ABSTRACT
BACKGROUND: The role of selenium (Se) in the management of type 2 diabetes mellitus (T2DM) remains unclear. We systematically assessed the effectiveness and safety of Se supplementation in adults with T2DM. METHODS: MEDLINE, EMBASE and the Cochrane Library were searched up to April 2018 for randomised controlled trials (RCTs) evaluating the effectiveness of Se against a comparator on DM-related outcomes. RESULTS: Four RCTs (241 participants) were included. In individual RCTs, Se supplementation significantly reduced fasting insulin levels [mean difference (MD) = -3.6 µIU mL-1 ; 95% confidence interval (CI) = -6.36 to -0.84; MD = -5.8 µIU mL-1 ; 95% CI = -9.23 to -2.37], homeostasis model of assessment-estimated insulin resistance (HOMA-IR) (MD = -1; 95% CI = -1.79 to -0.21; MD = -1.6; 95% CI, -2.58 to -0.62) and homeostasis model of assessment-estimated B cell function (HOMA-B) (MD = -13.6; 95% CI = -23.4 to -3.8; MD = -22.6; 95% CI = -36.39 to -8.81). No effects of Se were noted on most of the other outcomes of interest. None of the RCTs assessed the mortality, diabetes-related complications, non-high-density lipoprotein (non-HDL), blood pressure and health-related quality of life. The impact on HDL and fasting plasma glucose (FPG) was ambiguous. Only one adverse event (nausea) was reported as a reason for discontinuing the intervention; however, among the studies, the reporting was not accurate. Furthermore, only one RCT reported increase in FPG level in the Se group (MD = 36.38 mg dL-1 ; 95% CI = 15.39-57.37). CONCLUSIONS: Currently, there is no evidence to support the effectiveness of Se supplementation in the T2DM population.
Subject(s)
Diabetes Mellitus, Type 2/therapy , Dietary Supplements , Hypoglycemic Agents/administration & dosage , Selenium/administration & dosage , Trace Elements/administration & dosage , Adult , Aged , Aged, 80 and over , Blood Glucose/drug effects , Diabetes Mellitus, Type 2/blood , Fasting/blood , Female , Humans , Insulin Resistance , Male , Middle Aged , Randomized Controlled Trials as Topic , Treatment OutcomeABSTRACT
The purpose of this study was to monitor radiation-induced alterations of the blood-bone marrow barrier (BMB) and the reticuloendothelial system (RES) with AMI-227-enhanced magnetic resonance imaging (MRI). Twenty New Zealand white rabbits (n = 10 following total body irradiation and n = 10 controls) underwent AMI-227-enhanced MRI. Pulse sequences included dynamic fast low-angle shot (FLASH; TR/TE 50/4 msec, flip angle 60 degrees) MRI and static T1- and T2-weighted spin-echo (SE) and turbo-SE sequences of the lumbar spine and sacrum. Bone marrow enhancement was quantified as delta signal intensity (SI) (%) =|[(SIpost - SIpre)/SIpre] x 100%| and compared with histopathology, including iron stains and electron microscopy. Dynamic bone marrow deltaSI (%) data steadily increased up to 10-15 minutes after AMI-227 administration, while blood deltaSI (%) data stayed nearly constant, histologically corresponding to iron oxide leakage into the bone marrow interstitium. This bone marrow contrast enhancement increased significantly following irradiation, corresponding to alterations of the endothelial lining of the bone marrow sinusoids. Late postcontrast images exhibited a significant positive T1 enhancement and negative T2 enhancement of the normal bone marrow, which further increased with irradiation due to increased RES activity. Irradiation-induced changes in bone marrow physiology could be reliably assessed with AMI-227-enhanced MRI.
