硒水平与慢性肾脏病关联的Meta分析  

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

作　　者：刘溦 宋杰[1] 陈伟伟 叶丁 毛盈颖 LIU Wei;SONG Jie;CHEN Weiwei;YE Ding;MAO Yingying(School of Public Health,Zhejiang Chinese Medical University,Hangzhou,Zhejiang 310053,China)

机构地区：[1]浙江中医药大学公共卫生学院,浙江杭州310053

出　　处：《预防医学》2023年第8期669-676,共8页CHINA PREVENTIVE MEDICINE JOURNAL

摘　　要：目的系统评价人体硒水平与慢性肾脏病(CKD)发病风险,为CKD的防治提供依据。方法检索中国知网、万方数据知识服务平台、PubMed和Web ofScience,收集建库至2022年7月28日发表的关于硒水平与CKD的研究文献。采用Stata 16.0软件进行Meta分析,以标准化均数差(SMD)及其95%CI描述。采用亚组分析和Meta回归分析异质性来源;采用留一法进行敏感性分析;采用漏斗图、Egger检验和Begg检验评估发表偏倚,并采用剪补法评估结果的稳定性。结果共检索文献2990篇,最终纳入63篇,其中横断面研究18篇,病例对照研究40篇,队列研究2篇和随机对照试验3篇;CKD病例5099例,对照组6334人。Meta分析结果显示,CKD病例硒水平低于对照组(SMD=-1.828,95%CI:-2.132~-1.523,P<0.001)。亚组分析结果显示,亚洲、欧洲与混合不同地区人群的CKD病例硒水平低于对照组(P<0.05);CKD病例血硒水平低于对照组(P<0.05);保守治疗、血液透析和腹膜透析病例硒水平低于对照组(P<0.05);横断面研究、病例对照研究和随机对照试验中CKD病例硒水平低于对照组(P<0.05)。不同研究年份、样本量、文献质量评分均显示CKD病例硒水平低于对照组(P<0.05)。敏感性分析显示结果稳健。漏斗图、Begg检验和Egger检验提示存在发表偏倚,进一步用剪补法发现结果稳定。结论硒水平与CKD的发生可能存在关联。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 2990 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 5099 CKD patients and 6334 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

关 键 词：慢性肾脏病 硒 关联 META分析 

分 类 号：R692[医药卫生—泌尿科学]