1.
Effectiveness and safety of selenium supplementation for type 2 diabetes mellitus in adults: a systematic review of randomised controlled trials.
Stróżyk, A, Osica, Z, Przybylak, JD, Kołodziej, M, Zalewski, BM, Mrozikiewicz-Rakowska, B, Szajewska, H
Journal of human nutrition and dietetics : the official journal of the British Dietetic Association. 2019;(5):635-645
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.
2.
Pharmacological interventions for nonalcoholic fatty liver disease in adults and in children: a systematic review.
Socha, P, Horvath, A, Vajro, P, Dziechciarz, P, Dhawan, A, Szajewska, H
Journal of pediatric gastroenterology and nutrition. 2009;(5):587-96
Abstract
BACKGROUND Uncertainty exists regarding the treatment of patients with nonalcoholic fatty liver disease (NAFLD) who are unable to lose weight and/or change lifestyle. The present study assesses the effectiveness and safety of pharmacological and dietary supplement interventions for NAFLD. METHODS MEDLINE, EMBASE, and the Cochrane Library were searched for randomized controlled trials (RCTs) both in adults and in children. RESULTS Fifteen (2 pediatric patients and 13 adults) RCTs met the inclusion criteria. A significant effect on normalization of alanine transaminase was found in patients treated with metformin compared with vitamin E, and in those treated with high-dose (3 g) carnitine vs diet. In contrast, there was no difference in patients treated with pioglitazone combined with vitamin E versus vitamin E alone, ursodeoxycholic acid (UDCA) combined with vitamin E or alone versus placebo, or UDCA versus combination of vitamin E and vitamin C, and in patients treated with vitamin E, probucol, N-acetylcysteine, low doses of carnitine, or Yo Jyo Shi Ko compared with placebo. Aspartate aminotransferase normalization was significantly higher in those treated with UDCA combined with vitamin E versus UDCA alone or placebo, and in those treated with metformin. Small number of subjects, high drop-out rates, and numerous interventions in 1 study limit the value of many studies. Only 7 RCTs analyzed biopsy specimens, but most of them have significant methodological limitations. Pioglitazone had reduced liver necrosis and inflammation in 1 large study. CONCLUSIONS Limited data do not allow one to draw firm conclusions on the efficacy of various treatments for NAFLD.