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, 劉運起.關于大骨節病控制標準研制的回顧.中國地方病防治雜志, 1995, 10(3):168-169.
2.	郭雄.大骨節病病因與發病機制的研究進展及其展望.西安交通大學學報(醫學版), 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.	吳振甲, 羅福賢, 白生琦.三種不同投硒方法防治兒童大骨節病效果觀察.地方病通報, 1991, 6(2):97-99.
6.	牛光厚, 張寶振, 宋子云, 等.口服亞硒酸鈉防治大骨節病效果觀察.黑龍江醫學, 1981, (6):15-17.
7.	梁珮霖.維生素C與亞硒酸鈉防治大骨節病效果觀察.中國公共衛生, 1992, 8(10):446.
8.	曾憲濤, 曹世義, 孫鳳, 等. Meta分析系列之六:間接比較及網狀Meta分析.中國循證心血管醫學雜志, 2012, 4(5):399-402.
9.	衛生部. GB 16003-1995大骨節病診斷標準. 1995-12-21.
10.	梁樹棠, 張福金, 王立志, 等.大骨節病治療效果判定.中國地方病學雜志, 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.	張超, 徐暢, 曾憲濤.網狀Meta分析中網狀關系圖的繪制.中國循證醫學雜志, 2013, 13(11):1382-1386.
13.	曾憲濤, 徐暢, 張超, 等.網狀Meta分析在Stata軟件中的實現.中國循證醫學雜志, 2013, 13(11):1387-1391.
14.	田金徽, 李倫, 楊克虎.頻率統計方法網狀Meta分析在STATA軟件中的實現.中國循證兒科雜志, 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.	張天嵩.基于頻率學框架的網狀Meta回歸實現與應用.中國循證醫學雜志, 2015(8):988-992.
17.	全國永壽大骨節病科學考察組.硒防治大骨節病424例的效果及其作用機理.中國地方病學雜志, 1982, 1(3):145-150.
18.	王道順, 傅寶珊, 孫慶元, 等.亞硒酸鈉、維生素E治療大骨節病的動態觀察.中國地方病學雜志, 1983, 2(4):204-207.
19.	崔基哲, 林炳華, 金昌石, 等.維生素C及亞硒酸鈉治療大骨節病一年效果觀察.地方病通訊, 1984, 1(2):63.
20.	牛光厚, 張寶振, 李祥禎, 等.硒防治大骨節病兩年X線效果研究及病因學探討.中國地方病學雜志, 1984, 3(3):199-201.
21.	郭連璧, 魯清, 唐海峰, 等.口服亞硒酸鈉治療大骨節病一年的X線效果觀察.承德醫學院學報, 1985, (2):67-70.
22.	郭連璧, 魯清, 董會秋, 等.富硒酵母治療大骨節病一年效果觀察.中國地方病學雜志, 1986, 5(1):16-20.
23.	牛光厚, 張寶振, 侯少范, 等.口服亞硒酸鈉防治大骨節病二年X線效果研究.實用地方病學雜志, 1986, 1(1):16-18.
24.	伊春.口服亞硒酸鈉防治大骨節病X線效果觀察.中國地方病學雜志, 1986, 5(3):210-220.
25.	四川.口服亞硒酸鈉防治大骨節病三年效果觀察.中國地方病學雜志, 1988, 7(2):117-120.
26.	牛光厚, 張寶振, 侯少范.半量補硒法防治大骨節病效果研究.中國地方病學雜志, 1990, 9(2):99-100.
27.	周祥賡, 王文龍, 王恩慶, 等.硒鹽維生素C治療大骨節病效果觀察.地方病通報, 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.	陳燕, 翟俊民, 王治倫, 等.補硒、補維生素C和糧食干燥治療大骨節病效果的對比研究.中國地方病防治雜志, 2003, 18(6):343-346.
30.	李強, 趙志軍, 文海.三種不同投硒方法防治青海省貴德病區兒童大骨節病效果觀察.地方病通報, 2004, 19(4):62-64.
31.	蔡連文, 張玉龍.亞硒酸鈉治療兒童大骨節病40例X線效果觀察.社區醫學雜志, 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.	熊詠民, 王治倫, 代曉霞, 等.人微小病毒B19及硒與大骨節病關系的研究.西安交通大學學報(醫學版), 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.	賀幼平, 朱蓮珍.膳食中維生素E對克山病區糧飼養的大鼠硒代謝的影響.營養學報, 1988, 10(1):16-21.
37.	徐剛要, 呂曉婭, 曹小剛.陜西省大骨節病國家監測點19年監測結果分析.中國地方病防治雜志, 2009, 24(6):442-446.

1. 王志武, 劉運起.關于大骨節病控制標準研制的回顧.中國地方病防治雜志, 1995, 10(3):168-169.
2. 郭雄.大骨節病病因與發病機制的研究進展及其展望.西安交通大學學報(醫學版), 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. 吳振甲, 羅福賢, 白生琦.三種不同投硒方法防治兒童大骨節病效果觀察.地方病通報, 1991, 6(2):97-99.
6. 牛光厚, 張寶振, 宋子云, 等.口服亞硒酸鈉防治大骨節病效果觀察.黑龍江醫學, 1981, (6):15-17.
7. 梁珮霖.維生素C與亞硒酸鈉防治大骨節病效果觀察.中國公共衛生, 1992, 8(10):446.
8. 曾憲濤, 曹世義, 孫鳳, 等. Meta分析系列之六:間接比較及網狀Meta分析.中國循證心血管醫學雜志, 2012, 4(5):399-402.
9. 衛生部. GB 16003-1995大骨節病診斷標準. 1995-12-21.
10. 梁樹棠, 張福金, 王立志, 等.大骨節病治療效果判定.中國地方病學雜志, 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. 張超, 徐暢, 曾憲濤.網狀Meta分析中網狀關系圖的繪制.中國循證醫學雜志, 2013, 13(11):1382-1386.
13. 曾憲濤, 徐暢, 張超, 等.網狀Meta分析在Stata軟件中的實現.中國循證醫學雜志, 2013, 13(11):1387-1391.
14. 田金徽, 李倫, 楊克虎.頻率統計方法網狀Meta分析在STATA軟件中的實現.中國循證兒科雜志, 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. 張天嵩.基于頻率學框架的網狀Meta回歸實現與應用.中國循證醫學雜志, 2015(8):988-992.
17. 全國永壽大骨節病科學考察組.硒防治大骨節病424例的效果及其作用機理.中國地方病學雜志, 1982, 1(3):145-150.
18. 王道順, 傅寶珊, 孫慶元, 等.亞硒酸鈉、維生素E治療大骨節病的動態觀察.中國地方病學雜志, 1983, 2(4):204-207.
19. 崔基哲, 林炳華, 金昌石, 等.維生素C及亞硒酸鈉治療大骨節病一年效果觀察.地方病通訊, 1984, 1(2):63.
20. 牛光厚, 張寶振, 李祥禎, 等.硒防治大骨節病兩年X線效果研究及病因學探討.中國地方病學雜志, 1984, 3(3):199-201.
21. 郭連璧, 魯清, 唐海峰, 等.口服亞硒酸鈉治療大骨節病一年的X線效果觀察.承德醫學院學報, 1985, (2):67-70.
22. 郭連璧, 魯清, 董會秋, 等.富硒酵母治療大骨節病一年效果觀察.中國地方病學雜志, 1986, 5(1):16-20.
23. 牛光厚, 張寶振, 侯少范, 等.口服亞硒酸鈉防治大骨節病二年X線效果研究.實用地方病學雜志, 1986, 1(1):16-18.
24. 伊春.口服亞硒酸鈉防治大骨節病X線效果觀察.中國地方病學雜志, 1986, 5(3):210-220.
25. 四川.口服亞硒酸鈉防治大骨節病三年效果觀察.中國地方病學雜志, 1988, 7(2):117-120.
26. 牛光厚, 張寶振, 侯少范.半量補硒法防治大骨節病效果研究.中國地方病學雜志, 1990, 9(2):99-100.
27. 周祥賡, 王文龍, 王恩慶, 等.硒鹽維生素C治療大骨節病效果觀察.地方病通報, 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. 陳燕, 翟俊民, 王治倫, 等.補硒、補維生素C和糧食干燥治療大骨節病效果的對比研究.中國地方病防治雜志, 2003, 18(6):343-346.
30. 李強, 趙志軍, 文海.三種不同投硒方法防治青海省貴德病區兒童大骨節病效果觀察.地方病通報, 2004, 19(4):62-64.
31. 蔡連文, 張玉龍.亞硒酸鈉治療兒童大骨節病40例X線效果觀察.社區醫學雜志, 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. 熊詠民, 王治倫, 代曉霞, 等.人微小病毒B19及硒與大骨節病關系的研究.西安交通大學學報(醫學版), 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. 賀幼平, 朱蓮珍.膳食中維生素E對克山病區糧飼養的大鼠硒代謝的影響.營養學報, 1988, 10(1):16-21.
37. 徐剛要, 呂曉婭, 曹小剛.陜西省大骨節病國家監測點19年監測結果分析.中國地方病防治雜志, 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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