{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T23:58:58Z","timestamp":1784591938545,"version":"3.55.0"},"reference-count":46,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2018,1,22]]},"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To compare the effectiveness of five kinds of selenium supplementation for the treatment of patients with Kashin-Beck disease, and rank these selenium supplementations based on their performance.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>We searched for all publications between 1 January 1966 and 31 March 2017 using seven electronic databases. GRADE system to network meta-analyses (NMAs) was applied to rate the quality of the evidence. We conducted a random effects model NMA in STATA 12.1 to determine comparative effectiveness of each intervention. Rankings were obtained by using the surface under the cumulative ranking curve (SUCRA) values and mean ranks.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 15 randomised controlled trials involving 2931 patients were included. After assessment of the overall quality of the evidence, we downgraded our primary outcomes from high to low or very low quality. NMAs showed that all five kinds of selenium supplementation had higher metaphysis X-ray improvement which were superior to placebo. Ranking on efficacy indicated that selenium salt was ranked the highest, followed by sodium selenite + vitamin E, selenium enriched yeast, sodium selenite and then sodium selenite + vitamin C.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Based on the results of NMA, all five types of selenium supplements are more effective than placebo and so that selenium supplementation is of help in repairing metaphyseal lesions. Since the overall quality of the evidence was low or very low, the SUCRA values may be misleading and should be considered jointly with the The Grading of Recommendations Assessment, Development and Evaluation (GRADE) confidence in the estimates for each comparison. The quality of the evidence is insufficient to draw a conclusion about what method of selenium supplementation is most effective.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>PROSPERO registration number<\/jats:title>\n                  <jats:p>\n                     <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/www.crd.york.ac.uk\/PROSPERO\/display_record.php?ID=CRD42016051874\" ext-link-type=\"uri\">CRD42016051874<\/jats:ext-link>.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2017-017883","type":"journal-article","created":{"date-parts":[[2018,3,6]],"date-time":"2018-03-06T08:05:18Z","timestamp":1520323518000},"page":"e017883","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":32,"title":["Effects of five types of selenium supplementation for treatment of Kashin-Beck disease in children: a systematic review and network meta-analysis"],"prefix":"10.1136","volume":"8","author":[{"given":"Dongmei","family":"Xie","sequence":"first","affiliation":[{"name":"National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University"},{"name":"Department of Geriatrics, West China Hospital, Sichuan University, Chengdu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yulin","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, West China Hospital, Sichuan University, Chengdu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jirong","family":"Yue","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University"},{"name":"Department of Geriatrics, West China Hospital, Sichuan University, Chengdu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao","family":"Zhang","sequence":"additional","affiliation":[{"name":"Center for Evidence-based Medicine and Clinical Research, Taihe Hospital, Hubei University of Medicine, Shiyan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanyan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, West China Hospital, Sichuan University, Chengdu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuanyao","family":"Deng","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, West China Hospital, Sichuan University, Chengdu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, West China Hospital, Sichuan University, Chengdu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,3,6]]},"reference":[{"key":"2025101813564775000_8.3.e017883.1","doi-asserted-by":"publisher","DOI":"10.1007\/s002640050139"},{"key":"2025101813564775000_8.3.e017883.2","first-page":"343","article-title":"The history of Kashin-Beck disease","volume":"89","author":"Sokoloff","year":"1989","journal-title":"N Y State J Med"},{"key":"2025101813564775000_8.3.e017883.3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3109\/03009749409117126","article-title":"Kashin-Beck disease. An analysis of research and public health activities based on a bibliography 1849-1992","volume":"99","author":"Allander","year":"1994","journal-title":"Scand J Rheumatol Suppl"},{"key":"2025101813564775000_8.3.e017883.4","unstructured":"P. R. C. Ministry of Health. The prevention and control status of Kaschin-Beck disease in 2011.. 2012 http:\/\/www.nhfpc.gov.cn\/htmlfiles\/zwgkzt\/ptjnj\/year2012\/index2012.html"},{"key":"2025101813564775000_8.3.e017883.5","doi-asserted-by":"publisher","DOI":"10.1007\/s002640100248"},{"key":"2025101813564775000_8.3.e017883.6","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1080\/15287399209531597","article-title":"Study on the pathogenic factors of Kashin-Beck disease","volume":"35","author":"Peng","year":"1992","journal-title":"J Toxicol Environ Health"},{"key":"2025101813564775000_8.3.e017883.7","doi-asserted-by":"crossref","first-page":"1409","DOI":"10.1007\/s00264-010-1062-0","article-title":"Efficacy of celecoxib, meloxicam and paracetamol in elderly Kashin-Beck disease (KBD) patients","volume":"35","author":"Luo","year":"2011","journal-title":"Int Orthop"},{"key":"2025101813564775000_8.3.e017883.8","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1016\/j.joca.2014.04.012","article-title":"Evaluation of the therapeutic effect of treatment with intra-articular hyaluronic acid in knees for Kashin-Beck disease: a meta-analysis","volume":"22","author":"Yu","year":"2014","journal-title":"Osteoarthritis Cartilage"},{"key":"2025101813564775000_8.3.e017883.9","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1007\/s002640000206","article-title":"Effects of physical therapy on patients with Kashin-Beck disease in Tibet","volume":"25","author":"Mathieu","year":"2001","journal-title":"Int Orthop"},{"key":"2025101813564775000_8.3.e017883.10","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1016\/j.joca.2012.03.013","article-title":"Chondroitin sulfate and\/or glucosamine hydrochloride for Kashin-Beck disease: a cluster-randomized, placebo-controlled study","volume":"20","author":"Yue","year":"2012","journal-title":"Osteoarthritis Cartilage"},{"key":"2025101813564775000_8.3.e017883.11","unstructured":"Zhongmin T , Yang L , Zhou J , et al . Comparison of treatment results of arthroscopic knee debridement alone with a combination of arthroscopic debridement and drilling decompression in knee Kaschin-Beck disease (in Chinese). Chin J Endo 2009:371\u20134."},{"key":"2025101813564775000_8.3.e017883.12","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1007\/s002640050215","article-title":"Osteotomy at the knee for advanced cases of Kashin-Beck disease","volume":"22","author":"Liu","year":"1998","journal-title":"Int Orthop"},{"key":"2025101813564775000_8.3.e017883.13","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2014.07.023"},{"key":"2025101813564775000_8.3.e017883.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2008.06.011"},{"key":"2025101813564775000_8.3.e017883.15","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1016\/j.joca.2012.02.012","article-title":"Sodium selenite for treatment of Kashin-Beck disease in children: a systematic review of randomised controlled trials","volume":"20","author":"Jirong","year":"2012","journal-title":"Osteoarthritis Cartilage"},{"key":"2025101813564775000_8.3.e017883.16","unstructured":"National Health and Family Planning Commission of the People\u2019s Republic of China. Diagnostic criteria of Kashin-Beck disease (GB16003-1995). 1995 (accessed 15 Dec 1995)."},{"key":"2025101813564775000_8.3.e017883.17","first-page":"378","article-title":"The effect of the treatment of Kaschin Beck disease (in Chinese)","volume":"15","author":"Liang","year":"1996","journal-title":"Chin J Endo"},{"key":"2025101813564775000_8.3.e017883.18","unstructured":"Higgins J , Green S . Cochrane handbook for systematic reviews of interventions (version 5.1.0). London, UK: The Cochrane Collaboration, 2011. http:\/\/www.cochrane-handbook.org"},{"key":"2025101813564775000_8.3.e017883.19","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.g5630"},{"key":"2025101813564775000_8.3.e017883.20","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2008.10.013"},{"key":"2025101813564775000_8.3.e017883.21","doi-asserted-by":"publisher","DOI":"10.1002\/sim.6188"},{"key":"2025101813564775000_8.3.e017883.22","unstructured":"Niu GH , Zhang BH , Song ZY , et al . An observation study on effect of oral sodium selenite for prevention and treatment of kashin-beck effect (in Chinese). Heilongjiang Med J 1981:15\u201317."},{"key":"2025101813564775000_8.3.e017883.23","first-page":"145","article-title":"The Yongshou Scientific Survey Group of Kaschin-Beck Disease. Effect and mechanism of seleniumin the prevention and cure of 424 Kaschin-Beck\u2019s patients (in Chinese)","volume":"1","year":"1982","journal-title":"Chin J Endemiol"},{"key":"2025101813564775000_8.3.e017883.24","first-page":"204","article-title":"Dynamic observation of sodium selenite and vitamin E in the treatment of Kashin Beck disease (in Chinese)","volume":"2","author":"Wang","year":"1983","journal-title":"Chin J Endemiol"},{"key":"2025101813564775000_8.3.e017883.25","first-page":"63","article-title":"An observation on effect of the treatment of Kaschin-Beck disease using Vitamin C or sodium selenite (in Chinese)","volume":"1","author":"Cui","year":"1984","journal-title":"End Dis Bull"},{"key":"2025101813564775000_8.3.e017883.26","first-page":"199","article-title":"Results of study of two years on the preventing and controlling Kashin-Beck\u2019s disease with selenium seen under X-rays and discussion of etiology (in Chinese)","volume":"3","author":"Niu","year":"1984","journal-title":"Chin J Endemiol"},{"key":"2025101813564775000_8.3.e017883.27","unstructured":"Guo LB , Lu Q , Tang HF , et al . An one year observation by X-ray on effect of the treatment of Kaschin-Beck disease using oral sodium selenite (in Chinese). J Chengde Univ Med Sci 1985:67\u201370."},{"key":"2025101813564775000_8.3.e017883.28","first-page":"16","article-title":"One year of observation on effect of selenium enriched yeast for treatment of Kaschin Beck disease (in Chinese)","volume":"5","author":"Guo","year":"1986","journal-title":"Chin J Endemiol"},{"key":"2025101813564775000_8.3.e017883.29","first-page":"16","article-title":"Study of two years on the preventing and controlling Kashin-Beck\u2019s disease with oral sodium selenite seen under X-rays (in Chinese)","volume":"1","author":"Niu","year":"1986","journal-title":"J Pract Endemio"},{"key":"2025101813564775000_8.3.e017883.30","first-page":"210","article-title":"An observation by X-ray on effect of the prevention and treatment of Kaschin-Beck disease using oral sodium selenite (in Chinese)","volume":"5","author":"Qx","year":"1986","journal-title":"Chin J Endemiol"},{"key":"2025101813564775000_8.3.e017883.31","first-page":"117","article-title":"Effect of sodium selenite oral application on Kashin-Beck disease, a three years observation (in Chinese)","volume":"7","author":"Deng","year":"1988","journal-title":"Chin J Endemiol"},{"key":"2025101813564775000_8.3.e017883.32","unstructured":"Niu GH , Zhang BZ , Hou SF . Effect of semis-dosage selenium on controlling of Kashin-Beck disease (in Chinese). Chin J Endemiol 1990:99\u2013100."},{"key":"2025101813564775000_8.3.e017883.33","unstructured":"Zhou XK , Wang WL , Wang EQ , et al . The observation on effecto of selenium and vitamin C for treating Kaschin Beck disease (in Chinese). End Dis Bull 1991:100\u20133."},{"key":"2025101813564775000_8.3.e017883.34","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1093\/ajcn\/78.1.137","article-title":"Selenium and iodine supplementation of rural Tibetan children affected by Kashin-Beck osteoarthropathy","volume":"78","author":"Moreno-Reyes","year":"2003","journal-title":"Am J Clin Nutr"},{"key":"2025101813564775000_8.3.e017883.35","first-page":"343","article-title":"A comparative research on the treatment effect of Se supplement, Vit C supplement and cereals dryness on Kaschin -Beck disease (in Chinese)","volume":"18","author":"Chen","year":"2003","journal-title":"Chin J Endemiol"},{"key":"2025101813564775000_8.3.e017883.36","first-page":"60","article-title":"An observation by X-ray on effect of selenium in the treatment of 40 Kaschin-Beck children (in Chinese)","volume":"3","author":"Cai","year":"2005","journal-title":"J Comm Med"},{"key":"2025101813564775000_8.3.e017883.37","doi-asserted-by":"publisher","DOI":"10.1016\/j.nut.2011.03.002"},{"key":"2025101813564775000_8.3.e017883.38","first-page":"1421","article-title":"Correlation between selenium and Kaschin-Beck disease: a meta-analysis (in Chinese)","volume":"13","author":"Wang","year":"2013","journal-title":"Chin J Evid Based Med"},{"key":"2025101813564775000_8.3.e017883.39","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1007\/s12011-015-0437-x","article-title":"Salt-Rich selenium for prevention and control children with kashin-beck disease: a meta-analysis of community-based trial","volume":"170","author":"Yu","year":"2016","journal-title":"Biol Trace Elem Res"},{"key":"2025101813564775000_8.3.e017883.40","unstructured":"Guo X , Ding D , Wang Z , et al . A study on the reparative action of x-ray lesions in metaphyses and distal end of bone in children\u2019s fingers with kashin-beck disease treated by se-fortified wheat (in Chinese). Chin J Ctrl Endem Dis 1990:269\u201372."},{"key":"2025101813564775000_8.3.e017883.41","first-page":"299","article-title":"Effect of applying selenium fertilizer to improve soil and increase selenium level in food for prevention and treatment of Kaschin-Beck disease (in Chinese)","volume":"5","author":"Chen","year":"1993","journal-title":"J Env Sci"},{"key":"2025101813564775000_8.3.e017883.42","unstructured":"Gy X , Xy L , Cao XG . Analysis on monitoring data of Kaschin-Beck disease in Shannxi province during 19 years (in Chinese). Chin J Contr End Dis 2009:442\u20136."},{"key":"2025101813564775000_8.3.e017883.43","doi-asserted-by":"crossref","first-page":"6195","DOI":"10.3390\/nu7085276","article-title":"Is it the appropriate time to stop applying selenium enriched salt in Kashin-Beck disease areas in China?","volume":"7","author":"Ning","year":"2015","journal-title":"Nutrients"},{"key":"2025101813564775000_8.3.e017883.44","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199810153391604"},{"key":"2025101813564775000_8.3.e017883.45","first-page":"538","article-title":"bone, and articular cartilage in rats","volume":"10","author":"Sasaki","year":"1994","journal-title":"Nutrition"},{"key":"2025101813564775000_8.3.e017883.46","first-page":"225","article-title":"Effect of iodine deficiency on craniofacial growth in young common marmosets (Callithrix jacchus)","volume":"8","author":"Goss","year":"1988","journal-title":"J Craniofac Genet Dev Biol"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2017-017883","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T20:56:56Z","timestamp":1760821016000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2017-017883"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,3]]},"references-count":46,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2018,3,6]]},"published-print":{"date-parts":[[2018,3]]}},"alternative-id":["10.1136\/bmjopen-2017-017883"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2017-017883","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,3]]}}}