medicine, 2023, 35(8): 669-676.

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[1] KALANTAR-ZADEH K,JAFAR T H,NITSCH D,et al.Chronic kidney disease[J].Lancet,2021,398(10302):786-802.
[2] BIKBOV B,PURCELL C A,LEVEY A S,et al.Global,regional,and national burden of chronic kidney disease,1990-2017:a systematic analysis for the global burden of disease study 2017[J].Lancet,2020,395(10225):709-733.
[3] FOREMAN K J,MARQUEZ N,DOLGERT A,et al.Forecasting life expectancy,years of life lost,and all-cause and cause-specific mortality for 250 causes of death:reference and alternative scenarios for 2016-40 for 195 countries and territories[J].Lancet,2018,392(10159):2052-2090.
[4] ZACHARA B A.Selenium and selenium-dependent antioxidants in chronic kidney disease[J].Adv Clin Chem,2015,68:131-151.
[5] 黄晶,汤荟,张春.硒蛋白与肾脏疾病的研究进展[J].中华肾脏病杂志,2020,36(2):165-170.
[6] DRUEKE T B,PARFREY P S.Summary of the KDIGO guideline on anemia and comment:reading between the (guide)line(s)[J].Kidney Int,2012,82(9):952-960.
[7] STANG A.Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses[J].Eur J Epidemiol,2010,25(9):603-605.
[8] JAJAD A R,MOOCE R A,CARROLL D,et al.Assessing the quality of reports of randomized clinical trials:is blinding necessary?[J].Control Clin Trials,1996,17(1):1-12.
[9] BRUNE D,SAMSAHL K,WESTER P O.A comparison between the amounts of As,Au,Br,Cu,Fe,Mo,Se and Zn in normal and uraemic human whole blood by means of neutron activation analysis[J].Clin Chim Acta,1966,13(3):285-291.
[10] SMYTHE W R,ALFREY A C,CRASWELL P W,et al.Trace element abnormalities in chronic uremia[J].Ann Intern Med,1982,96(3):302-310.
[11] MILLER L,MILLS B J,BLOTCKY A J,et al.Red blood cell and serum selenium concentrations as influenced by age and selected diseases[J].Am Coll Nutr,1983,2(4):331-341.
[12] KALLISTRATOS G,EVANGELOU A,SEFERIADIS K,et al.Selenium and haemodialysis:serum selenium levels in healthy persons,non-cancer and cancer patients with chronic renal failure[J].Nephron,1985,41(3):217-222.
[13] WALLAEYS B,CORNELIS R,MEES L,et al.Trace elements in serum,packed cells,and dialysate of CAPD patients[J].Kidney Int,1986,30(4):599-604.
[14] DWORKIN B,WESELEY S,ROSENTHAL W S,et al.Diminished blood selenium levels in renal failure patients on dialysis:correlations with nutritional status[J].Am J Med Sci,1987,293(1):6-12.
[15] FOOTE J W,HINKS L J,LLOYD B.Reduced plasma and white blood cell selenium levels in haemodialysis patients[J].Clin Chim Acta,1987,164(3):323-328.
[16] KOSTAKOPOULOS A,KOTSALOS A,ALEXOPOULOS J,et al.Serum selenium levels in healthy adults and its changes in chronic renal failure[J].Int Urol Nephrol,1990,22(4):397-401.
[17] RICHARD M J,ARNAUD J,JURKOVITZ C,et al.Trace elements and lipid peroxidation abnormalities in patients with chronic renal failure[J].Nephron,1991,57(1):10-15.
[18] MIHAILOVIĆ M,LINDBERG P,JOVANOVIĆ I,et al.Selenium status of patients with Balkan endemic nephropathy[J].Biol Trace Elem Res,1992,33:71-77.
[19] MILLY K,WIT L,DISKIN C,et al.Selenium in renal failure patients[J].Nephron,1992,61(2):139-144.
[20] TURAN B,DELILBAŞI E,DALAY N,et al.Serum selenium and glutathione-peroxidase activities and their interaction with toxic metals in dialysis and renal transplantation patients[J].Biol Trace Elem Res,1992,33:95-102.
[21] GIRELLI D,LUPO A,TREVISAN M T,et al.Red blood cell susceptibility to lipid peroxidation,membrane lipid composition,and antioxidant enzymes in continuous ambulatory peritoneal dialysis patients[J].Perit Dial Int,1992,12(2):205-210.
[22] LOUGHREY C M,YOUNG I S,LIGHTBODY J H,et al.Oxidative stress in haemodialysis[J].Contrib Nephrol,1994,87(11):679-683.
[23] BONOMINI M,MANFRINI V,MARINI A,et al.Hemodialysis with regenerated cellulosic membranes does not reduce plasma selenium levels in chronic uremic patients[J].Artif Organs,1995,19(1):81-85.
[24] MCGRATH L T,DOUGLAS A F,MCCLEAN E,et al.Oxidative stress and erythrocyte membrane fluidity in patients undergoing regular dialysis[J].Clin Chim Acta,1995,235(2):179-188.
[25] BELLISOLA G,GUIDI G C,CINQUE G,et al.Selenium status and plasma glutathione peroxidase in patients with IgA nephropathy[J].J Trace Elem Med Biol,1996,10(3):189-196.
[26] LIN T H,CHEN J G,LIAW J M,et al.Trace elements and lipid peroxidation in uremic patients on hemodialysis[J].Biol Trace Elem Res,1996,51(3):277-283.
[27] MARCHANTE-GAYON J M,SANCHEZ-URIA J E,SANZ-MEDEL A.Serum and tissue selenium contents related to renal disease and colon cancer as determined by electrothermal atomic absorption spectrometry[J].J Trace Elem Med Biol,1996,10(4):229-236.
[28] BONOMINI M,FORSTER S,MANFRINI V,et al.Geographic factors and plasma selenium in uremia and dialysis[J].Nephron,1996,72(2):197-204.
[29] CEBALLOS-PICOT I,WITKO-SARSAT V,MERAD-BOUDIA M,et al.Glutathione antioxidant system as a marker of oxidative stress in chronic renal failure[J].Free Radic Biol Med,1996,21(6):845-853.
[30] YOSHIMURA S,SUEMIZU H,NOMOTO Y,et al.Plasma glutathione peroxidase deficiency caused by renal dysfunction[J].Nephron,1996,73(2):207-211.
[31] BONNEFONT-ROUSSELOT D,JAUDON M C,ISSAD B,et al.Antioxidant status of elderly chronic renal patients treated by continuous ambulatory peritoneal dialysis[J].Nephrol Dial Transplant,1997,12(7):1399-1405.
[32] ZIMA T,MESTEK O,NĔMECEK K,et al.Trace elements in hemodialysis and continuous ambulatory peritoneal dialysis patients[J].Blood Purif,1998,16(5):253-260.
[33] ZACHARA B A,ADAMOWICZ A,TRAFIKOWSKA U,et al.Decreased plasma glutathione peroxidase activity in uraemic patients[J].Nephron,2000,84(3):278-281.
[34] ZACHARA B A,TRAFIKOWSKA U,ADAMOWICZ A,et al.Selenium,glutathione peroxidases,and some other antioxidant parameters in blood of patients with chronic renal failure[J].J Trace Elem Med Biol,2001,15(2/3):161-166.
[35] SABÉ R,RUBIO R,GARCÍA-BELTRÁN L.Reference values of selenium in plasma in population from Barcelona.Comparison with several pathologies[J].J Trace Elem Med Biol,2002,16(4):231-237.
[36] ADAMOWICZ A,TRAFIKOWSKA U,TRAFIKOWSKA A,et al.Effect of erythropoietin therapy and selenium supplementation on selected antioxidant parameters in blood of uremic patients on long-term hemodialysis[J].Med Sci Monit,2002,8(3):202-205.
[37] APOSTOLIDIS N S,PANOUSSOPOULOS D G,STAMOU K M,et al.Selenium metabolism in patients on continuous ambulatory peritoneal dialysis[J].Perit Dial Int,2002,22(3):400-404.
[38] MORRIS-STIFF G J,OLEESKY D,JUREWICZ W A.Is selenium deficiency an important risk factor for chronic graft nephropathy? A pilot study[J].Transplantation,2003,76(7):1100-1104.
[39] FYDRYK J,OLSZEWSKA M,URASINSKI T,et al.Serum selenium level and glutathione peroxidase activity in steroid-sensitive nephrotic syndrome[J].Pediatr Nephrol,2003,18(10):1063-1065.
[40] ZWOLIŃSKA D,GRZESZCZAK W,KILIŚ-PSTRUSIŃSKA K,et al.Lipid peroxidation and antioxidant enzymes in children with chronic renal failure[J].Pediatr Nephrol,2004,19(8):888-892.
[41] YAVUZ O,BICIK Z,CINAR Y,et al.The effect of different dialysis membranes on oxidative stress and selenium status[J].Clin Chim Acta,2004,346(2):153-160.
[42] VURAL A,YILMAZ M I,CAGLAR K,et al.Assessment of oxidative stress in the early posttransplant period:comparison of cyclosporine A and tacrolimus-based regimens[J].Am J Nephrol,2005,25(3):250-255.
[43] HSIEH Y Y,SHEN W S,LEE L Y,et al.Long-term changes in trace elements in patients undergoing chronic hemodialysis[J].Biol Trace Elem Res,2006,109(2):115-121.
[44] YILMAZ M I,SAGLAM M,CAGLAR K,et al.The determinants of endothelial dysfunction in CKD:oxidative stress and asymmetric dimethylarginine[J].Am J Kidney Dis,2006,47(1):42-50.
[45] ORTAÇ E,OZKAYA O,SARAYMEN R,et al.Low hair selenium and plasma glutathione peroxidase in children with chronic renal failure[J].Pediatr Nephrol,2006,21(11):1739-1745.
[46] BOBER J,KWIATKOWSKA E,KEDZIERSKA K,et al.Influence of glucose in the dialysate on the activity of erythrocyte-glutathione-peroxidase and blood selenium concentration in hemodialyzed patients[J].Arch Med Res,2007,38(3):330-336.
[47] AKYOL T,BULUCU F,SENER O,et al.Functions and oxidative stress status of leukocytes in patients with nephrotic syndrome[J].Biol Trace Elem Res,2007,116(3):237-248.
[48] KNAP B,PREZELJ M,BUTUROVIC-PONIKVAR J,et al.Antioxidant enzymes show adaptation to oxidative stress in athletes and increased stress in hemodialysis patients[J].Ther Apher Dial,2009,13(4):300-305.
[49] CHEN B,LAMBERTS L V,BEHETS G J,et al.Selenium,lead,and cadmium levels in renal failure patients in China[J].Biol Trace Elem Res,2009,131(1):1-12.
[50] JOHNSON-DAVIS K L,FERNELIUS C,ELIASON N B,et al.Blood enzymes and oxidative stress in chronic kidney disease:a cross sectional study[J].Ann Clin Lab Sci,2011,41(4):331-339.
[51] MISHRA O P,GUPTA A K,PRASAD R,et al.Antioxidant status of children with idiopathic nephrotic syndrome[J].Pediatr Nephrol,2011,26(2):251-256.
[52] FUJISHIMA Y,OHSAWA M,ITAI K,et al.Serum selenium levels in hemodialysis patients are significantly lower than those in healthy controls[J].Blood Purif,2011,32(1):43-47.
[53] OCHI A,ISHIMURA E,TSUJIMOTO Y,et al.Trace elements in the hair of hemodialysis patients[J].Biol Trace Elem Res,2011,143(2):825-834.
[54] YANG C Y,WU M L,CHOU Y Y,et al.Essential trace element status and clinical outcomes in long-term dialysis patients:a two-year prospective observational cohort study[J].Clin Nutr,2012,31(5):630-636.
[55] PRODANCHUK M,MAKAROV O,PISAREV E,et al.Disturbances of trace element metabolism in ESRD patients receiving hemodialysis and hemodiafiltration[J].Cent European J Urol,2014,66(4):472-476.
[56] AZIZ M A,MAJEED G H,DIAB K S,et al.The association of oxidant-antioxidant status in patients with chronic renal failure[J].Ren Fail,2016,38(1):20-26.
[57] GÓMEZ DE OÑA C,MARTÍNEZ-MORILLO E,GAGO GONZÁLEZ E,et al.Variation of trace element concentrations in patients undergoing hemodialysis in the north of Spain[J].Scand J Clin Lab Invest,2016,76(6):492-499.
[58] SHANMUGAM L,GREEN S R,RADHAKRISHNAN H,et al.Trace elements in chronic haemodialysis patients and healthy individuals-a comparative study[J].J Clin Diagn Res,2016,10(10):14-17.
[59] XIANG S,YAO Y,WAN Y,et al.Comparative study on trace element excretions between nonanuric and anuric patients undergoing continuous ambulatory peritoneal dialysis[J/OL].Nutrients,2016,8(12)[2023-06-10].https://doi.org/10.3390/nu8120826.
[60] DIYABALANAGE S,FONSEKA S,DASANAYAKE D,et al.Environmental exposures of trace elements assessed using keratinized matrices from patients with chronic kidney diseases of uncertain etiology(CKDu)in Sri Lanka[J].J Trace Elem Med Biol,2017,39:62-70.
[61] PAN C F,LIN C J,CHEN S H,et al.Association between trace element concentrations and anemia in patients with chronic kidney disease:a cross-sectional population-based study[J].J Investig Med,2019,67(6):995-1001.
[62] ESMAEILI M,RAKHSHANIZADEH F.Serum trace elements in children with end-stage renal disease[J].J Ren Nutr,2019,29(1):48-54.
[63] 赵纬昊,朱小静,李艳,等.慢性肾脏病患者血清硒元素水平及其与临床指标的相关性[J].西安交通大学学报(医学版),2019,40(5):760-764.
[64] WANG C L,LIN K P,HSU G W,et al.Altered mineral metabolism and disequilibrium between calcification promoters and inhibitors in chronic hemodialysis patients[J].Biol Trace Elem Res,2020,193(1):14-22.
[65] XU B,ZHANG Y,CHEN Y,et al.Simultaneous multielement analysis by ICP-MS with simple whole blood sample dilution and its application to uremic patients undergoing long-term hemodialysis[J].Scand J Clin Lab Invest,2020,80(3):247-255.
[66] ALMEIDA A,GAJEWSKA K,DURO M,et al.Trace element imbalances in patients undergoing chronic hemodialysis therapy - report of an observational study in a cohort of Portuguese patients[J/OL].J Trace Elem Med Biol,2020,62[2023-06-10].https://doi.org/10.1016/j.jtemb.2020.126580.
[67] SHEN Y,YIN Z,LV Y,et al.Plasma element levels and risk of chronic kidney disease in elderly populations(≥ 90 years old)[J/OL].Chemosphere,2020,254[2023-06-10].https://doi.org/10.1016/j.chemosphere.2020.126809.
[68] BARROSO C F,PIRES L V,SANTOS L B,et al.Selenium nutritional status and glutathione peroxidase activity and its relationship with hemodialysis time in individuals living in a Brazilian region with selenium-rich soil[J].Biol Trace Elem Res,2021,199(7):2535-2542.
[69] AL-FARTOSY A J M,AWAD N A,ALSALIMI S A.Clinical markers and some trace elements in patients with type-2 diabetic nephropathy:impact of insulin resistance[J].J Med Invest,2021,68(1/2):76-84.
[70] CHEN C Y,CHIU C H,WU I W,et al.Micronutrients and renal outcomes:a prospective cohort study[J/OL].Nutrients,2022,14(15)[2023-06-10].https://doi.org/10.3390/nu14153063.
[71] 谢妮. 慢性肾脏病患者微量元素硒的变化及意义[D].恩施:湖北民族大学,2022.
[72] LIN T,TAO J,CHEN Y,et al.Selenium deficiency leads to changes in renal fibrosis marker proteins and Wnt/beta-catenin signaling pathway components[J].Biol Trace Elem Res,2022,200(3):1127-1139.
[73] TINGGI U,PERKINS A V.Selenium status:its interactions with dietary mercury exposure and implications in human health[J/OL].Nutrients,2022,14(24)[2023-06-10].https://doi.org/10.3390/nu14245308.