Low selenium levels are associated with decreased bone mineral densities

Preventive machine learning models incorporating health checkup data and hair mineral analysis for low bone mass identification

Machine learning (ML) models have been increasingly employed to predict osteoporosis. However, the incorporation of hair minerals into ML models remains unexplored. This study aimed to develop ML models for predicting low bone mass (LBM) using health checkup data and hair mineral analysis. A total of 1206 postmenopausal women and 820 men aged 50 years or older at a health promotion center were included in this study. LBM was defined as a T-score below - 1 at the lumbar, femur neck, or total hip area. The proportion of individuals with LBM was 59.4% (n = 1205). The features used in the models comprised 50 health checkup items and 22 hair minerals. The ML algorithms employed were Extreme Gradient Boosting (XGB), Random Forest (RF), Gradient Boosting (GB), and Adaptive Boosting (AdaBoost). The subjects were divided into training and test datasets with an 80:20 ratio. The area under the receiver operating characteristic curve (AUROC), accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and an F1 score were evaluated to measure the performances of the models. Through 50 repetitions, the mean (standard deviation) AUROC for LBM was 0.744 (± 0.021) for XGB, the highest among the models, followed by 0.737 (± 0.023) for AdaBoost, and 0.733 (± 0.023) for GB, and 0.732 (± 0.021) for RF. The XGB model had an accuracy of 68.7%, sensitivity of 80.7%, specificity of 51.1%, PPV of 70.9%, NPV of 64.3%, and an F1 score of 0.754. However, these performance metrics did not demonstrate notable differences among the models. The XGB model identified sulfur, sodium, mercury, copper, magnesium, arsenic, and phosphate as crucial hair mineral features. The study findings emphasize the significance of employing ML algorithms for predicting LBM. Integrating health checkup data and hair mineral analysis into these models may provide valuable insights into identifying individuals at risk of LBM.

Apoptosis and Inflammation Involved with Fluoride-Induced Bone Injuries

BACKGROUND

Excessive fluoride exposure induces skeletal fluorosis, but the specific mechanism responsible is still unclear. Therefore, this study aimed to identify the pathogenesis of fluoride-induced bone injuries.

METHODS

We systematically searched fluoride-induced bone injury-related genes from five databases. Then, these genes were subjected to enrichment analyses. A TF (transcription factor)-mRNA-miRNA network and protein-protein interaction (PPI) network were constructed using Cytoscape, and the Human Protein Atlas (HPA) database was used to screen the expression of key proteins. The candidate pharmacological targets were predicted using the Drug Signature Database.

RESULTS

A total of 85 studies were included in this study, and 112 osteoblast-, 35 osteoclast-, and 41 chondrocyte-related differential expression genes (DEGs) were identified. Functional enrichment analyses showed that the Atf4, Bcl2, Col1a1, Fgf21, Fgfr1 and Il6 genes were significantly enriched in the PI3K-Akt signaling pathway of osteoblasts, Mmp9 and Mmp13 genes were enriched in the IL-17 signaling pathway of osteoclasts, and Bmp2 and Bmp7 genes were enriched in the TGF-beta signaling pathway of chondrocytes. With the use of the TF-mRNA-miRNA network, the Col1a1, Bcl2, Fgfr1, Mmp9, Mmp13, Bmp2, and Bmp7 genes were identified as the key regulatory factors. Selenium methyl cysteine, CGS-27023A, and calcium phosphate were predicted to be the potential drugs for skeletal fluorosis.

CONCLUSIONS

These results suggested that the PI3K-Akt signaling pathway being involved in the apoptosis of osteoblasts, with the IL-17 and the TGF-beta signaling pathways being involved in the inflammation of osteoclasts and chondrocytes in fluoride-induced bone injuries.

Associations Between Serum Selenium and Bone Mineral Density in 8-19-year-old children and adolescents: NHANES 2013-2018

The peak bone mass (PBM) in puberty has been proven to be a critical determinant of osteoporosis and brittle fractures in the elderly. Selenium is an essential trace element that could influence bone metabolism in our bodies. However, no study has investigated the impact of selenium status on bone mineral density (BMD) among children and adolescents. This was a cross-section study from National Health and Nutrition Examination Survey (NHANES) in the USA involving participants aged 8-19 years. We conducted multiple linear regression models to assess the relationship between selenium status and BMD among children and adolescents, and then stratified analyses were performed according to genders and races. Smooth curve fits and two-piecewise linear regression models were conducted to explore their nonlinear relationship. A total of 4570 participants (2338 boys and 2232 girls) were included in the present study, with a mean age of 13.57 ± 3.41 years. In the multivariable adjustment model, serum selenium was positively associated with lumbar spine BMD (β = 0.021 95% CI: 0.008, 0.034, P = 0.001). The dose-response analyses indicated a non-linear inverted U-shaped relationship between serum selenium and lumbar spine BMD. Lower and higher selenium concentrations were related to decreased BMD, and the inflection point of serum selenium was 2.60 umol/L. The inverted U-shaped association was also observed in females (inflection point: 2.49 umol/L), males (inflection point: 2.65 umol/L), Non-Hispanic White (inflection point: 2.50 umol/L), Non-Hispanic Black (inflection point: 2.50 umol/L), and other races (Including multi-racial) (inflection point: 2.81 umol/L). Our study first shows a non-linear inversed U-shaped association between selenium status and BMD among children and adolescents. The proper selenium status will benefit bone health in children and adolescents. More research is still required to verify our findings and their potential mechanisms.

Causal Effect of Selenium Levels on Osteoporosis: A Mendelian Randomization Study

Prior research has demonstrated equivocal associations between selenium (Se) concentrations and osteoporosis (OP), yielding inconclusive findings. The purpose of the current study was to examine the potential correlation between Se levels and the risk of OP by using the Mendelian randomization (MR) study design. The genetic variants related to Se levels were obtained from a meta-analysis of a Genome-Wide Association Study (GWAS) conducted on toenail Se levels (n = 4162) and blood Se levels (n = 5477). The data summary for OP and bone mineral density (BMD) was obtained by utilizing the GWAS database. To examine the association between Se levels and BMD and OP, we employed three statistical methods: inverse variance weighted, weighted median, and MR-Egger. The reliability of the analysis was verified by sensitivity testing. All three methods of MR analysis revealed that Se levels had no effect on OP risk. In addition, the sensitivity analysis revealed no heterogeneity or pleiotropy, and the significance of the overall effect remained unaffected by single-nucleotide polymorphisms (SNPs), as determined by the leave-one-out analysis, indicating that our findings are relatively reliable. The results of our study indicate that there is no causal association between Se levels and the risk of OP. However, additional investigation is necessary to ascertain whether there is a potential association between these variables.

The Role of Trace Elements and Minerals in Osteoporosis: A Review of Epidemiological and Laboratory Findings

The objective of the present study was to review recent epidemiological and clinical data on the association between selected minerals and trace elements and osteoporosis, as well as to discuss the molecular mechanisms underlying these associations. We have performed a search in the PubMed-Medline and Google Scholar databases using the MeSH terms "osteoporosis", "osteogenesis", "osteoblast", "osteoclast", and "osteocyte" in association with the names of particular trace elements and minerals through 21 March 2023. The data demonstrate that physiological and nutritional levels of trace elements and minerals promote osteogenic differentiation through the up-regulation of BMP-2 and Wnt/β-catenin signaling, as well as other pathways. miRNA and epigenetic effects were also involved in the regulation of the osteogenic effects of trace minerals. The antiresorptive effect of trace elements and minerals was associated with the inhibition of osteoclastogenesis. At the same time, the effect of trace elements and minerals on bone health appeared to be dose-dependent with low doses promoting an osteogenic effect, whereas high doses exerted opposite effects which promoted bone resorption and impaired bone formation. Concomitant with the results of the laboratory studies, several clinical trials and epidemiological studies demonstrated that supplementation with Zn, Mg, F, and Sr may improve bone quality, thus inducing antiosteoporotic effects.

Development and Validation of Machine Learning Models for Prediction of Fracture Risk in Patients with Elderly-Onset Rheumatoid Arthritis

Objective

Fracture is a critical unfavorable prognostic factor in patients with rheumatoid arthritis(RA) and osteoporosis. At present, models involving clinical indices that accurately predict fracture are still uncommon. We addressed this gap by developing machine learning (ML)-based predictive models to individualize the risk of fracture in elderly patients with RA and osteoporosis and to identify a high-risk group for fracture.

Methods

487 patients diagnosed with RA and osteoporosis at the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture were randomly divided into a training cohort (used for building the model) and a validation cohort (used for validating the model). Five ML-assisted models were developed from candidate clinical features using two-step estimation methods. The receiver operating characteristic curve (ROC), decision curve analysis (DCA), and clinical impact curve (CIC) were performed to evaluate the robustness and clinical practicability of each model.

Results

A total of twenty-two candidate variables were included, and the prediction model was established by an ML-based algorithm. The areas under the ROC curve (AUCs) of the random forest classifier (RFC) model, artificial neural network (ANN), support vector machine (SVM), eXtreme gradient boosting (XGBoost), decision tree (DT), probability of major osteoporotic fractures (PMOF), and probability of hip fracture (PHF) ranged from 0.695 to 0.878. Among them, RFC obtained the optimal prediction efficiency via adding serum selenium and clinical indices, that is, glucocorticoid, and erythrocyte sedimentation rate (ESR).

Conclusion

Based on the classic clinical parameters, the fracture risk of RA patients with osteoporosis can be accurately predicted. In particular, RFC prediction model shows good discrimination ability in identifying high-risk patients with fracture.

Progress of Selenium Deficiency in the Pathogenesis of Arthropathies and Selenium Supplement for Their Treatment

Selenium, an essential trace element for human health, exerts an indispensable effect in maintaining physiological homeostasis and functions in the body. Selenium deficiency is associated with arthropathies, such as Kashin-Beck disease, rheumatoid arthritis, osteoarthritis, and osteoporosis. Selenium deficiency mainly affects the normal physiological state of bone and cartilage through oxidative stress reaction and immune reaction. This review aims to explore the role of selenium deficiency and its mechanisms existed in the pathogenesis of arthropathies. Meanwhile, this review also summarized various experiments to highlight the crucial functions of selenium in maintaining the homeostasis of bone and cartilage.

Dietary consumption of selenium inversely associated with osteoporosis in postmenopausal women

Background

Osteoporosis is a skeletal disease characterized by reduced bone mineral density (BMD), which increases the risk of falls and fractures and reduces mobility. Some nutrients have a well-established role in maintaining bone health and preventing osteoporosis, while selenium (Se) has aroused interest in bone health possibly because of its anti-inflammatory and antioxidant capacity. The aim of this study was to evaluate the association between dietary Se consumption and BMD in postmenopausal women.

Materials and methods

Cross-sectional, observational, analytical study carried out with women in menopause for at least 12 months, aged ≥ 50 years. Sociodemographic, lifestyle, and clinical data variables were studied. BMD was assessed using Dual Energy X-ray Absorptiometry (DXA) and the participants classified as having normal BMD, osteopenia, or osteoporosis. Dietary consumption of Se was assessed by the food frequency questionnaire (FFQ) and classified into quartiles of consumption. Multivariate logistic regression with three fit models was applied to investigate the association of BMD with Se consumption quartiles. The significance level adopted for all tests was 5.0%.

Results

The final sample consisted of 124 women aged in average 66.8 ± 6.1 years and with a time since menopause of 19.6 ± 8.8 years. According to the BMD, 41.9% of the women had osteopenia and 36.3% osteoporosis. The mean consumption of Se was 154.4 ± 88.7 μg/day. The highest consumption of Se was observed among women with normal BMD (51.9%), whereas lower consumption levels were found in 57.7% of women with osteopenia and in 60.0% of women with osteoporosis (p = 0.003). In the multivariate analysis, after adjusting for possible confounding variables, Se remained associated with the group of women with osteoporosis. Postmenopausal women in the highest quartile (≥94.0 μg/day) of Se consumption had an OR of 0.02 (95%CI: 0.001-0.41; p = 0.012) of having osteoporosis when compared with women in the lowest quartile.

Conclusion

Se consumption was associated with BMD and postmenopausal women with higher Se consumption were less likely to have osteoporosis.

The occurrence, transformation and control of selenium in coal-fired power plants: Status quo and development

As a trace element, selenium can cause serious harm to organisms when the concentration is too high. Coal-fired power plants are the main source of man-made selenium emissions. How to control the selenium pollution of coal-fired power plants to realize the renewable selenium and the sustainability of coal has not attracted enough attention from the whole world. This paper outlines the conversion and occurrence of selenium in coal-fired power plants. A small part of the selenium produced by combustion can be removed by selective catalytic reduction (SCR) and electrostatic precipitator (ESP) after the gas phase undergoes physical condensation and chemical adsorption to combine with the particulate matter in the flue gas.Because the chemical precipitation method has poor selenium removal effect, the remaining part enters the flue gas desulfurization absorption tower and can be enriched in the desulfurization slurry. The occurrence situation and conversion pathway of selenium in desulfurization slurry are introduced subsequently, the research progress of selenium removal from wet desulfurization wastewater is reviewed from three aspects: physics, biology and chemistry. We believe that the coupling application of oxidation-reduction potential (ORP) and pH can optimize selenium removal in the desulfurization system by improving the oxidation control. As a technology for wet desulfurization system to treat selenium pollution, it has a good development prospect in near future.Implications: Selenium is a trace element present in coal. It is not only of great significance to the life activities of organisms, but also a kind of rare resource. As the most important source of man-made emissions, coal-fired power plants will cause waste of selenium resources and selenium pollution in the surrounding environment. In this study, the occurrence, conversion and control of selenium in coal-fired power plants were systematically sorted out and analyzed. It is helpful for scholars to study the selenium transformation process more deeply. It is of great significance for policy formulation of recommended control technologies and emission limits. It is of great value for the formulation of recommended control technology and the in-depth study of the selenium transformation process.

The Role of Selenium in Pathologies: An Updated Review

Selenium is an essential microelement required for a number of biological functions. Selenium—and more specifically the amino acid selenocysteine—is present in at least 25 human selenoproteins involved in a wide variety of essential biological functions, ranging from the regulation of reactive oxygen species (ROS) concentration to the biosynthesis of hormones. These processes also play a central role in preventing and modulating the clinical outcome of several diseases, including cancer, diabetes, Alzheimer’s disease, mental disorders, cardiovascular disorders, fertility impairments, inflammation, and infections (including SARS-CoV-2). Over the past years, a number of studies focusing on the relationship between selenium and such pathologies have been reported. Generally, an adequate selenium nutritional state—and in some cases selenium supplementation—have been related to improved prognostic outcome and reduced risk of developing several diseases. On the other hand, supra-nutritional levels might have adverse effects. The results of recent studies focusing on these topics are summarized and discussed in this review, with particular emphasis on advances achieved in the last decade.

The Effects of Selenium on Bone Health: From Element to Therapeutics

Osteoporosis, characterized by low bone mass and a disruption of bone microarchitecture, is traditionally treated using drugs or lifestyle modifications. Recently, several preclinical and clinical studies have investigated the effects of selenium on bone health, although the results are controversial. Selenium, an important trace element, is required for selenoprotein synthesis and acts crucially for proper growth and skeletal development. However, the intake of an optimum amount of selenium is critical, as both selenium deficiency and toxicity are hazardous for health. In this review, we have systematically analyzed the existing literature in this field to determine whether dietary or serum selenium concentrations are associated with bone health. In addition, the mode of administration of selenium as a supplement for treating bone disease is important. We have also highlighted the importance of using green-synthesized selenium nanoparticles as therapeutics for bone disease. Novel nanobiotechnology will be a bridgehead for clinical applications of trace elements and natural products.

A Cross-Sectional Study of Association between Plasma Selenium Levels and the Prevalence of Osteoarthritis: Data from the Xiangya Osteoarthritis Study

OBJECTIVES

Selenium plays an indispensable role in antioxidant and antiinflammation processes. Oxidative stress and inflammation have been hypothesized to be involved in the pathogenesis of cartilage degeneration. We sought to examine the association between plasma selenium levels and the prevalence of radiographic osteoarthritis (ROA).

DESIGN

A population-based cross-sectional study.

SETTING AND PARTICIPANTS

Individuals aged ≥ 50 years were retrieved from the Xiangya Osteoarthritis (XO) Study, a community-based study conducted among the residents of the rural areas of China.

METHODS

Plasma selenium concentration was measured by inductively coupled plasma-dynamic reaction cell-mass spectrometry. ROA was defined as Kellgren/Lawrence score ≥ 2 in at least one knee, hip or hand joint. The association between plasma selenium levels and ROA was evaluated by applying logistic and spline regression.

RESULTS

A total of 1,032 subjects (women: 52.5%; mean age: 63.1 years; ROA prevalence: 45.4%) were included. Compared with the highest tertile, the odds ratios (ORs) for ROA were 1.24 (95% confidence interval [CI]: 0.91 to 1.68) and 1.77 (95% CI: 1.31 to 2.40) in the middle and lowest tertile of plasma selenium, respectively (P for trend<0.05). The results were not changed materially with adjustment of potential confounders. In addition, subjects who had lower plasma selenium levels exhibited a higher prevalence of ROA in a dose-response relationship manner (P=0.005).

CONCLUSION

This study suggests that subjects with lower levels of plasma selenium exhibited a higher prevalence of ROA in a dose-response relationship manner. However, additional studies are still needed to verify the potential causal relationship.

Hair Selenium Content in Middle-Aged and Elderly Chinese Population

Selenium (Se) is an essential nutrient element for human health, and middle-aged and elderly people (age ≥ 45 years old) are at higher risk of nutrient deficiency including Se due to their physiological characteristics. This study investigated the hair Se content of middle-aged and elderly people in China with the purpose of providing a reference for prescription of hair Se normal range in this population. In this study, the hair Se content of 2155 middle-aged and elderly people was detected with atomic fluorescence photometry. The participants were recruited from 15 provinces or municipalities spreading from south to north of China with a diverse Se content in soil. Additionally, the relationships between hair Se content with sex, age, and BMI were analyzed. The results found that the median and 95% quantile of hair Se content were 0.36 μg/g and 0.60 μg/g respectively, with a range of 0.08 to 20.04 μg/g in middle-aged and elderly Chinese. The hair Se content mostly concentrated at 0.23~0.48 μg/g in 81.11% of participants. The participants in Guangdong and Hunan provinces had the highest hair Se levels (medians were 0.51 and 0.50 μg/g, respectively), while Henan and Shaanxi provinces had the lowest levels (medians were 0.30 and 0.29 μg/g, respectively). In addition, the Se content of males was higher than that of females (p < 0.05), whereas there was no significant difference between different ages and BMI (p > 0.05). In conclusion, this study found that the hair Se content of middle-aged and elderly Chinese ranges from 0.08 to 20.04 μg/g, with median and 95% quantile of 0.36 μg/g and 0.60 μg/g, respectively. Our results provide a reference for the establishment of hair Se content in this population and suggest that the differences of region and sex should be considered when setting up the range.

Higher Dietary Se Intake Is Associated With the Risk of New-Onset Fracture: A National Longitudinal Study for 20 Years

Background: The association between dietary selenium (Se) intake and osteoporosis-related fractures remains inconsistent. We aimed to examine the dose relationship between Se intake and incident fracture among Chinese adults. Methods: The dietary data were retrieved from the China Health and Nutrition Survey conducted between 1991 and 2011, and 17,150 participants aged above 20 were included. A 3-day, 24-h recall of food intake was performed to assess cumulative average dietary Se intake. The fracture was based on self-report in each survey between 1997 and 2011. The association between Se intake and fracture was tested by Cox regression, and the non-linear association was examined by restricted cubic splines (RCS). Results: There were 976 fracture cases during a mean of 10.2 years follow-up. In a fully adjusted Cox model, across the quartiles of Se intake, the hazard ratios (HRs) for fracture were 1.07 (95% CI .86-1.33), 1 (reference), 1.25 (95% CI 1.02-1.53), and 1.33 (95% CI 1.07-1.65). RCS showed a parabolic association (P non-linear = 0.037) between Se and fracture for men as well as a U-shape dose-response (P non-linear = 0.04) between Se and fracture for subjects living in highly urbanized areas. Conclusion: In conclusion, there is a non-linear association between selenium intake and fracture, with higher intake associated with increased risk. The shape of the association varies by gender and urbanization level.

Selenium status is independently related to bone mineral density, FRAX score, and bone fracture history: NHANES, 2013 to 2014

Selenium is an essential trace mineral element for humans. Although previous in vitro and animal studies have reported the vital role of selenium in bone, the results of the relationship between the selenium status and bone health were inconsistent in epidemiological studies. The risk of selenium deficiency is negligible for U.S. general population, however, the relationship between selenium status and bone health has never been surveyed in a nationally representative sample. In this study, we analyzed the data of 2983 adults (aged ≥40 years) in the National Health and Nutrition Examination Survey (NHANES) 2013-2014 to investigate the association among three markers of the selenium status (measured from whole blood, serum, and dietary intake), total spine and femur bone mineral density (BMD), and FRAX scores, and history of bone fractures. We found a one-unit increase in the ln-whole-blood selenium level was correlated with an increase in the total femur BMD of 0.064 g/cm² (S.E. = 0.025; P = 0.022) in all participants and 0.086 g/cm² (S.E. = 0.031; P = 0.013) in menopausal women. Additionally, a one-unit increase in the ln-selenium intake amount was associated with an increase in the total femur BMD of 0.014 g/cm² (S.E. = 0.007; P = 0.043) in all participants. We also found that the dietary and whole-blood selenium statuses were negatively associated with the FRAX score, while levels of all the three selenium biomarkers were negatively associated with a history of bone fractures. In conclusion, increased selenium status is correlated with an increased total femur BMD, decreased FRAX scores, and a reduced incidence of previous bone fractures in the U.S. representative survey of adults. Further study is warranted to clarify the causal inference.