Selenium Supplementation for Treatment of Kashin-Beck Disease: A Network Meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

 XIEDong-mei ¹ , WANGRong-hai ² , LIAOYu-lin ¹ , XULi ¹ ,  YUEJi-rong ¹ , DENGChuan-yao ¹

1. Department of Geriatrics, West China Hospital, Sichuan University, Chengdu 610041, China;
2. Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding author：

YUEJi-rong, Email: yuejirong11@hotmail.com

Keywords：

Kashin-Beck disease; Selenium supplementation; Network meta-analysis; Randomized controlled trial

DOI：

10.7507/1672-2531.20160195

Video：

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Objective To assess the comparative efficacy of all kinds of selenium supplementation in the treatment of patients with Kashin-Beck disease (KBD) by network meta-analysis. Methods We searched seven electronic databases including PubMed, EMbase, The Cochrane Library (Issue 7, 2016), CBM, VIP, WanFang Data and CNKI databases up to July 2016. All randomized controlled trials (RCTs) assessing the effect of selenium supplementation on KBD were included. Two reviewers independently screened literatures, extracted data and assessed the risk bias of included studies, and then meta-analysis was performed by using Stata13.1 software. Results A total of 16 RCTs involving 2 883 participants were included. Direct meta-analysis comparison showed that:Compared with placebo or blank group, sodium selenite (OR=5.00, 95%CI 3.21 to 7.78), selenium supplement salt (OR=7.60, 95%CI 2.34 to 24.67), and combination of sodium selenite and vitamin E (OR=11.05, 95%CI 2.61 to 46.80) had higher metaphysis X-ray improvement (P < 0.05). Ranking on efficacy indicated that combination of sodium selenite and vitamin E were highest, followed by selenium supplement salt, sodium selenite, sodium selenite plus vitamin C, vitamin C, and placebo/blank. Conclusion Based on the results of network meta-analysis, selenium supplement (sodium selenite, combination of sodium selenite and vitamin C, combination of sodium selenite and vitamin E, as well as selenium salt) is more effective than placebo or no treatment in promoting the repairement of metaphysis impairment. The effect of combination of sodium selenite and vitamin E are highest.

Citation： XIEDong-mei, WANGRong-hai, LIAOYu-lin, XULi, YUEJi-rong, DENGChuan-yao. Selenium Supplementation for Treatment of Kashin-Beck Disease: A Network Meta-analysis. Chinese Journal of Evidence-Based Medicine, 2016, 16(11): 1284-1290. doi: 10.7507/1672-2531.20160195 Copy

1.	王志武, 刘运起.关于大骨节病控制标准研制的回顾.中国地方病防治杂志, 1995, 10(3):168-169.
2.	郭雄.大骨节病病因与发病机制的研究进展及其展望.西安交通大学学报(医学版), 2008, 29(5):481-488.
3.	Zou K, Liu G, Wu T, et al. Selenium for preventing Kashin-Beck osteoarthropathy in children:a meta-analysis. Osteoarthritis Cartilage, 2009, 17(2):144-151.
4.	Jirong Y, Huiyun P, Zhongzhe Y, et al. Sodium selenite for treatment of Kashin-Beck disease in children:a systematic review of randomised controlled trials. Osteoarthritis Cartilage, 2012, 20(7):605-613.
5.	吴振甲, 罗福贤, 白生琦.三种不同投硒方法防治儿童大骨节病效果观察.地方病通报, 1991, 6(2):97-99.
6.	牛光厚, 张宝振, 宋子云, 等.口服亚硒酸钠防治大骨节病效果观察.黑龙江医学, 1981, (6):15-17.
7.	梁珮霖.维生素C与亚硒酸钠防治大骨节病效果观察.中国公共卫生, 1992, 8(10):446.
8.	曾宪涛, 曹世义, 孙凤, 等. Meta分析系列之六:间接比较及网状Meta分析.中国循证心血管医学杂志, 2012, 4(5):399-402.
9.	卫生部. GB 16003-1995大骨节病诊断标准. 1995-12-21.
10.	梁树棠, 张福金, 王立志, 等.大骨节病治疗效果判定.中国地方病学杂志, 1996, 15(6):378-380.
11.	Higgins J, Green S. Cochrane Handbook for Systematic Reviews of Interventions (Version 5.1.0). The Cochrane Collaboration, 2011. Available at:http://wwwcochrane-handbookorg.
12.	张超, 徐畅, 曾宪涛.网状Meta分析中网状关系图的绘制.中国循证医学杂志, 2013, 13(11):1382-1386.
13.	曾宪涛, 徐畅, 张超, 等.网状Meta分析在Stata软件中的实现.中国循证医学杂志, 2013, 13(11):1387-1391.
14.	田金徽, 李伦, 杨克虎.频率统计方法网状Meta分析在STATA软件中的实现.中国循证儿科杂志, 2014, 9(6):472-474.
15.	Higgins JP, Jackson D, Barrett JK, et al. Consistency and inconsistency in network meta-analysis:concepts and models for multi-arm studies. Res Synth Methods, 2012, 3(2):98-110.
16.	张天嵩.基于频率学框架的网状Meta回归实现与应用.中国循证医学杂志, 2015(8):988-992.
17.	全国永寿大骨节病科学考察组.硒防治大骨节病424例的效果及其作用机理.中国地方病学杂志, 1982, 1(3):145-150.
18.	王道顺, 傅宝珊, 孙庆元, 等.亚硒酸钠、维生素E治疗大骨节病的动态观察.中国地方病学杂志, 1983, 2(4):204-207.
19.	崔基哲, 林炳华, 金昌石, 等.维生素C及亚硒酸钠治疗大骨节病一年效果观察.地方病通讯, 1984, 1(2):63.
20.	牛光厚, 张宝振, 李祥祯, 等.硒防治大骨节病两年X线效果研究及病因学探讨.中国地方病学杂志, 1984, 3(3):199-201.
21.	郭连璧, 鲁清, 唐海峰, 等.口服亚硒酸钠治疗大骨节病一年的X线效果观察.承德医学院学报, 1985, (2):67-70.
22.	郭连璧, 鲁清, 董会秋, 等.富硒酵母治疗大骨节病一年效果观察.中国地方病学杂志, 1986, 5(1):16-20.
23.	牛光厚, 张宝振, 侯少范, 等.口服亚硒酸钠防治大骨节病二年X线效果研究.实用地方病学杂志, 1986, 1(1):16-18.
24.	伊春.口服亚硒酸钠防治大骨节病X线效果观察.中国地方病学杂志, 1986, 5(3):210-220.
25.	四川.口服亚硒酸钠防治大骨节病三年效果观察.中国地方病学杂志, 1988, 7(2):117-120.
26.	牛光厚, 张宝振, 侯少范.半量补硒法防治大骨节病效果研究.中国地方病学杂志, 1990, 9(2):99-100.
27.	周祥赓, 王文龙, 王恩庆, 等.硒盐维生素C治疗大骨节病效果观察.地方病通报, 1991, 6(2):100-103.
28.	Morenoreyes R, Mathieu F, Boelaert M, et al. Selenium and iodine supplementation of rural Tibetan children affected by Kashin-Beck osteoarthropathy. Am J Clin Nutr, 2003, 78(1):137-144.
29.	陈燕, 翟俊民, 王治伦, 等.补硒、补维生素C和粮食干燥治疗大骨节病效果的对比研究.中国地方病防治杂志, 2003, 18(6):343-346.
30.	李强, 赵志军, 文海.三种不同投硒方法防治青海省贵德病区儿童大骨节病效果观察.地方病通报, 2004, 19(4):62-64.
31.	蔡连文, 张玉龙.亚硒酸钠治疗儿童大骨节病40例X线效果观察.社区医学杂志, 2005, 3(3):60-61.
32.	Yang GQ, Ge KY, Chen JS, et al. Selenium-related endemic diseases and the daily selenium requirement of humans. World Rev Nutr Diet, 1988, 55:98-152.
33.	Yang L, Zhao GH, Yu FF, et al. Selenium and Iodine Levels in Subjects with Kashin-Beck Disease:a Meta-analysis. Biol Trace Elem Res, 2016, 170(1):43-54.
34.	熊咏民, 王治伦, 代晓霞, 等.人微小病毒B19及硒与大骨节病关系的研究.西安交通大学学报(医学版), 2004, 25(1):45-47.
35.	Sasaki S, Iwata H, Ishiguro N, et al. Low-selenium diet, bone, and articular cartilage in rats. Nutrition, 1994, 10(6):538-543.
36.	贺幼平, 朱莲珍.膳食中维生素E对克山病区粮饲养的大鼠硒代谢的影响.营养学报, 1988, 10(1):16-21.
37.	徐刚要, 吕晓娅, 曹小刚.陕西省大骨节病国家监测点19年监测结果分析.中国地方病防治杂志, 2009, 24(6):442-446.

1. 王志武, 刘运起.关于大骨节病控制标准研制的回顾.中国地方病防治杂志, 1995, 10(3):168-169.
2. 郭雄.大骨节病病因与发病机制的研究进展及其展望.西安交通大学学报(医学版), 2008, 29(5):481-488.
3. Zou K, Liu G, Wu T, et al. Selenium for preventing Kashin-Beck osteoarthropathy in children:a meta-analysis. Osteoarthritis Cartilage, 2009, 17(2):144-151.
4. Jirong Y, Huiyun P, Zhongzhe Y, et al. Sodium selenite for treatment of Kashin-Beck disease in children:a systematic review of randomised controlled trials. Osteoarthritis Cartilage, 2012, 20(7):605-613.
5. 吴振甲, 罗福贤, 白生琦.三种不同投硒方法防治儿童大骨节病效果观察.地方病通报, 1991, 6(2):97-99.
6. 牛光厚, 张宝振, 宋子云, 等.口服亚硒酸钠防治大骨节病效果观察.黑龙江医学, 1981, (6):15-17.
7. 梁珮霖.维生素C与亚硒酸钠防治大骨节病效果观察.中国公共卫生, 1992, 8(10):446.
8. 曾宪涛, 曹世义, 孙凤, 等. Meta分析系列之六:间接比较及网状Meta分析.中国循证心血管医学杂志, 2012, 4(5):399-402.
9. 卫生部. GB 16003-1995大骨节病诊断标准. 1995-12-21.
10. 梁树棠, 张福金, 王立志, 等.大骨节病治疗效果判定.中国地方病学杂志, 1996, 15(6):378-380.
11. Higgins J, Green S. Cochrane Handbook for Systematic Reviews of Interventions (Version 5.1.0). The Cochrane Collaboration, 2011. Available at:http://wwwcochrane-handbookorg.
12. 张超, 徐畅, 曾宪涛.网状Meta分析中网状关系图的绘制.中国循证医学杂志, 2013, 13(11):1382-1386.
13. 曾宪涛, 徐畅, 张超, 等.网状Meta分析在Stata软件中的实现.中国循证医学杂志, 2013, 13(11):1387-1391.
14. 田金徽, 李伦, 杨克虎.频率统计方法网状Meta分析在STATA软件中的实现.中国循证儿科杂志, 2014, 9(6):472-474.
15. Higgins JP, Jackson D, Barrett JK, et al. Consistency and inconsistency in network meta-analysis:concepts and models for multi-arm studies. Res Synth Methods, 2012, 3(2):98-110.
16. 张天嵩.基于频率学框架的网状Meta回归实现与应用.中国循证医学杂志, 2015(8):988-992.
17. 全国永寿大骨节病科学考察组.硒防治大骨节病424例的效果及其作用机理.中国地方病学杂志, 1982, 1(3):145-150.
18. 王道顺, 傅宝珊, 孙庆元, 等.亚硒酸钠、维生素E治疗大骨节病的动态观察.中国地方病学杂志, 1983, 2(4):204-207.
19. 崔基哲, 林炳华, 金昌石, 等.维生素C及亚硒酸钠治疗大骨节病一年效果观察.地方病通讯, 1984, 1(2):63.
20. 牛光厚, 张宝振, 李祥祯, 等.硒防治大骨节病两年X线效果研究及病因学探讨.中国地方病学杂志, 1984, 3(3):199-201.
21. 郭连璧, 鲁清, 唐海峰, 等.口服亚硒酸钠治疗大骨节病一年的X线效果观察.承德医学院学报, 1985, (2):67-70.
22. 郭连璧, 鲁清, 董会秋, 等.富硒酵母治疗大骨节病一年效果观察.中国地方病学杂志, 1986, 5(1):16-20.
23. 牛光厚, 张宝振, 侯少范, 等.口服亚硒酸钠防治大骨节病二年X线效果研究.实用地方病学杂志, 1986, 1(1):16-18.
24. 伊春.口服亚硒酸钠防治大骨节病X线效果观察.中国地方病学杂志, 1986, 5(3):210-220.
25. 四川.口服亚硒酸钠防治大骨节病三年效果观察.中国地方病学杂志, 1988, 7(2):117-120.
26. 牛光厚, 张宝振, 侯少范.半量补硒法防治大骨节病效果研究.中国地方病学杂志, 1990, 9(2):99-100.
27. 周祥赓, 王文龙, 王恩庆, 等.硒盐维生素C治疗大骨节病效果观察.地方病通报, 1991, 6(2):100-103.
28. Morenoreyes R, Mathieu F, Boelaert M, et al. Selenium and iodine supplementation of rural Tibetan children affected by Kashin-Beck osteoarthropathy. Am J Clin Nutr, 2003, 78(1):137-144.
29. 陈燕, 翟俊民, 王治伦, 等.补硒、补维生素C和粮食干燥治疗大骨节病效果的对比研究.中国地方病防治杂志, 2003, 18(6):343-346.
30. 李强, 赵志军, 文海.三种不同投硒方法防治青海省贵德病区儿童大骨节病效果观察.地方病通报, 2004, 19(4):62-64.
31. 蔡连文, 张玉龙.亚硒酸钠治疗儿童大骨节病40例X线效果观察.社区医学杂志, 2005, 3(3):60-61.
32. Yang GQ, Ge KY, Chen JS, et al. Selenium-related endemic diseases and the daily selenium requirement of humans. World Rev Nutr Diet, 1988, 55:98-152.
33. Yang L, Zhao GH, Yu FF, et al. Selenium and Iodine Levels in Subjects with Kashin-Beck Disease:a Meta-analysis. Biol Trace Elem Res, 2016, 170(1):43-54.
34. 熊咏民, 王治伦, 代晓霞, 等.人微小病毒B19及硒与大骨节病关系的研究.西安交通大学学报(医学版), 2004, 25(1):45-47.
35. Sasaki S, Iwata H, Ishiguro N, et al. Low-selenium diet, bone, and articular cartilage in rats. Nutrition, 1994, 10(6):538-543.
36. 贺幼平, 朱莲珍.膳食中维生素E对克山病区粮饲养的大鼠硒代谢的影响.营养学报, 1988, 10(1):16-21.
37. 徐刚要, 吕晓娅, 曹小刚.陕西省大骨节病国家监测点19年监测结果分析.中国地方病防治杂志, 2009, 24(6):442-446.

Chinese Journal of Evidence-Based Medicine

Selenium Supplementation for Treatment of Kashin-Beck Disease: A Network Meta-analysis

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