Evidence mapPaperPMID 33053149Full record

SynthesisThe American journal of clinical nutrition2020

Selenium, antioxidants, cardiovascular disease, and all-cause mortality: a systematic review and meta-analysis of randomized controlled trials.

David J A Jenkins, David Kitts, Edward L Giovannucci, Sandhya Sahye-Pudaruth, Melanie Paquette, Sonia Blanco Mejia, Darshna Patel, Meaghan Kavanagh, Tom Tsirakis, Cyril W C Kendall and 2 more

Open access · greenAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in The American journal of clinical nutrition, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 74 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
74citing papers in PubMed, 1 pooled it
9.8field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

74 citing papers in PubMed, 1 synthesis or guideline pooled it, 139 citations in OpenAlex.

  1. Antioxidants for adults with chronic kidney disease.The Cochrane database of systematic reviews · 2023
    Pooled it
  2. Trial
  3. Review
  4. Article
  5. Article
  6. Review
  7. Article
  8. Review
  9. Article
  10. Article
  11. Article
  12. Article
  13. Article
  14. Effects and Impact of Selenium on Human Health, A Review.Molecules (Basel, Switzerland) · 2024
    Review
  15. Article
  16. Article
  17. Article
  18. Article
  19. Review
  20. Selenium Species in Diabetes Mellitus Type 2.Biological trace element research · 2024
    Review

14 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 4 institutions in 2 countries.

David J A JenkinsDepartment of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
David KittsFood Nutrition and Health, Faculty of Land and Food Systems, University of British Columbia, Vancouver, British Columbia, Canada.
Edward L GiovannucciDepartment of Nutrition and Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA.
Sandhya Sahye-PudaruthDepartment of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Melanie PaquetteDepartment of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Sonia Blanco MejiaDepartment of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Darshna PatelDepartment of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Meaghan KavanaghDepartment of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Tom TsirakisClinical Nutrition Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Ontario, Canada.
Cyril W C KendallDepartment of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Sathish C PichikaDepartment of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
John L SievenpiperDepartment of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
St. Michael's Hospital · CAHarvard University · USUniversity of British Columbia · CAUniversity of Toronto · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAntioxidants have been promoted for cardiovascular disease (CVD) risk reduction and for the prevention of cancer. Our preliminary analysis suggested that only when selenium was present were antioxidant mixtures associated with reduced all-cause mortality.

objectiveWe conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to determine the effect of selenium supplementation alone and of antioxidant mixtures with or without selenium on the risk of CVD, cancer, and mortality.

methodsWe identified studies using the Cochrane Library, Medline, and Embase for potential CVD outcomes, cancer, and all-cause mortality following selenium supplementation alone or after antioxidant supplement mixtures with and without selenium up to June 5, 2020. RCTs of ≥24 wk were included and data were analyzed using random-effects models and classified by the Grading of Recommendations, Assessment, Development, and Evaluation approach.

resultsThe meta-analysis identified 9423 studies, of which 43 were used in the final analysis. Overall, no association of selenium alone or antioxidants was seen with CVD and all-cause mortality. However, a decreased risk with antioxidant mixtures was seen for CVD mortality when selenium was part of the mix (RR: 0.77; 95% CI: 0.62, 0.97; P = 0.02), with no association when selenium was absent. Similarly, when selenium was part of the antioxidant mixture, a decreased risk was seen for all-cause mortality (RR: 0.90; 95% CI: 0.82, 0.98; P = 0.02) as opposed to an increased risk when selenium was absent (RR: 1.09; 95% CI: 1.04, 1.13; P = 0.0002).

conclusionThe addition of selenium should be considered for supplements containing antioxidant mixtures if they are to be associated with CVD and all-cause mortality risk reduction. This trial was registered at https://www.crd.york.ac.uk/PROSPERO/ as CRD42019138268.

Indexed as

AntioxidantsCardiovascular DiseasesDietary SupplementsHumansRandomized Controlled Trials as TopicSeleniumAntioxidantsSeleniumall-cause mortalityantioxidantscardiovascular diseasemeta-analysisseleniumsupplements

Identifiers

PMID33053149
PMCPMC7727482
OpenAlexW3093118219

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.