Effect of selenium supplementation on cardiometabolic risk factors in polycystic ovary syndrome (PCOS) patients: A systematic review and meta-analysis of randomized clinical trials

Background

Polycystic ovary syndrome (PCOS) has been shown to be associated with cardiometabolic risk factors. Selenium (Se) is a naturally occurring mineral trace element that constitutes an essential component of selenoproteins and plays a vital role in antioxidant defense. This systematic review and meta-analysis aims to assess the effects of selenium supplementation on cardiometabolic risk factors in patients with PCOS.

Methods

MEDLINE, Cochrane Central Register of Controlled Trials, Web of Science, and Scopus databases were searched up to March 2023 for randomized clinical trials that evaluated the effect of oral selenium supplementation on patients with PCOS. We employed a random-effects model to generate pooled estimates and 95% confidence intervals (CI).

Results

Seven trials published between 2015 and 2022 were included. All the included studies were double blind, placebo-controlled trials. Selenium supplementation resulted in a significant decrease in VLDL (SMD = −0.35, 95% CI: −0.65; −0.05), MDA (SMD = −0.89, 95% CI: −1.21; −0.57) and hs-CRP (SMD = −0.38, 95% CI: −0.73; −0.03), as well as a significant increase in QUICKI (SMD = 0.78, 95% CI: 0.47; 1.09). The current meta-analysis did not find any significant changes in FPG, insulin, HOMA-IR, TC, TG, HDL, LDL, TAC, GSH, NO, SHBG, total testosterone, or mFG score for PCOS patients following selenium supplementation compared to placebo.

Conclusion

Selenium supplementation may serve as a good adjunct therapy in patients with PCOS to decrease lipid peroxidation and inflammatory status. Moreover, selenium may improve insulin sensitivity in these patients. However, the overall effects of selenium on all cardiometabolic risk factors in PCOS patients still need to be evaluated through large population and long duration RCTs.