Association between serum selenium level and type 2 diabetes mellitus: a non-linear dose–response meta-analysis of observational studies

BACKGROUND The association between serum selenium levels and type 2 diabetes mellitus (T2DM) is controversial. We performed a systematic review and non-linear dose-response meta-analysis of observational studies to investigate the association in the present study. METHODS A comprehensive literature search was conducted using MEDLINE and EMBASE databases. A pooled odds ratio (OR) and related 95 % confidence interval (95 % CI) for T2DM between the highest and lowest serum selenium categories, and a non-linear dose-response relationship between selenium and T2DM were estimated. RESULTS A total of five studies (of 13,460 participants) were identified as meeting the inclusion criteria. The pooled OR indicated that there was a significantly higher prevalence of T2DM in the highest category of blood selenium compared with the lowest (OR = 1.63, 95 % CI: 1.04-2.56, P = 0.033). Moreover, a significant non-linear dose-response relationship was observed between serum selenium levels and T2DM (P < 0.001). Serum selenium levels were positively associated with T2DM in populations with relatively low serum selenium levels (<97.5 μg/l) and those with high serum selenium levels (>132.5 μg/l). CONCLUSIONS The positive association between serum selenium levels and T2DM existed in populations with relatively low levels and high levels of serum selenium, indicating a likely U-shaped non-linear dose-response relationship between serum selenium and T2DM.