Association of circulating selenium concentration with dyslipidemia: Results from the NHANES

Associations between serum selenium and serum lipids in adolescents aged 12-19: A cross-sectional study

BACKGROUND

Selenium is an essential trace element in the human body and is important in lipid metabolism. Previous studies on the relationship between selenium and serum lipids were almost conducted in adults, and the research conclusions were inconsistent. Evidence linking selenium and lipids in adolescents is very limited. As an important stage of growth and development, studying the effects of trace elements on the body during adolescence is meaningful.

OBJECTIVE

This study examined the association between serum selenium and serum lipids in adolescents aged 12-19.

METHODS

This cross-sectional study analyzed 2209 adolescents aged 12-19 years from NHANES 2011 to 2016. Multiple linear regression analyses were performed to evaluate selenium's association with serum lipids (containing TC, TG, LDL-C, and HDL-C). Moreover, a generalized additive model (GAM) and a fitted smoothing curve (penalized spline method) were conducted to explore the exact curve shape between them.

RESULTS

In the fully adjusted model, it showed a positive association between selenium and TC, TG, LDL-C [TC (β = 0.144 (, 95 % CI (0.084, 0.204), P < 0.001), TG (β = 0.285, 95 % CI (0.134, 0.437), P < 0.001), LDL-C (β = 0.098, 95 % CI (0.022, 0.174), P = 0.011)], whereas a negative association [(β = -0.031, 95 % CI (-0.054, - 0.009), P = 0.006)] between Se and HDL-C. Subgroup analysis showed that the above associations were more significant in females aged 12-19 (P for trend < 0.05). Furthermore, linear associations were performed in Se between TC and LDL-C.

CONCLUSION

This is the first study to find evidence demonstrating associations between serum Se and serum lipids in adolescents aged 12-19. The validation of our findings will require further research.

Associations of blood selenium with dyslipidemia in children and adolescents: a cross-sectional analysis

OBJECTIVE

This study aims to examine the association between blood selenium levels and dyslipidemia in children and adolescents.

METHODS

Data from the National Health and Nutrition Examination Survey (NHANES) 2011-2020 were analyzed, including 8191 participants aged 6-19 years. Dyslipidemia was defined by elevated total cholesterol (TC ≥ 200 mg/dL), lowered high-density lipoprotein cholesterol (HDL-C < 40 mg/dL), or elevated non-HDL-C (≥ 145 mg/dL). Associations between blood selenium levels and dyslipidemia were examined using multivariate logistic regression, linear regression, and restricted cubic spline (RCS) analysis.

RESULTS

The study population had a mean age of 12.33 years, with 51.21 % boys. After adjusting for multiple confounding factors, including dietary selenium intakes and supplementation, higher blood selenium levels were associated with increased odds of dyslipidemia and its components. In the highest quartile of blood selenium (>193.99 μg/L), adjusted odds ratios (ORs) were 1.60 (95 % confidence interval [CI]: 1.23-2.08) for dyslipidemia, 1.70 (95 % CI: 1.19-2.43) for elevated TC, 1.38 (95 % CI: 0.97-1.96) for lowered HDL-C, and 1.73 (95 % CI: 1.20-2.48) for elevated non-HDL-C. A significant nonlinear association was observed, with dyslipidemia prevalence increasing notably above a threshold of 184.28 μg/L (P-nonlinearity=0.02), following a J-shaped curve. Subgroup analysis revealed significant interaction by race (P-interaction=0.02), with non-Hispanic White individuals showing a stronger association (OR=1.83, 95 % CI: 1.19-2.80) compared to other racial groups (OR=1.40, 95 % CI: 1.05-1.88).

CONCLUSION

Elevated blood selenium levels are associated with higher prevalence of dyslipidemia in children and adolescents, particularly among non-Hispanic White individuals. The association is nonlinear, with a notable increase in the prevalence of dyslipidemia observed above a blood selenium level of 184.28 μg/L. These findings suggest a need for further research to understand selenium's role in lipid profiles and its implications for public health.

Association between urinary cobalt exposure and kidney stones in U.S. adult population: results from the National Health and Nutrition Examination Survey

PURPOSE

Heavy metal exposure can cause impaired or reduced pathology in the kidneys, lungs, liver, and other vital organs. However, the relationship between heavy metal exposure and kidney stones has not been determined. The goal of this research was to determine the association between heavy metal exposure and kidney stones in a population of American adults in general.

MATERIALS AND METHODS

We evaluated 29,201 individuals (≥20 years) from the National Health and Nutrition Examination Survey (NHANES). The association between heavy metal exposure and kidney stones was verified by multiple logistic regression and restricted cubic spline (RCS) regression. Dose-response curves were generated to analyze the relationship between heavy metal concentrations and the occurrence of kidney stones. Moreover, we used propensity score matching (PSM) to exclude the effect of confounding variables.

RESULTS

After a rigorous enrollment screening process, we included 8518 participants. Logistic regression showed that urinary cadmium (U-Cd) and urinary cobalt (U-Co) concentrations were significantly different in the kidney stone group before PSM (p < 0.001). Dose-response curves revealed that the occurrence of kidney stones increased significantly with increasing U-Cd and U-Co concentrations. After adjustment for covariates, only biomarkers of U-Co were linked to the occurrence of kidney stones. When the lowest quartile was used as a reference, the 95% confidence intervals (95% CIs) for kidney stones across the other quartiles were 1.015 (0.767-1.344), 1.409 (1.059-1.875), and 2.013 (1.505-2.693) for U-Cos (p < 0.001).

CONCLUSION

In the U.S. population, high U-Co levels are positively correlated with the potential risk of kidney stones.

Oxidative balance score and associations with dyslipidemia and mortality among US adults: A mortality follow-up study of a cross-sectional cohort

BACKGROUND

Oxidative stress has been implicated in the pathogenesis and progression of dyslipidemia. We aimed to investigate the association between the oxidative balance score, and dyslipidemia, as well as to assess the mortality risk associated with oxidative balance score in patients with dyslipidemia.

METHODS

We performed a mortality follow-up study of a cross-sectional cohort of 26,118 adults from the National Health and Nutrition Examination Survey 1999-2018. The total oxidative balance score was calculated by 16 dietary nutrients (dietary oxidative balance score) and four lifestyle factors (lifestyle oxidative balance score). Weighted Cox proportional hazard model was applied to determine the relationship between oxidative balance score and all-cause or cardiovascular disease (CVD) mortality within the dyslipidemia group.

RESULTS

During a median follow-up of 118 months, 2448 all-cause deaths (766 CVD-related) occurred. A significant negative correlation was observed between total oxidative balance score, dietary oxidative balance score, lifestyle oxidative balance score, and dyslipidemia. The multivariable-adjusted odds ratios and 95% CIs for dyslipidemia were 0.86 (0.77-0.97), 0.80 (0.72-0.91), and 0.63 (0.56-0.70), respectively, when comparing the second, third, and fourth quartiles of total oxidative balance score to the reference lowest quartile (P for trend <0.0001). Increasing total oxidative balance score was inversely associated with all-cause (hazard ratio [HR] = 0.98, 95% CI 0.98-0.99) and CVD-specific mortality (HR = 0.98, 95% CI 0.97-0.99) in participants with dyslipidemia.

CONCLUSIONS

Oxidative balance score is inversely associated with dyslipidemia and linked to all-cause and CVD-related mortality, highlighting the potentially protective role of an antioxidant-rich diet against dyslipidemia.

Diet-related inflammation is positively associated with atherogenic indices

Current evidence suggests that non-traditional serum lipid ratios are more effective than traditional serum lipid parameters in predicting vascular diseases, and both of them are associated with dietary patterns. Therefore, this study aimed to investigate the relationship between the dietary inflammatory index (DII) and atherogenic indices using traditional serum lipid parameters (triglyceride (TG), total cholesterol (TC), LDL cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c)) and non-traditional serum lipid ratios (atherogenic index of plasma (AIP), Castelli's index-I (CRI_I), Castelli's index-II (CRI_II), the lipoprotein combination index (LCI), and the atherogenic coefficient (AC)). Basic information from the Ravansar Non-Communicable Diseases cohort study was utilized in the present cross-sectional observational study. The study included 8870 adults aged 35-65 years. A validated food frequency questionnaire (FFQ) was used to measure DII. We compared the distributions of outcomes by DII score groups using multivariable linear regression. The difference between DII score groups was evaluated by the Bonferroni test. The mean ± SD DII was - 2.5 ± 1.43, and the prevalence of dyslipidemia was 44%. After adjusting for age, sex, smoking status, alcohol consumption status, physical activity, systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood sugar (FBS), body mass index (BMI) and socioeconomic status (SES), participants in the highest quartile of DII had a greater risk for CRI_I (β = 0.11, CI 0.05, 0.18), CRI_II (β = 0.06, CI 0.01, 0.11), LCI (β = 0.11, CI 288.12, 8373.11), AC (β = 0.11, CI 0.05, 0.17) and AIP (β = 0.06, CI 0.02, 0.10). Moreover, according to the adjusted logistic regression model, the risk of dyslipidemia significantly increased by 24% (OR: 1.24, 95% CI 1.08-1.41), 7% (OR: 1.07, 95% CI 0.94, 1.21) and 3% (OR: 1.03, 95% CI 0.91, 1.16) in Q4, Q3 and Q2 of the DII, respectively. Finally, diet-related inflammation, as estimated by the DII, is associated with a higher risk of CRI-I, CRI-II, LCI, AC, and AIP and increased odds of dyslipidemia.

Associations Between Individual and Combined Metal Exposures in Whole Blood and Kidney Function in U.S. Adults Aged 40 Years and Older

The effects of metal exposure on kidney function have been reported in previous literature. There is limited and inconsistent information on the associations between individual and combined exposures to metals and kidney function among the middle-aged and older population. The aim of this study was to clarify the associations of exposure to individual metals with kidney function while accounting for potential coexposure to metal mixtures and to evaluate the joint and interactive associations of blood metals with kidney function. A total of 1669 adults aged 40 years and older were enrolled in the present cross-sectional study using the 2015-2016 National Health and Nutrition Examination Survey (NHANES). Single-metal and multimetal multivariable logistic regression models, quantile G-computation, and Bayesian kernel machine regression models (BKMR) were fitted to explore the individual and joint associations of whole blood metals [lead (Pb), cadmium (Cd), mercury (Hg), cobalt (Co), manganese (Mn), and selenium (Se)] with the odds of decreased estimated glomerular filtration rate (eGFR) and albuminuria. A decreased eGFR was defined as an eGFR ≤ 60 mL/min per 1.73 m2, and albuminuria was categorized as a urinary albumin-creatinine ratio (UACR) of ≥ 30.0 mg/g. The results from quantile G-computation and BKMR indicated positive associations between exposure to the metal mixture and the prevalence of decreased eGFR and albuminuria (all P values < 0.05). These positive associations were mainly driven by blood Co, Cd, and Pb. Furthermore, blood Mn was identified as an influential element contributing to an inverse correlation with kidney dysfunction within metal mixtures. Increasing blood Se levels were negatively associated with the prevalence of decreased eGFR and positively associated with albuminuria. In addition, a potential pairwise interaction between Mn-Co on decreased eGFR was identified by BKMR analysis. Findings from our study suggested a positive association between exposure to the whole blood metal mixture and decreased kidney function, with blood Co, Pb, and Cd being the main contributors to this association, while Mn demonstrated an inverse relationship with renal dysfunction. However, as our study was cross-sectional in nature, further prospective studies are warranted to better understand the individual and combined effects of metals on kidney function.

Higher Levels of Blood Selenium are Associated with Higher Levels of Serum Lipid Profile in US Adults with CKD: Results from NHANES 2013-2018

The association between selenium (Se) and lipid profile has been controversial in different populations, and the aim of the study was to investigate the relationship between Se and lipid profile in patients with chronic kidney disease (CKD). A total of 861 US adult patients with CKD (male: female = 404:457) from the National Health and Nutrition Examination Survey database were enrolled in this cross-sectional study. We used smoothing spline plots and multivariate binary logistic regression analyses to elucidate the relationships between blood Se and lipid profile. Multivariate adjusted smoothing spline plots showed that higher levels of blood Se were associated with higher levels of serum remnant cholesterol (RC), total cholesterol (TC), triglycerides (TG), and low-density lipoprotein cholesterol (LDL-C) levels. Threshold and saturation effects were also observed between serum RC, TC, TG, LDL-C, and blood Se. In multivariate binary logistic regression analyses, the fully adjusted model showed that as blood Se increases by every 1 µg/L, the OR of high RC, high TG and high LDL-C in patients was 1.012 (95% CI: 1.001, 1.023 P = 0.046), 1.011 (95% CI: 1.001, 1.021 P = 0.043) and 1.009 (95% CI: 1.003, 1.016 P = 0.012), respectively. Furthermore, stratified analyses showed that the associations between blood Se and high RC/high TG were significantly stronger in patients aged < 65 years. Higher levels of blood Se were associated with increased serum lipid profile levels and increased risk of high RC, high TC, high LDL-C, and low HDL-C dyslipidemia in adult patients with CKD in the US. However, the real associations between blood Se and lipid profiles in this population should be verified in future prospective and randomized trials.

Association between Serum Selenium Levels and Lipids among People with and without Diabetes

The current study aimed to examine the association between serum selenium levels and lipids and explore whether the association was modified by diabetic status. A total of 4132 adults from the National Health and Nutrition Examination Survey (2011-2016) were included in this study. Multiple linear regression models were used to estimate the association between serum selenium and lipids. Higher serum selenium levels were significantly associated with increased total cholesterol (TC) (p < 0.001), triglyceride (TG) (p = 0.003), and low-density lipoprotein cholesterol (LDL-C) (p = 0.003) in the overall population. Diabetic status interacted with serum selenium for TC and LDL-C (p for interaction = 0.007 and <0.001). Comparing the highest with the lowest tertiles of serum selenium, the multivariate-adjusted β coefficients (95% CIs) were 17.88 (10.89, 24.87) for TC, 13.43 (7.68, 19.18) for LDL-C among subjects without diabetes, but nonsignificant among those with diabetes. In US adults, the serum selenium was positively associated with lipids and the association was modified by diabetic status. Higher serum selenium levels were significantly associated with increased TC and LDL-C among participants without diabetes, but not among participants with diabetes.

Dose-response relationship of elements with blood lipids and the potential interaction: A cross-sectional study from four areas with different pollution levels in China

BACKGROUND

A growing number of researches indicated the association between plasma trace elements and blood lipids. However, the potential interaction and dose-response relationship were less frequently reported.

METHODS

In this study, a total of 3548 participants were recruited from four counties in Hunan Province, South China. Demographic characteristics were collected by face-to-face interviews and inductively coupled plasma mass spectrometry (ICPMS) was used to determine the levels of 23 trace elements in plasma. We applied a fully adjusted generalized linear regression model (GLM) and a multivariate restricted cubic spline (RCS) to estimate the correlation, dose-response relationship and possible interaction between 23 trace elements and four blood lipid markers.

RESULTS

The results indicated positive dose-response relationships of plasma ⁶⁶zinc with triglycerides (TG) and low density lipoprotein cholesterol (LDL-C), plasma ⁷⁸selenium with LDL-C and total cholesterol (TCH), and plasma ⁵⁹cobalt with high-density lipoprotein cholesterol (HDL-C). There was a negative dose-response relationship between ⁵⁹cobalt and LDL-C. Further analysis found that ⁶⁶zinc and ⁵⁹cobalt had an antagonistic effect on the risk of increased LDL-C level.

CONCLUSIONS

This study added new evidence for the potential adverse effects of ⁶⁶Zn and ⁷⁸Se on blood lipids, and provided new insight into the threshold value setting for metals as well as the intervention strategy for dyslipidemia.

Uncovering the Relationship between Selenium Status, Age, Health, and Dietary Habits: Insights from a Large Population Study including Nonagenarian Offspring from the MARK-AGE Project

An inadequate selenium (Se) status can accelerate the aging process, increasing the vulnerability to age-related diseases. The study aimed to investigate plasma Se and Se species in a large population, including 2200 older adults from the general population (RASIG), 514 nonagenarian offspring (GO), and 293 GO Spouses (SGO). Plasma Se levels in women exhibit an inverted U-shaped pattern, increasing with age until the post-menopausal period and then declining. Conversely, men exhibit a linear decline in plasma Se levels with age. Subjects from Finland had the highest plasma Se values, while those from Poland had the lowest ones. Plasma Se was influenced by fish and vitamin consumption, but there were no significant differences between RASIG, GO, and SGO. Plasma Se was positively associated with albumin, HDL, total cholesterol, fibrinogen, and triglycerides and negatively associated with homocysteine. Fractionation analysis showed that Se distribution among plasma selenoproteins is affected by age, glucometabolic and inflammatory factors, and being GO or SGO. These findings show that sex-specific, nutritional, and inflammatory factors play a crucial role in the regulation of Se plasma levels throughout the aging process and that the shared environment of GO and SGO plays a role in their distinctive Se fractionation.

Biological Activity of Selenium and Its Impact on Human Health

Selenium (Se) is a naturally occurring metalloid element essential to human and animal health in trace amounts but it is harmful in excess. Se plays a substantial role in the functioning of the human organism. It is incorporated into selenoproteins, thus supporting antioxidant defense systems. Selenoproteins participate in the metabolism of thyroid hormones, control reproductive functions and exert neuroprotective effects. Among the elements, Se has one of the narrowest ranges between dietary deficiency and toxic levels. Its level of toxicity may depend on chemical form, as inorganic and organic species have distinct biological properties. Over the last decades, optimization of population Se intake for the prevention of diseases related to Se deficiency or excess has been recognized as a pressing issue in modern healthcare worldwide. Low selenium status has been associated with an increased risk of mortality, poor immune function, cognitive decline, and thyroid dysfunction. On the other hand, Se concentrations slightly above its nutritional levels have been shown to have adverse effects on a broad spectrum of neurological functions and to increase the risk of type-2 diabetes. Comprehension of the selenium biochemical pathways under normal physiological conditions is therefore an important issue to elucidate its effect on human diseases. This review gives an overview of the role of Se in human health highlighting the effects of its deficiency and excess in the body. The biological activity of Se, mainly performed through selenoproteins, and its epigenetic effect is discussed. Moreover, a brief overview of selenium phytoremediation and rhizofiltration approaches is reported.

Association of Urinary Zinc Concentrations with Dyslipidemia and Its Subtypes: Baseline Data from the Chinese Multi-Ethnic Cohort (CMEC) Study

This study elucidates the association between urinary zinc concentration and the risk of developing dyslipidemia and its subtypes in China's ethnic minority residents. Based on the baseline survey data of the Chinese Multi-Ethnic Cohort (CMEC) study, 10,620 subjects were included in the study. Logistic regression analysis evaluated the relationship between urinary zinc concentration and dyslipidemia and its subtypes. After adjustment, compared with urinary zinc concentration quartile 1 (Q1), the odds ratios (ORs) and 95% confidence intervals (95% CIs) of dyslipidemia participants in the quartile 2 (Q2), quartile 3 (Q3), and quartile 4 (Q4) groups were 1.091 (0.963, 1.237), 1.151 (1.051, 1.304), and 1.393 (1.230, 1.579), respectively (P for trend < 0.001). While that of hypertriglyceridemia participants in the Q2, Q3, and Q4 groups were 1.130 (0.979, 1.306), 1.283 (1.113, 1.480), and 1.483 (1.287, 1.709), respectively (P for trend < 0.001). Lastly, the ORs and 95% CIs of hyperbetalipoproteinemia participants in the Q2, Q3, and Q4 groups were 1.166 (0.945, 1.439), 1.238 (1.007, 1.522), and 1.381 (1.126, 1.695), respectively (P for trend < 0.002). This study found that urinary zinc concentrations were not associated with hypercholesterolemia and hypoalphalipoproteinemia. The dose-response relationship was non-linear between urinary zinc concentration and dyslipidemia, hypertriglyceridemia and hyperbetalipoproteinemia (P for trend < 0.001). In the stratified analysis, urinary zinc levels were positively associated with the risk of dyslipidemia, hypertriglyceridemia, and hyperbetalipoproteinemia in male, ≥ 60 years old, Miao nationality, hypertension, diabetes, and BMI ≥ 24.0 kg/m² subgroups. Our study provides some possible evidence that elevated urinary zinc concentrations are associated with an increased risk of dyslipidemia, hypertriglyceridemia, hyperbetalipoproteinemia.

Association of Remnant Cholesterol and Non-High Density Lipoprotein Cholesterol with Risk of Cardiovascular Mortality Among US General Population

Background

There are strong association between remnant cholesterol (RC)/non-high density lipoprotein cholesterol (NHDL-C) and increase cardiovascular (CV) risk. The aim of present study was to investigate the association between target lipid parameters (RC and NHDL-C) and the risk of CV mortality in general population.

Methods

Data set from an open database—National Health and Nutrition Examination Surveys (NHANES) 2003–2014 were extracted (n = 14992). Kaplan-Meier, multivariable COX regression, and restricted cubic spline (RCS) parameters.

Results

Compared to the lowest quartile, RC (adjusted hazard ratio [HR] = 1.63 95%CI 1.05–2.52, P for trend = 0.037) and triglycerides (TG: Model 3: HR = 1.69 95%CI 1.10–2.60, P for trend = 0.049) in the highest quartile were independently associated with the increased cardiovascular mortality, while NHDL-C and apolipoprotein B (ApoB) in adjusted models did not show association (P for trend >0.05). In addition, RCS regression demonstrated that RC (P for nonlinearity = 0.011) and TG (P for nonlinearity = 0.010) levels had a similar J-shape association with CV mortality. Threshold effect analysis showed that when RC ≤ 29.3 mg/dL, the level of RC and CV mortality risk were positively correlated.

Conclusions

Our findings suggest high RC levels are associated with an increased risk of CV mortality, which support that the integration of TG-rich lipoproteins parameters in risk assessment might optimize the identification and management of selected population.

A Prospective Study of Fruit Juice Consumption and the Risk of Overall and Cardiovascular Disease Mortality

There is little evidence for the association between fruit juice, especially 100% fruit juice, and mortality risk. In addition, whether 100% fruit juice can be a healthy alternative to whole fruit remains uncertain. This prospective study utilized the data from the US National Health and Nutrition Examination Survey (NHANES) from 1999 to 2014. After a median follow-up of 7.8 years, 4904 deaths among 40,074 participants aged 18 years or older were documented. Compared to non-consumption, daily consumption of 250 g or more of 100% fruit juice was associated with higher overall mortality (hazard ratio (HR) = 1.30, 95% confidence interval (CI): 1.11–1.52) and mortality from heart disease (HR = 1.49, 95 CI: 1.01–2.21). A similar pattern was observed for total fruit juice, with HRs of 1.28 (95% CI: 1.09–1.49) for overall mortality and 1.48 (95% CI: 1.01–2.17) for heart disease mortality. Replacing 5% of energy from whole fruit with 100% or total fruit juice was associated with a 9% (95% CI: 2–16%) and 8% (95% CI: 1–15%) increased mortality risk, respectively. Our findings suggest that both total and 100% fruit juice could be associated with high mortality risk, and need to be validated in well-designed studies given the potential misclassification of diet and death reasons.

Selenium nutritional status and its association with SLEDAI-2K, HOMA-IR and lipid profile in Juvenile Systemic Lupus Erythematosus patients

OBJECTIVES

To assess nutritional status regarding selenium in adolescents with Juvenile Systemic Lupus Erythematosus (jSLE) and analyze possible associations with disease activity, insulin resistance and lipid profile.

METHODS

This was an observational, cross-sectional study of 31 female adolescents with jSLE and 31 healthy female volunteers as a comparison group. We obtained demographic, anthropometric (weight, stature, waist, and neck circumferences), and clinical data (disease activity measured by SLEDAI-2K) from both groups; laboratory data including: lipid profile, plasma selenium, erythrocyte glutathione peroxidase activity (GPx), plasma malondialdehyde (MDA), ultrasensitive C-reactive protein (usCRP), insulin levels, and glycemia (Homeostasis Model Assessment for Insulin Resistance-HOMA-IR).

RESULTS

Mean age at diagnosis of jSLE group was 15.9±1.7 years, with mean disease duration of 3.6±2.6 years. 48% of patients and controls had below-reference Se levels (≤46mcg/L). GPx was more frequently below reference levels (<4.171U/L) in the jSLE group, compared to controls. A ROC curve was used to assess the power of the variables to discriminate between both groups; insulin (AUC = 0.712; CI 95% 0.584-0.840), waist-to-height ratio (AUC = 0.704; CI 95% 0.572-0.837), and HOMA-IR (AUC = 0.689; CI 95% 0.556-0.822) were the variables with the greatest discriminatory power. Linear regression showed an independent inverse association between Se levels and c-LDL; no such correlation was found for GPx activity. SLEDAI-2 K and HOMA-IR showed no association with levels of Se and GPx activity.

CONCLUSIONS

Approximately, 50% of jSLE adolescents had below reference Se levels. The frequency of inadequate GPx values was higher in patients, compared to controls. There was an independent inverse association between Se and c-LDL levels in both groups; this was not the case for HOMA-IR and SLEDAI-2K. The data show the importance of assessing Se nutritional status in jSLE patients.

Association of blood cobalt concentrations with dyslipidemia, hypertension, and diabetes in a US population: A cross-sectional study

Various heavy metal elements in the human body have been reported to be associated with dyslipidemia, hypertension, and diabetes. The role of cobalt in these conditions is unclear. The current study aimed to investigate the association of blood cobalt concentrations with dyslipidemia, hypertension, and diabetes.Using the data collected from the National Health and Nutrition Examination Survey (2015-2018), we performed logistic regression to explore the association of blood cobalt concentrations with total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides, hypertension, and diabetes.A total of 6866 adults were included in this study. Participants with higher blood cobalt levels appeared to be older and have a lower body mass index and, were more likely to be female (P for trend < .05). After fully adjusting for demographic characteristics (Model 2), compared with the lowest quartile, the highest quartile of blood cobalt concentrations had lower odds ratios (ORs) for elevated TC [OR: 0.62, 95% confidential interval (CI): 0.53 to 0.72, P < .001], elevated LDL-C (OR: 0.65, 95% CI: 0.53-0.80, P < .001) and low HDL-C (OR: 0.81, 95% CI: 0.69-0.96, P = .013). The adjusted ORs for elevated TC, elevated LDL-C and low HDL-C were negatively correlated with increased blood cobalt concentrations (P for trend < .05). The adjusted ORs for hypertension and diabetes were not associated with blood cobalt concentrations (P > .05 and P for trend > .05).In conclusion, higher blood cobalt concentrations were associated with a lower risk of dyslipidemia. However, blood cobalt concentrations were not associated with the risk of hypertension or diabetes.

The Impact of Selenium Supplementation on Trauma Patients-Systematic Review and Meta-Analysis

This study aimed to assess current evidence regarding the effect of selenium (Se) supplementation on the prognosis in patients sustaining trauma. MEDLINE, Embase, and Web of Science databases were searched with the following terms: “trace element”, “selenium”, “copper”, “zinc”, “injury”, and “trauma”. Seven studies were included in the meta-analysis. The pooled results showed that Se supplementation was associated with a lower mortality rate (OR 0.733, 95% CI: 0.586, 0.918, p = 0.007; heterogeneity, I² = 0%). Regarding the incidence of infectious complications, there was no statistically significant benefit after analyzing the four studies (OR 0.942, 95% CI: 0.695, 1.277, p = 0.702; heterogeneity, I² = 14.343%). The patients with Se supplementation had a reduced ICU length of stay (standard difference in means (SMD): −0.324, 95% CI: −0.382, −0.265, p < 0.001; heterogeneity, I² = 0%) and lesser hospital length of stay (SMD: −0.243, 95% CI: −0.474, −0.012, p < 0.001; heterogeneity, I² = 45.496%). Se supplementation after trauma confers positive effects in decreasing the mortality and length of ICU and hospital stay.

Association of allelic combinations in selenoprotein and redox related genes with markers of lipid metabolism and oxidative stress - multimarkers analysis in a cross-sectional study

BACKGROUND

Selenium (Se) and selenoproteins have been shown to be involved in lipid metabolism mainly due to their ability to modulate redox homeostasis in adipose tissue. The underlying mechanisms are yet to be evaluated. In the light of few data related to the association between polymorphic variants of selenoprotein encoding genes and metabolic syndrome or obesity in humans, the role of selenoprotein polymorphisms in lipid metabolism remains unclear. The aim of this study was to investigate the impact of allelic combination within selenoprotein and redox related genes on the markers of lipid metabolism and oxidative stress.

METHODS

The study comprised 441 healthy individuals from Poland, in the 18-74 year age group. Allelic combinations were investigated within the polymorphic variants of four selenoprotein encoding genes (GPX1 rs1050450, GPX4 rs713041, SELENOP rs3877899 and SELENOF rs5859) and the redox related gene (SOD2 rs4880). The impact of the most common allelic GPX1-GPX4-SELENOP-SELENOF-SOD2 combinations was assessed on the following markers: triglycerides (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), glutathione peroxidase activities (GPX1, GPX3), lipid peroxidation (as TBARS), ceruloplasmin (Cp) and superoxide dismutase 1 (SOD1).

RESULTS

Multivariable analysis revealed significant associations between three allelic combinations and markers of lipid metabolism, including HDL-C and TC/HDL-C ratio (AAAAa), LDL-C (aaAaa), and triglycerides (aaaaA), whereas two allelic combinations (aAaAA, aaaAA) were associated with GPX3 activity.

CONCLUSION

This study confirms the possible implication of selenoproteins in lipid metabolism and warrants further research on specific allele combinations within selenoprotein and redox related genes in order to identify functional genetic combinations linked to metabolic phenotype.

The role of selenium in type-2 diabetes mellitus and its metabolic comorbidities

This review addresses the role of the essential trace element, selenium, in type-2 diabetes mellitus (T2DM) and its metabolic co-morbidities, i.e., metabolic syndrome, obesity and non-alcoholic fatty liver disease. We refer to the dietary requirements of selenium and the key physiological roles of selenoproteins. We explore the dysregulated fuel metabolism in T2DM and its co-morbidities, emphasizing the relevance of inflammation and oxidative stress. We describe the epidemiology of observational and experimental studies of selenium in diabetes and related conditions, explaining that the interaction between selenium status and glucose control is not limited to hyperglycemia but extends to hypoglycemia. We propose that the association between high plasma/serum selenium and T2DM/fasting plasma glucose observed in many cross-sectional studies may rely on the upregulation of hepatic selenoprotein-P biosynthesis in conditions of hyperglycemia and insulin resistance. While animal studies have revealed potential molecular mechanisms underlying adverse effects of severe selenium/selenoprotein excess and deficiency in the pathogenesis of insulin resistance and β-cell dysfunction, their translational significance is rather limited. Importantly, dietary selenium supplementation does not appear to be a major causal factor for the development of T2DM in humans though we cannot currently exclude a small contribution of selenium on top of other risk factors, in particular if it is ingested at high (supranutritional) doses. Elevated selenium biomarkers that are often measured in T2DM patients are more likely to be a consequence, rather than a cause, of diabetes.

A Functional Variant in SEPP1 Interacts With Plasma Selenium Concentrations on 3-Year Lipid Changes: A Prospective Cohort Study

Background: Excess selenium has been related with adverse lipid levels in previous epidemiological studies. Meanwhile, a functional variant in SEPP1 (encodes selenoprotein P), namely rs7579, has been suggested to modulate lipid metabolism. However, the interactions between selenium status and rs7579 polymorphism on lipid changes remain unclear.

Objective: To examine whether the associations between plasma selenium and 3-year lipid changes is modified by rs7579 polymorphism.

Methods: A prospective cohort study was conducted among 1,621 individuals to examine the associations between baseline plasma selenium and 3-year lipid changes, as well as the interactions between plasma selenium and rs7579 polymorphism on lipid changes.

Results: The median (interquartile range) concentration of plasma selenium was 91.68 (81.55–104.92) μg/L. Higher plasma selenium was associated with adverse 3-year lipid changes. Comparing the highest to the lowest quartiles of plasma selenium concentrations, 3-year lipid changes were elevated by 8.25% (95% CI: 1.54–14.96%) for triglycerides (P = 0.016), 5.88% (3.13–8.63%) for total cholesterol (P < 0.001), 7.37% (3.07–11.67%) for low-density lipoprotein cholesterol (P = 0.0008), 6.44% (2.66–10.21%) for non-high-density lipoprotein cholesterol (P = 0.0009), 4.99% (0.62–9.36%) for total cholesterol/high-density lipoprotein cholesterol ratio (P = 0.025), and 7.00% (1.55–12.46%) for low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio (P = 0.012). In analyses stratified by rs7579 genotypes, positive associations between plasma selenium concentrations and 3-year changes in triglycerides, TC, LDL-C, non-HDL-C, TC/HDL-C ratio, and LDL-C/HDL-C ratio were observed among CC genotype carriers, but negative associations between plasma selenium and TC/HDL-C ratio, and LDL-C/HDL-C ratio were observed among TT genotype carriers.

Conclusions: Our findings suggested that plasma selenium was associated with 3-year lipid changes differentially by rs7579 genotypes, and higher plasma selenium was associated with adverse lipid changes among rs7579 CC genotype carriers, but not among T allele carriers.

Clinical Relevance of Serum Selenium Levels and Abdominal Aortic Calcification

Selenium (Se) is an essential micronutrient with antioxidative properties, but previous studies have shown that extremely high circulating Se concentrations are associated with a higher prevalence of cardiovascular diseases (CVDs). To date, it remains unknown whether this association has connections with arterial calcification. A total of 982 participants with both serum Se concentration and abdominal aortic calcification (AAC) score data were enrolled from the 2013-2014 National Health and Nutrition Examination Survey (NHANES), a cross-sectional study of a noninstitutionalized population in the USA. Serum Se levels were determined by inductively coupled plasma-dynamic reaction cell-mass spectrometry. AAC was obtained from dual-energy X-ray absorptiometry and quantified by the Kauppila score system. Severe AAC was defined as Kauppila score ≥ 5. Among all participants, the mean serum Se level was 132.89 μg/L. The average AAC score was 1.51, and 11.7% had severe AAC. Compared with those in the lowest quartile of Se (< 121.1 μg/L), the highest quartile subgroup (> 143.1 μg/L) was associated with a higher mean AAC score (β-coefficient 0.88; 95% CI 0.28, 1.47; p = 0.004) and greater odds of having severe AAC (odds ratio 2.19; 95% CI 1.10, 4.36; p = 0.026) after adjusting for demographic, biochemical, and clinical characteristics. The concentrations of other circulating trace elements showed no statistically significant association with the AAC score. High serum Se levels were independently associated with an increased mean AAC score and aggravated AAC severity among noninstitutionalized US adults. Serum Se might adversely affect the cardiovascular system when the serum Se concentration exceeds 143 μg/L.

Associations between Urinary and Dietary Selenium and Blood Metabolic Parameters in a Healthy Northern Italy Population

Selenium is both an essential nutrient and a highly toxic element, depending on its dose and chemical forms. We aimed to quantify urinary selenium excretion and dietary selenium intake in 137 healthy non-smoking blood donors living in the northern Italian province of Reggio Emilia. We assessed selenium status by determining urinary selenium levels (mean 26.77 µg/L), and by estimating dietary selenium intake (mean 84.09 µg/day) using a validated semi-quantitative food frequency questionnaire. Fasting blood levels of glucose, lipids and thyroid-stimulating hormone were measured using automatized laboratory procedures. Dietary and urinary selenium were correlated (beta coefficient (β) = 0.19). Despite this, the association of the two indicators with health endpoints tended to diverge. Using linear regression analysis adjusted for age, sex, body mass index, cotinine levels and alcohol intake, we observed a positive association between urinary selenium and blood triglyceride (β = 0.14), LDL-cholesterol (β = 0.07) and glucose levels (β = 0.08), and an inverse one with HDL-cholesterol (β = −0.12). Concerning dietary selenium, a slightly positive association could be found with glycemic levels only (β = 0.02), while a negative one emerged for other endpoints. The two selenium indicators showed conflicting and statistically highly imprecise associations with circulating TSH levels. Our findings suggest that higher selenium exposure is adversely associated with blood glucose levels and lipid profile. This is the case even at selenium exposures not exceeding tolerable upper intake levels according to current guidelines.

Selenium, Copper, Zinc Concentrations and Cu/Zn, Cu/Se Molar Ratios in the Serum of Patients with Acute Ischemic Stroke in Northeastern Poland-A New Insight into Stroke Pathophysiology

Background: In recent years, trace elements (TEs) have gained considerable attention in the course of treatment and diagnosis of ischemic stroke. The purpose of the conducted research was to determine the trace mineral status (Se, Cu, Zn, Cu/Zn ratio, and Cu/Se ratio) in patients with acute ischemic stroke compared to the population of healthy people in the northeastern region of Poland. Materials and methods: 141 patients with acute ischemic stroke (AIS) and 69 healthy control subjects were examined. The serum concentrations of mineral components were assessed by the atomic absorption spectrometry method. Clinical parameters were updated based on medical records. Results: The serum Se and Zn concentrations were significantly decreased (p < 0.0001; p < 0.0001) in patients with AIS compared with healthy control subjects. However, no significant differences were revealed in terms of the serum Cu concentration (p = 0.283). As expected, we found that the serum Cu/Zn and Cu/Se molar ratios were significantly higher (p = 0.001; p < 0.0001) in patients with AIS compared with healthy control subjects. Conclusions: Disturbed metal homeostasis is a significant contributor to AIS pathogenesis. Furthermore, marked disruption of the serum Cu/Zn and Cu/Se molar ratios could serve as a valuable indicator of AIS patients’ nutritional status and oxidative stress levels.

Dietary selenium intake and risk of hospitalization for type 2 diabetes in the Moli-sani study cohort

BACKGROUND AND AIMS

Experimental and non-experimental human studies have consistently shown a positive association between exposure to the trace element selenium, which occurs primarily through diet, and risk of type 2 diabetes mellitus. Plausible biological mechanisms include adverse effects of selenium and selenium-containing proteins on glucose metabolism. However, the levels of exposure above which risk increases are uncertain.

METHODS AND RESULTS

We examined the association between selenium intake and first hospitalization for type 2 diabetes during a median follow-up period of 8.2 years among 21,335 diabetes-free participants in the Moli-sani cohort, Italy. Selenium intake was ascertained at baseline using a food frequency questionnaire, showing a median value of 59 μg/day. During follow-up, we identified 135 incident cases of hospitalization for diabetes, based on population-based hospital discharge data. We used a Cox proportional hazards model to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for hospitalization for diabetes, adjusting for potential confounders. HRs (95% CIs) were 1.01 (0.60-1.70), 1.13 (0.66-1.96) and 1.75 (0.99-3.10) comparing the second, third, and fourth sex-specific quartiles with the first quartile, respectively. Risk was 64% greater in the fourth quartile as compared with the previous three. Spline regression analysis also indicated a steeper increase in risk occurring among men compared with women.

CONCLUSIONS

In a large population of Italian adults free of type 2 diabetes at cohort entry, high dietary selenium intake was associated with increased risk of hospitalization for diabetes.

Association of serum selenium with anemia-related indicators and risk of anemia

Few studies have examined the association of serum selenium with anemia-related indicators and risk of anemia. We conducted a cross-sectional analysis of 2,902 adults in 2003-2004 National Health and Nutrition Examination Survey database. Multivariable linear and logistic regression models were used to examine the association of serum selenium with anemia-related indicators and risk of anemia. The nonlinear relationship was analyzed using a generalized additive model with the smoothing plot. A total of 1,472 males and 1,430 females with a mean age of 61.94 ± 13.73 years were included. Compared with the lowest quintile, the highest quintile of serum selenium was associated with increased level of serum iron (β = 12.44, 95% confidence interval [CI]: 7.14, 17.75, p < .001), mean corpuscular hemoglobin concentration (MCHC) (β = 0.14, 95%CI: 0.02, 0.26, p = .020), and hemoglobin (β = 0.40, 95%CI: 0.19, 0.61, p < .001), and decreased risk of anemia (odds ratio [OR] = 0.47, 95%CI: 0.28, 0.77, p = .002). Furthermore, smoothed plots suggested the nonlinear relationships between serum selenium and MCHC, hemoglobin level, and risk of anemia. Interestingly, on the left of inflection point, serum selenium was associated with decreased risk of anemia (OR = 0.972, 95%CI: 0.960, 0.985, p < .001), and then, the risk of anemia increased with increasing serum selenium concentration (OR = 1.011, 95%CI: 1.002, 1.021, p = .023). Future large-scale, polycentric prospective studies should be conducted to verify our results.

Selenium levels and glutathione peroxidase activity in patients with ataxia-telangiectasia: association with oxidative stress and lipid status biomarkers

Introduction

Ataxia-Telangiectasia (A-T) is a multi-system disorder that may be associated with endocrine changes, oxidative stress in addition to inflammation. Studies suggest that selenium is a trace element related to protection against damage caused by oxidative stress.

Objective

To describe the plasma levels of selenium and erythrocyte glutathione peroxidase activity in A-T patients and to relate them to oxidative stress and lipid status biomarkers.

Methods

This is a cross-sectional and controlled study evaluating 22 A-T patients (age median, 12.2 years old) matched by gender and age with 18 healthy controls. We evaluated: nutritional status, food intake, plasma selenium levels, erythrocyte glutathione peroxidase activity, lipid status, inflammation and oxidative stress biomarkers.

Results

Adequate levels of selenium were observed in 24/36 (66.7%) in this evaluated population. There was no statistically significant difference between the groups in selenium levels [47.6 μg/L (43.2–57.0) vs 54.6 (45.2–62.6) μg/dL, p = 0.242]. Nine of A-T patients (41%) had selenium levels below the reference value. The A-T group presented higher levels of LDL-c, non-HDL-c, oxidized LDL, Apo B, Apo-B/Apo-A-I1, LDL-c/HDL-c ratio, malondialdehyde [3.8 µg/L vs 2.8 µg/L, p = 0.029] and lower Apo-A-I1/HDL-c and glutathione peroxidase activity [7300 U/L vs 8686 U/L, p = 0.005]. Selenium levels were influenced, in both groups, independently, by the concentrations of oxidized LDL, malonaldehyde and non-HDL-c. The oxidized LDL (AUC = 0.849) and ALT (AUC = 0.854) were the variables that showed the greatest discriminatory power between groups.

Conclusion

In conclusion, we observed the presence of selenium below the reference value in nearly 40% and low GPx activity in A-T patients. There was a significant, inverse and independent association between selenium concentrations and oxidative stress biomarkers. Those data reinforce the importance of assessing the nutritional status of selenium in those patients.

Low-level environmental lead and cadmium exposures and dyslipidemia in adults: Findings from the NHANES 2005-2016

BACKGROUND

Previous experimental and occupational health studies have shown the toxic effects of relatively high-level cadmium and lead on lipid metabolism. However, limited studies investigated the relationships between serum lipid levels and exposure to low-level lead and cadmium in adults.

OBJECTIVE

To investigate the associations between lead and cadmium levels in blood and dyslipidemia in adults.

METHODS

A retrospective cross-sectional study of 7,457 adults aged 20-79 years who were recruited in the National Health and Nutrition Examination Survey (NHANES, 2005-2016) was conducted. Multivariate linear and logistic regressions were used to examine the associations of blood lead and cadmium levels with serum lipid profiles and risk of dyslipidemia, respectively.

RESULTS

The weighted geometric means [95% confidence intervals (CIs)] of lead and cadmium in blood were 1.23 (1.21, 1.25) μg/dL and 0.36 (0.35, 0.37) μg/L, respectively. Blood lead was significantly associated with serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C), and apolipoprotein B (Apo B) levels after adjusting for covariates. Compared with the adults in the lowest blood lead quartile (≤0.76 μg/dL), those in the highest lead quartile (>1.90 μg/dL) had higher risks of elevated TC (OR = 1.88, 95% CI: 1.59-2.22), non-HDL-C (OR = 1.59, 95% CI: 1.33-1.91), LDL-C (OR = 1.68, 95% CI: 1.41-1.99) and Apo B (OR = 2.00, 95% CI: 1.46-2.73). However, the single effect of cadmium exposure and the joint effect of lead and cadmium exposures on dyslipidemia were not observed.

CONCLUSION

Blood lead well below the current recommended level was positively associated with the risk of dyslipidemia in adults, while the low-level cadmium exposure currently observed in adults did not show any significant associations with lipid levels.