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Augustyniak M, Galas A. Selenium dietary intake and survival among CRC patients. INT J VITAM NUTR RES 2023; 93:518-528. [PMID: 36176217 DOI: 10.1024/0300-9831/a000768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background: Despite advances in prevention and treatment, colorectal cancer remains the second most common cause of cancer death. To date, little is known about the role of prediagnostic selenium intake in colorectal cancer survival. Objective: The purpose of the study was to verify whether selenium intake in habitual diet before diagnosis is associated with survival in colorectal cancer patients. Study design: This was a prospective observation of patients primarily recruited for a case-control study between 2000 and 2012 in Cracow, Poland. A group of 671 incident cases of colorectal cancer was included. Habitual diet was assessed using a validated 148-item food questionnaire. 338 deaths were identified throughout 2017 by the Polish National Vital Registry. To evaluate the impact of dietary selenium on survival, the multivariable Cox regression model was used. Results: After standardization for several potential confounders (including key determinants, such as radical surgery, chemotherapy, tumor stage, and dietary factors), a decrease in the risk of death from colorectal cancer was observed in the group with higher dietary selenium intake (≥48.8 μg/day, group mean: 63.9 μg/day) compared to the group with lower dietary selenium intake (<48.8 μg/day, mean: 38.5 μg/day) (HR=0.73; 95% CI: 0.54-0.98) (the median was used for categorization). Conclusion: Our study suggests selenium as an additional dietary factor which may be associated with survival among colorectal cancer patients referred to surgery. Due to the observational nature of the study, the results should be taken with caution. These preliminary findings, however, provide the basis for well-structured clinical trials.
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Affiliation(s)
- Malgorzata Augustyniak
- Department of Epidemiology, Chair of Epidemiology and Preventive Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Aleksander Galas
- Department of Epidemiology, Chair of Epidemiology and Preventive Medicine, Jagiellonian University Medical College, Krakow, Poland
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Song M, Wan Y, Si J, Yao Q, Man T, Mu Y, Huang Y, Zhu L, Zhu C, Deng S. Point-of-Care Diagnosis on Selenium Nutrition Based on Time-Resolved Fluorometric Glycoaffinity Chromatography. Anal Chem 2023; 95:14797-14804. [PMID: 37737115 DOI: 10.1021/acs.analchem.3c03032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/23/2023]
Abstract
Given the lack of timely evaluation of the well-received selenium fortification, a neat lateral-flow chromatographic solution was constructed here by using the recently identified urinary selenosugar (Sel) as a strongly indicative marker. As there are no ready-made receptors for this synthetic standard, phenylboronic acid (PBA) esterification and Dolichos biflorus agglutinin (DBA) affinity joined up to pinch and pin down the analyte into a sandwich-type glycol complex. Pilot lectin screening on homemade glycan microarrays verified such a new pairing between dual recognizers as PBA-Sel-DBA with a firm monosaccharide-binding constant. To quell the sample autofluorescence, europium nanoparticles with efficient long-life afterglow were employed as conjugating probes under 1 μs excitation. After systematic process optimizations, the prepared Sel-dipstick achieved swift and sensitive fluorometry over the physiological level of the target from 0.1 to 10 μM with a detection limit down to 0.06 μM. Further efforts were made to eliminate matrix effects from both temperature and pH via an approximate formula. Upon completion, the test strips managed to quantify the presence of Sel in not just imitated but real human urine, with comparable results to those in the references. As far as we know, this would be the first in-house prototype for user-friendly and facile diagnosis of Se nutrition with fair accuracy as well as selectivity. Future endeavors will be invested to model a more traceable Se-supplementary plan based on the rhythmic feedback of Sel excretion.
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Affiliation(s)
- Meiyan Song
- School of Environmental and Biological Engineering, Nanjing University of Science and Technology, Nanjing 210094, China
| | - Ying Wan
- School of Mechanical Engineering, Nanjing University of Science and Technology, Nanjing 210094, China
| | - Jingyi Si
- Department of Gastroenterology and Hepatology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Qunyan Yao
- Department of Gastroenterology and Hepatology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Tiantian Man
- School of Mechanical Engineering, Nanjing University of Science and Technology, Nanjing 210094, China
| | - Yao Mu
- School of Environmental and Biological Engineering, Nanjing University of Science and Technology, Nanjing 210094, China
| | - Yaqi Huang
- School of Mechanical Engineering, Nanjing University of Science and Technology, Nanjing 210094, China
| | - Longyi Zhu
- School of Chemistry and Chemical Engineering, Nanjing University of Science and Technology, Nanjing 210094, China
| | - Changfeng Zhu
- Department of Gastroenterology and Hepatology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Shengyuan Deng
- School of Environmental and Biological Engineering, Nanjing University of Science and Technology, Nanjing 210094, China
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Turck D, Bohn T, Castenmiller J, de Henauw S, Hirsch‐Ernst K, Knutsen HK, Maciuk A, Mangelsdorf I, McArdle HJ, Peláez C, Pentieva K, Siani A, Thies F, Tsabouri S, Vinceti M, Aggett P, Crous Bou M, Cubadda F, Ciccolallo L, de Sesmaisons Lecarré A, Fabiani L, Titz A, Naska A. Scientific opinion on the tolerable upper intake level for selenium. EFSA J 2023; 21:e07704. [PMID: 36698500 PMCID: PMC9854220 DOI: 10.2903/j.efsa.2023.7704] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Following a request from the European Commission, the EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) was asked to deliver a scientific opinion on the tolerable upper intake level (UL) for selenium. Systematic reviews of the literature were conducted to identify evidence regarding excess selenium intake and clinical effects and potential biomarkers of effect, risk of chronic diseases and impaired neuropsychological development in humans. Alopecia, as an early observable feature and a well-established adverse effect of excess selenium exposure, is selected as the critical endpoint on which to base a UL for selenium. A lowest-observed-adverse-effect-level (LOAEL) of 330 μg/day is identified from a large randomised controlled trial in humans (the Selenium and Vitamin E Cancer Prevention Trial (SELECT)), to which an uncertainty factor of 1.3 is applied. A UL of 255 μg/day is established for adult men and women (including pregnant and lactating women). ULs for children are derived from the UL for adults using allometric scaling (body weight0.75). Based on available intake data, adult consumers are unlikely to exceed the UL, except for regular users of food supplements containing high daily doses of selenium or regular consumers of Brazil nuts. No risk has been reported with the current levels of selenium intake in European countries from food (excluding food supplements) in toddlers and children, and selenium intake arising from the natural content of foods does not raise reasons for concern. Selenium-containing supplements in toddlers and children should be used with caution, based on individual needs.
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Filippini T, Fairweather-Tait S, Vinceti M. Selenium and immune function: a systematic review and meta-analysis of experimental human studies. Am J Clin Nutr 2023; 117:93-110. [PMID: 36789948 DOI: 10.1016/j.ajcnut.2022.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 10/20/2022] [Accepted: 11/04/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Selenium is an essential trace element with both beneficial and detrimental effects on health depending on dose and chemical form. Currently, there is debate on recommendations for selenium supplementation as a public health measure to improve immune function and reduce infectious disease susceptibility. OBJECTIVES We performed a systematic review and meta-analysis of experimental studies assessing the effect of selenium supplementation on immunity-related outcomes in healthy people. METHODS We undertook a search of published and unpublished studies in literature databases such as PubMed/MEDLINE, Embase, and clinicaltrials.gov up to 17 October, 2022, and performed a meta-analysis comparing the effects on immunity-related outcomes between Se-supplemented versus control arms. Whenever possible we assessed the nonlinear relation using a dose-response approach. RESULTS 9 trials were included, 5 in North America, and 4 in Europe, with a duration between 8 and 48 weeks and supplementation of both inorganic and organic selenium forms. Selenium supplementation did not substantially affect immunoglobulin or white blood cell concentrations, and the dose-response meta-analysis indicated that an increase in plasma selenium concentrations above 100 μg/L did not further increase IgA levels nor T cells. An inverted U-shaped relation emerged for NK cell count, with a lower number of these cells both below and above 120 μg/L. The only beneficial effect of selenium supplementation was the increased activity for NK lysis, but the available data did not permit dose-response analysis. Cytokine levels were substantially unaffected by selenium supplementation. CONCLUSIONS Although some of the data suggested beneficial effects of selenium supplementation on immune function, the overall picture appears to be inconsistent and heterogeneous due to differences in trial duration and interventions, plus evidence of null and even detrimental effects. Overall, the evidence that we extracted from the literature in this systematic review does not support the need to supplement selenium beyond the recommended dietary intake to obtain beneficial effects on immune function. This trial was registered at PROSPERO (CRD42022312280).
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Affiliation(s)
- Tommaso Filippini
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; School of Public Health, University of California Berkeley, Berkeley, CA, USA
| | | | - Marco Vinceti
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
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5
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Vinceti M, Filippini T, Jablonska E, Saito Y, Wise LA. Safety of selenium exposure and limitations of selenoprotein maximization: Molecular and epidemiologic perspectives. ENVIRONMENTAL RESEARCH 2022; 211:113092. [PMID: 35259406 DOI: 10.1016/j.envres.2022.113092] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 03/04/2022] [Accepted: 03/04/2022] [Indexed: 02/08/2023]
Abstract
Recent evidence from laboratory and epidemiologic studies has shed a different light on selenium health effects and its recommended range of environmental exposure, compared with earlier research. Specifically, epidemiologic studies in Western populations have shown adverse effects of selenium exposure at low levels, sometimes below or slightly above selenium intakes needed to maximize selenoprotein expression and activity. In addition, three recent lines of evidence in molecular and biochemical studies suggest some potential drawbacks associated with selenoprotein maximization: 1) the possibility that selenoprotein upregulation is a compensatory response to oxidative challenge, induced by selenium itself or other oxidants; 2) the capacity of selenoproteins to trigger tumor growth in some circumstances; and 3) the deleterious metabolic effects of selenoproteins and particularly of selenoprotein P. The last observation provides a toxicological basis to explain why in humans selenium intake levels as low as 60 μg/day, still in the range of selenium exposure upregulating selenoprotein expression, might start to increase risk of type 2 diabetes. Overall, these new pieces of evidence from the literature call into question the purported benefit of selenoprotein maximization, and indicate the need to reassess selenium dietary reference values and upper intake level. This reassessment should clarify which range of selenoprotein upregulation follows restoration of adequate selenium availability and which range is driven by a compensatory response to selenium toxicity and oxidative stress.
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Affiliation(s)
- Marco Vinceti
- CREAGEN Research Center of Environmental, Genetic and Nutritional Epidemiology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.
| | - Tommaso Filippini
- CREAGEN Research Center of Environmental, Genetic and Nutritional Epidemiology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Ewa Jablonska
- Department of Translational Research, Nofer Institute of Occupational Medicine, Lodz, Poland
| | - Yoshiro Saito
- Laboratory of Molecular Biology and Metabolism, Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai, Japan
| | - Lauren A Wise
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
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Urbano T, Filippini T, Lasagni D, De Luca T, Grill P, Sucato S, Polledri E, Djeukeu Noumbi G, Malavolti M, Santachiara A, Pertinhez TA, Baricchi R, Fustinoni S, Michalke B, Vinceti M. Association of Urinary and Dietary Selenium and of Serum Selenium Species with Serum Alanine Aminotransferase in a Healthy Italian Population. Antioxidants (Basel) 2021; 10:1516. [PMID: 34679651 PMCID: PMC8532767 DOI: 10.3390/antiox10101516] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 09/17/2021] [Accepted: 09/22/2021] [Indexed: 01/23/2023] Open
Abstract
The trace element selenium is of considerable interest due to its toxic and nutritional properties, which markedly differ according to the dose and the chemical form. It has been shown that excess selenium intake increases the risk of type 2 diabetes and, possibly, other metabolic diseases like hyperlipidemia and non-alcoholic fatty liver disease (NAFLD). For the latter, however, epidemiologic evidence is still limited. We carried out a cross-sectional study recruiting 137 healthy blood donors living in Northern Italy and assessed their exposure to selenium through different methods and measuring serum selenium species. We performed linear and spline regression analyses to assess the relation of selenium and its forms with serum alanine aminotransferase (ALT) levels, a marker of NAFLD. Urinary selenium levels were positively and somewhat linearly correlated with ALT (beta regression coefficient (β) 0.11). Conversely, the association of dietary selenium intake with ALT was positive up to 100 µg/day and null above that amount (β 0.03). Total serum selenium was inversely associated with ALT up to 120 µg/L, and slightly positive above that amount. Concerning the different serum selenium species, ALT positively correlated with two organic forms, selenocysteine (β 0.27) and glutathione peroxidase-bound selenium (β 0.09), showed a U-shaped relation with the inorganic tetravalent form, selenite, and an inverse association with human serum albumin-bound selenium (β -0.56). Our results suggest that overall exposure to selenium, and more specifically to some of its chemical forms, is positively associated with ALT, even at levels so far generally considered to be safe. Our findings add to the evidence suggesting that low-dose selenium overexposure is associated with NAFLD.
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Affiliation(s)
- Teresa Urbano
- CREAGEN—Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy; (T.U.); (T.F.); (G.D.N.); (M.M.)
| | - Tommaso Filippini
- CREAGEN—Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy; (T.U.); (T.F.); (G.D.N.); (M.M.)
| | - Daniela Lasagni
- Transfusion Medicine Unit, Azienda USL-IRCCS of Reggio Emilia, 42123 Reggio Emilia, Italy; (D.L.); (T.D.L.); (T.A.P.); (R.B.)
| | - Tiziana De Luca
- Transfusion Medicine Unit, Azienda USL-IRCCS of Reggio Emilia, 42123 Reggio Emilia, Italy; (D.L.); (T.D.L.); (T.A.P.); (R.B.)
| | - Peter Grill
- Research Unit Analytical BioGeoChemistry, German Research Center for Environmental Health, Helmholtz Center Munich, 85764 Neuherberg, Germany; (P.G.); (B.M.)
| | - Sabrina Sucato
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; (S.S.); (E.P.); (S.F.)
| | - Elisa Polledri
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; (S.S.); (E.P.); (S.F.)
| | - Guy Djeukeu Noumbi
- CREAGEN—Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy; (T.U.); (T.F.); (G.D.N.); (M.M.)
| | - Marcella Malavolti
- CREAGEN—Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy; (T.U.); (T.F.); (G.D.N.); (M.M.)
| | | | - Thelma A. Pertinhez
- Transfusion Medicine Unit, Azienda USL-IRCCS of Reggio Emilia, 42123 Reggio Emilia, Italy; (D.L.); (T.D.L.); (T.A.P.); (R.B.)
- Department of Medicine and Surgery, University of Parma, 43125 Parma, Italy
| | - Roberto Baricchi
- Transfusion Medicine Unit, Azienda USL-IRCCS of Reggio Emilia, 42123 Reggio Emilia, Italy; (D.L.); (T.D.L.); (T.A.P.); (R.B.)
| | - Silvia Fustinoni
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; (S.S.); (E.P.); (S.F.)
- IRCCS Ca’ Granda Foundation Maggiore Policlinico Hospital, 20122 Milan, Italy
| | - Bernhard Michalke
- Research Unit Analytical BioGeoChemistry, German Research Center for Environmental Health, Helmholtz Center Munich, 85764 Neuherberg, Germany; (P.G.); (B.M.)
| | - Marco Vinceti
- CREAGEN—Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy; (T.U.); (T.F.); (G.D.N.); (M.M.)
- Department of Epidemiology, Boston University School of Public Health, Boston, MA 02118, USA
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Vinceti M, Bonaccio M, Filippini T, Costanzo S, Wise LA, Di Castelnuovo A, Ruggiero E, Persichillo M, Cerletti C, Donati MB, de Gaetano G, Iacoviello L. Dietary selenium intake and risk of hospitalization for type 2 diabetes in the Moli-sani study cohort. Nutr Metab Cardiovasc Dis 2021; 31:1738-1746. [PMID: 33853720 DOI: 10.1016/j.numecd.2021.02.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 02/11/2021] [Accepted: 02/16/2021] [Indexed: 01/28/2023]
Abstract
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.
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Affiliation(s)
- Marco Vinceti
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; Department of Epidemiology, Boston University School of Public Health, Boston, USA.
| | - Marialaura Bonaccio
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli, IS, Italy
| | - Tommaso Filippini
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Simona Costanzo
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli, IS, Italy
| | - Lauren A Wise
- Department of Epidemiology, Boston University School of Public Health, Boston, USA
| | | | - Emilia Ruggiero
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli, IS, Italy
| | | | - Chiara Cerletti
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli, IS, Italy
| | | | - Giovanni de Gaetano
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli, IS, Italy
| | - Licia Iacoviello
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli, IS, Italy; Department of Medicine and Surgery, Research Center in Epidemiology and Preventive Medicine (EPIMED), University of Insubria, Varese-Como, Italy
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8
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Vinceti M, Filippini T, Wise LA, Rothman KJ. A systematic review and dose-response meta-analysis of exposure to environmental selenium and the risk of type 2 diabetes in nonexperimental studies. ENVIRONMENTAL RESEARCH 2021; 197:111210. [PMID: 33895112 DOI: 10.1016/j.envres.2021.111210] [Citation(s) in RCA: 63] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 04/15/2021] [Accepted: 04/17/2021] [Indexed: 06/12/2023]
Abstract
Accumulating evidence from both experimental and nonexperimental human studies in the last 15 years indicates that exposure to high levels of the trace element selenium increases the risk of type 2 diabetes. However, the relation of dose to effect is not well understood because randomized controlled trials used only one dose (200 μg/day) of selenium supplementation. While no new trial on this topic has been published since 2018, several nonexperimental studies have appeared. We therefore updated a previous meta-analysis to include recently published observational studies, and incorporated the recently developed one-stage random-effects model to display the dose-response relation between selenium and type 2 diabetes. We retrieved 34 potentially eligible nonexperimental studies on selenium and diabetes risk up to April 15, 2021. The bulk of the evidence indicates a direct relation between blood, dietary and urinary levels of selenium and risk of diabetes, but not with nail selenium, which may be considered a less reliable biomarker. The association was nonlinear, with risk increasing above 80 μg/day of dietary selenium. Whole blood/plasma/serum selenium concentrations of 160 μg/L corresponded to a risk ratio of 1.96 (95% CI 1.27-3.03) compared with a concentration of 90 μg/L (approximately 60 μg of daily selenium intake). The cohort studies, which are less susceptible to reverse causation bias, indicated increased risk for both blood and urine selenium levels and dietary selenium intake, whereas no such pattern emerged from studies relying on nail selenium content. Overall, the nonexperimental studies agree with findings from randomized controlled trials, indicating that moderate to high levels of selenium exposure are associated with increased risk for type 2 diabetes.
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Affiliation(s)
- Marco Vinceti
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.
| | - Tommaso Filippini
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Lauren A Wise
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Kenneth J Rothman
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA; RTI Health Solutions, Research Triangle Park, NC, USA
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9
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Wang X, Seo YA, Park SK. Serum selenium and non-alcoholic fatty liver disease (NAFLD) in U.S. adults: National Health and Nutrition Examination Survey (NHANES) 2011-2016. ENVIRONMENTAL RESEARCH 2021; 197:111190. [PMID: 33872646 PMCID: PMC8187321 DOI: 10.1016/j.envres.2021.111190] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 04/08/2021] [Accepted: 04/12/2021] [Indexed: 05/03/2023]
Abstract
BACKGROUND Selenium is an essential trace element that shows beneficial or adverse health effects depending on the dose. Laboratory studies suggest that high selenium may contribute to the development of non-alcoholic fatty liver disease (NAFLD). However, human evidence is limited. We evaluated the associations of serum selenium level with serum alanine aminotransferase (ALT) activity and suspected NAFLD prevalence in U.S. adults. METHODS We conducted the cross-sectional analysis in 3827 adults aged 20 years and older without viral hepatitis, hemochromatosis, or alcoholic liver disease who participated in the National Health and Nutrition Examination Survey (NHANES) 2011-2012, 2013-2014, and 2015-2016. Serum selenium was measured using inductively coupled plasma dynamic reaction cell mass spectrometry. Suspected NAFLD cases were defined in the presence of serum ALT >30 international units (IU)/L in men and >19 I.U./L in women in the absence of other identifiable causes of liver disease. RESULTS The median (interquartile range) of serum selenium level was 127.9 (117.9, 139.4) μg/L. Non-linear associations of serum selenium with NAFLD prevalence and serum ALT activity were observed in the generalized additive models with penalized splines. After adjustment for sociodemographic variables, lifestyle factors, body mass index, and NHANES survey cycles, positive associations were found at > ~130 μg/L serum selenium with both NAFLD and ALT, whereas the associations were flattened at < ~130 μg/L. CONCLUSIONS Our findings provide evidence of non-linear associations of serum selenium with ALT activity and NAFLD prevalence. In particular, positive associations were found above serum selenium level of 130 μg/L, whereas no association was observed below this value. This finding requires confirmation in future prospective cohort studies.
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Affiliation(s)
- Xin Wang
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
| | - Young Ah Seo
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Sung Kyun Park
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA; Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA
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10
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Berger MM, Herter-Aeberli I, Zimmermann MB, Spieldenner J, Eggersdorfer M. Strengthening the immunity of the Swiss population with micronutrients: A narrative review and call for action. Clin Nutr ESPEN 2021; 43:39-48. [PMID: 34024545 PMCID: PMC7987506 DOI: 10.1016/j.clnesp.2021.03.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 03/08/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND The enormous health impact of the COVID-19 pandemic has refocused attention on measures to optimize immune function and vaccine response. Dietary deficiencies of micronutrients can weaken adaptive immunity. The aim of this review was to examine links between micronutrients, immune function and COVID-19 infection, with a focus on nutritional risks in subgroups of the Swiss population. METHODS Scoping review on the associations between selected micronutrients (vitamins D and C, iron, selenium, zinc, and n-3 PUFAs) and immunity, with particular reference to the Swiss population. These nutrients were chosen because previous EFSA reviews have concluded they play a key role in immunity. RESULTS The review discusses the available knowledge on links between sufficient nutrient status, optimal immune function, and prevention of respiratory tract infections. Because of the rapid spread of the COVID-19 pandemic, controlled intervention studies of micronutrients in the context of COVID-19 infection are now underway, but evidence is not yet available to draw conclusions. The anti-inflammatory properties of n-3 PUFAs are well established. In Switzerland, several subgroups of the population are at clear risk of nutrient deficiencies; e.g., older adults, multiple comorbidities, obesity, pregnancy, and institutionalized. Low intakes of n-3 PUFA are present in a large proportion of the population. CONCLUSION There are clear and strong relationships between micronutrient and n-3 PUFA status and immune function, and subgroups of the Swiss population are at risk for deficient intakes. Therefore, during the COVID-19 pandemic, as a complement to a healthy and balanced diet, it may be prudent to consider supplementation with a combination of moderate doses of Vitamins C and D, as well as of Se, Zn and n-3 PUFA, in risk groups.
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Affiliation(s)
- Mette M Berger
- Lausanne University Hospital (CHUV) & University of Lausanne, Lausanne, Switzerland.
| | - Isabelle Herter-Aeberli
- Laboratory of Human Nutrition, Institute of Food, Nutrition, and Health, ETH Zürich, Zurich, Switzerland.
| | | | | | - Manfred Eggersdorfer
- Department of Internal Medicine, University Medical Center Groningen, Groningen, the Netherlands.
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11
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Ala M, Kheyri Z. The rationale for selenium supplementation in inflammatory bowel disease: A mechanism-based point of view. Nutrition 2021; 85:111153. [PMID: 33578241 DOI: 10.1016/j.nut.2021.111153] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 12/19/2020] [Accepted: 01/05/2021] [Indexed: 02/07/2023]
Abstract
Management of inflammatory bowel disease (IBD) has always been a challenge for physicians. Current treatment protocols may cause numerous adverse effects. Selenium is known for its putative antiinflammatory properties. Selenium is needed for the biosynthesis of enzymatically active selenoproteins, which contribute to antioxidative defense, and effective function of immune systems. Several studies have shown that patients with IBD have a lower selenium level compared to healthy subjects. Hence, experimental studies mimicking ulcerative colitis and Crohn's disease investigated the effect of selenium supplementation on IBD. Previous studies indicated the following: 1) Selenoproteins can curb the inflammatory response and attenuate oxidative stress. This antiinflammatory property caused remission in animal models of colitis. 2) Selenium supports protective gut microbiota, which indirectly improves management of IBD. 3) Selenium may block some of the predominant tumorigenesis pathways proposed in colitis-associated colorectal cancer. 4) Selenium supplementation showed promising results in preliminary clinical studies, particularly in patients with selenium deficiency. While selenium supplementation seems to be beneficial for IBD, clinical studies have remained too preliminary in this regard. Randomized clinical trials are needed to measure the short-term and long-term effects of selenium on both active and quiescent IBD, particularly in patients with IBD who have documented selenium deficiency.
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Affiliation(s)
- Moein Ala
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
| | - Zahedin Kheyri
- Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
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12
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Chawla R, Filippini T, Loomba R, Cilloni S, Dhillon KS, Vinceti M. Exposure to a high selenium environment in Punjab, India: Biomarkers and health conditions. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 719:134541. [PMID: 31862262 DOI: 10.1016/j.scitotenv.2019.134541] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 09/17/2019] [Accepted: 09/17/2019] [Indexed: 06/10/2023]
Abstract
Seleniferous areas have been identified and described in many parts of the world. Despite the interest in selenium as a trace element of considerable toxicologic and nutritional relevance, however, only a few studies have been carried out on human health effects of such high selenium environments. We collected blood, hair and nail samples from 680 adult volunteers (267 men and 413 women) living in seven villages located in the seleniferous area of Punjab, India. We measured selenium levels in these specimens. We also administered a questionnaire to collect information about diet and other lifestyle characteristics, to identify the sources of selenium exposure and to correlate it with a number of health conditions. Serum and hair selenium contents were highly correlated, while the association of these biomarkers with nail selenium content was weaker. Serum selenium showed limited association with consumption of locally produced foods, while pulses and vegetables, along with cereals and pulses, were associated to higher hair and nail selenium contents, respectively. Association of a number of adverse health endpoints with serum and hair selenium was stronger than for nail selenium contents. Such endpoints included higher prevalence of nausea and vomiting, bad breath, worm infestation, breathlessness exert and bad breath, chest pain, hair and nail abnormalities and loss, garlic odor, edema, spontaneous abortion, and overall selenosis. In contrast, we gathered no evidence of dermatitis or loss of appetite in residents most exposed to selenium. Overall, and despite some statistical imprecision in effect estimates, these results confirm the occurrence of adverse health effects in subjects exposed to high levels of environmental selenium. Nail selenium contents may be less adequate to reflect and monitor such overexposure, compared with blood and hair levels.
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Affiliation(s)
- Rajinder Chawla
- Christian Medical College & Hospital, Ludhiana, India; Accuscript Consultancy, Ludhiana, India
| | - Tommaso Filippini
- CREAGEN - Environmental, Genetic and Nutritional Epidemiology Research Center, University of Modena and Reggio Emilia, Reggio Emilia, Italy
| | - Rinchu Loomba
- Christian Medical College & Hospital, Ludhiana, India
| | - Silvia Cilloni
- CREAGEN - Environmental, Genetic and Nutritional Epidemiology Research Center, University of Modena and Reggio Emilia, Reggio Emilia, Italy
| | | | - Marco Vinceti
- CREAGEN - Environmental, Genetic and Nutritional Epidemiology Research Center, University of Modena and Reggio Emilia, Reggio Emilia, Italy; Department of Epidemiology, Boston University School of Public Health, Boston, MA, United States.
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13
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Johnson-Davis KL, Farnsworth C, Law C, Parker R. Method validation for a multi-element panel in serum by inductively coupled plasma mass spectrometry (ICP-MS). Clin Biochem 2020; 82:90-98. [PMID: 32407718 DOI: 10.1016/j.clinbiochem.2020.05.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 05/07/2020] [Accepted: 05/07/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Laboratory testing for trace and toxic elements is important to diagnose metal toxicity and nutritional deficiency. There are several essential elements that are necessary for biological function and non-essential elements that can pose risk from exposure. Both essential and nonessential elements can be toxic if concentrations exceed a certain threshold. METHODS An aliquot of serum was diluted in a diluent solution, which contained iridium (Ir) as the internal standard, gold (Au), 0.05% Triton X-100, and 1% nitric acid (HNO3). The diluted specimen was aspirated into an inductively coupled plasma-mass spectrometer for quantitative elemental analysis of chromium (Cr), cobalt (Co), copper (Cu), manganese (Mn), nickel (Ni), selenium (Se) and zinc (Zn). The sample was introduced into the instrument spray chamber to form aerosol droplets, then atomized and ionized in argon plasma. The ions exited the plasma, passed through the interface of the instrument, then arrived at the entrance of the collision cell where helium gas was introduced to remove polyatomic interferences by kinetic energy discrimination (KED). After exiting the collision cell, the ions were filtered by a quadrupole mass spectrometer. RESULTS The analytical measurement range was determined specifically for each element. Imprecision was <20% CV for the lowest limit of quantification for each element and accuracy was within ±15%. CONCLUSIONS This method was validated for the quantification of seven elements in serum to assess nutritional deficiency and toxicity. The multi-element panel by ICP-MS met the validation criteria for biological monitoring of trace and toxic elements in patient specimens.
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Affiliation(s)
- Kamisha L Johnson-Davis
- Department of Pathology, University of Utah Health Sciences Center, Salt Lake City, UT, United States; ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, UT, United States.
| | | | - Christian Law
- ARUP Laboratories, Salt Lake City, UT, United States
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14
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Loomba R, Filippini T, Chawla R, Chaudhary R, Cilloni S, Datt C, Singh S, Dhillon KS, Vinceti M. Exposure to a high selenium environment in Punjab, India: Effects on blood chemistry. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 716:135347. [PMID: 31843317 DOI: 10.1016/j.scitotenv.2019.135347] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 10/31/2019] [Accepted: 11/01/2019] [Indexed: 06/10/2023]
Abstract
Many studies have shown that overexposure to environmental selenium may exert a wide pattern of adverse effects on human health, but much uncertainty still surrounds some of them as well as the exact amounts of exposure involved. In particular, very few studies have addressed the possible changes in blood chemistry following high selenium exposure. In a Northeastern part of Punjab, India, very high soil selenium content has been documented, with a value exceeding 2 mg/kg (up to 5) as compared with the <0.5 mg/kg selenium content characterizing the surrounding referent areas. In seven villages located in that seleniferous areas, we carried out a survey by recruiting volunteers and sampling blood, hair and nail specimens. We administered a questionnaire to the participants and analyzed the specimens for the selenium, along with a series of biochemical and haematological parameters in blood. We included 680 adult volunteers (267 men and 413 women), who showed median selenium levels of 171.30 µg/L in serum, 1.25 µg/g in hair, and 5.7 µg/g in nails. Overall, increasing selenium exposure tended to correlate with higher levels of total cholesterol, albumin, free triiodothyronine, deionidase activity, and with red cell and platelet counts. After stratifying the subjects according to category of selenium exposure, we observed a dose-response relation between serum selenium and risk of high total cholesterol, and between hair selenium and risk of high total and low-density lipoprotein cholesterol, high pancreatic lipase, altered thyroid-stimulating hormone and free triiodothyronine levels. Nail selenium exposure category positively correlated with risk of high alanine-aminotransferase, altered albumin levels, high pancreatic lipase and low levels of thyroid-stimulating hormone. Chronic selenium overexposure appears to adversely affect lipid profiles and pancreatic, liver, and thyroid function, with selenium biomarkers having different abilities to predict such effects.
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Affiliation(s)
- Rinchu Loomba
- Christian Medical College & Hospital, Ludhiana, India
| | - Tommaso Filippini
- CREAGEN - Environmental, Genetic and Nutritional Epidemiology Research Center, University of Modena and Reggio Emilia, Reggio Emilia, Italy
| | - Rajinder Chawla
- Christian Medical College & Hospital, Ludhiana, India; Accuscript Consultancy, Ludhiana, India
| | | | - Silvia Cilloni
- CREAGEN - Environmental, Genetic and Nutritional Epidemiology Research Center, University of Modena and Reggio Emilia, Reggio Emilia, Italy
| | - Chander Datt
- ICAR-National Dairy Research Institute, Karnal, India
| | | | | | - Marco Vinceti
- CREAGEN - Environmental, Genetic and Nutritional Epidemiology Research Center, University of Modena and Reggio Emilia, Reggio Emilia, Italy; Department of Epidemiology, Boston University School of Public Health, Boston, MA, United States.
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15
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Abstract
PURPOSE OF REVIEW Selenium, a trace element, is ubiquitous in the environment. The main source of human exposure is diet. Despite its nutritional benefits, it is one of the most toxic naturally occurring elements. Selenium deficiency and overexposure have been associated with adverse health effects. Its level of toxicity may depend on its chemical form, as inorganic and organic species have distinct biological properties. RECENT FINDINGS Nonexperimental and experimental studies have generated insufficient evidence for a role of selenium deficiency in human disease, with the exception of Keshan disease, a cardiomyopathy. Conversely, recent randomized trials have indicated that selenium overexposure is positively associated with type 2 diabetes and high-grade prostate cancer. In addition, a natural experiment has suggested an association between overexposure to inorganic hexavalent selenium and two neurodegenerative diseases, amyotrophic lateral sclerosis and Parkinson's disease. Risk assessments should be revised to incorporate the results of studies demonstrating toxic effects of selenium. Additional observational studies and secondary analyses of completed randomized trials are needed to address the uncertainties regarding the health risks of selenium exposure.
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16
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Vinceti M, Crespi CM, Malagoli C, Bottecchi I, Ferrari A, Sieri S, Krogh V, Alber D, Bergomi M, Seidenari S, Pellacani G. A Case-Control Study of the Risk of Cutaneous Melanoma Associated with Three Selenium Exposure Indicators. TUMORI JOURNAL 2018; 98:287-95. [DOI: 10.1177/030089161209800302] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aims and background A direct association between exposure to the metalloid selenium and risk of cutaneous melanoma has been suggested by some observational and experimental cohort studies, whereas other studies have yielded inconsistent results. Since some of the inconsistencies may be due to exposure misclassification arising from the use of exposure indicators that do not adequately reflect body tissue selenium content or the levels of the biologically relevant species of this metalloid, we examined this issue using multiple indicators of exposure. Methods We analyzed the relation of selenium exposure with risk of cutaneous melanoma using two different biomarkers, plasma and toenail selenium concentration, and estimated dietary selenium intake in a population-based case-control series (54 cases, 56 controls) from an Italian community. Results In unmatched and matched logistic regression models as well as nonparametric generalized additive models, higher plasma selenium levels were strongly associated with excess disease risk. In contrast, toenail and dietary selenium exhibited little relation with melanoma risk. The pattern of correlation among indicators of exposure differed by disease status, with dietary intake associated with plasma selenium levels in patients but not in controls. Conclusions Our data showed that different selenium exposure indicators can yield different inferences about melanoma risk. Although the series was small, our results are consistent with a positive association between circulating levels of selenium and melanoma risk. Further investigation of the exposure classification performance of various selenium biomarkers and of metabolic patterns of the metalloid and of its speciation are needed to help elucidate the relation between selenium exposure and human health.
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Affiliation(s)
- Marco Vinceti
- Environmental, Genetic and Nutritional
Epidemiology Research Center (CREAGEN), Department of Public Health Sciences,
University of Modena and Reggio Emilia, Reggio Emilia, Italy
| | - Catherine M Crespi
- Department of Biostatistics,
University of California Los Angeles School of Public Health, Los Angeles,
California, USA
| | - Carlotta Malagoli
- Environmental, Genetic and Nutritional
Epidemiology Research Center (CREAGEN), Department of Public Health Sciences,
University of Modena and Reggio Emilia, Reggio Emilia, Italy
| | - Ilaria Bottecchi
- Environmental, Genetic and Nutritional
Epidemiology Research Center (CREAGEN), Department of Public Health Sciences,
University of Modena and Reggio Emilia, Reggio Emilia, Italy
| | - Angela Ferrari
- Environmental, Genetic and Nutritional
Epidemiology Research Center (CREAGEN), Department of Public Health Sciences,
University of Modena and Reggio Emilia, Reggio Emilia, Italy
| | - Sabina Sieri
- Nutritional Epidemiology Unit,
National Cancer Institute, Milan, Italy
| | - Vittorio Krogh
- Nutritional Epidemiology Unit,
National Cancer Institute, Milan, Italy
| | - Dorothea Alber
- Department of Trace Element Research
in the Life Sciences, Helmholtz Center, Berlin, Germany
| | - Margherita Bergomi
- Environmental, Genetic and Nutritional
Epidemiology Research Center (CREAGEN), Department of Public Health Sciences,
University of Modena and Reggio Emilia, Reggio Emilia, Italy
| | - Stefania Seidenari
- Department of Dermatology, University
of Modena and Reggio Emilia, Modena, Italy
| | - Giovanni Pellacani
- Department of Dermatology, University
of Modena and Reggio Emilia, Modena, Italy
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17
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Vinceti M, Filippini T, Del Giovane C, Dennert G, Zwahlen M, Brinkman M, Zeegers MPA, Horneber M, D'Amico R, Crespi CM. Selenium for preventing cancer. Cochrane Database Syst Rev 2018; 1:CD005195. [PMID: 29376219 PMCID: PMC6491296 DOI: 10.1002/14651858.cd005195.pub4] [Citation(s) in RCA: 121] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND This review is the third update of the Cochrane review "Selenium for preventing cancer". Selenium is a naturally occurring element with both nutritional and toxicological properties. Higher selenium exposure and selenium supplements have been suggested to protect against several types of cancer. OBJECTIVES To gather and present evidence needed to address two research questions:1. What is the aetiological relationship between selenium exposure and cancer risk in humans?2. Describe the efficacy of selenium supplementation for cancer prevention in humans. SEARCH METHODS We updated electronic searches of the Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 2), MEDLINE (Ovid, 2013 to January 2017, week 4), and Embase (2013 to 2017, week 6), as well as searches of clinical trial registries. SELECTION CRITERIA We included randomised controlled trials (RCTs) and longitudinal observational studies that enrolled adult participants. DATA COLLECTION AND ANALYSIS We performed random-effects (RE) meta-analyses when two or more RCTs were available for a specific outcome. We conducted RE meta-analyses when five or more observational studies were available for a specific outcome. We assessed risk of bias in RCTs and in observational studies using Cochrane's risk assessment tool and the Newcastle-Ottawa Scale, respectively. We considered in the primary analysis data pooled from RCTs with low risk of bias. We assessed the certainty of evidence by using the GRADE approach. MAIN RESULTS We included 83 studies in this updated review: two additional RCTs (10 in total) and a few additional trial reports for previously included studies. RCTs involved 27,232 participants allocated to either selenium supplements or placebo. For analyses of RCTs with low risk of bias, the summary risk ratio (RR) for any cancer incidence was 1.01 (95% confidence interval (CI) 0.93 to 1.10; 3 studies, 19,475 participants; high-certainty evidence). The RR for estimated cancer mortality was 1.02 (95% CI 0.80 to 1.30; 1 study, 17,444 participants). For the most frequently investigated site-specific cancers, investigators provided little evidence of any effect of selenium supplementation. Two RCTs with 19,009 participants indicated that colorectal cancer was unaffected by selenium administration (RR 0.99, 95% CI 0.69 to 1.43), as were non-melanoma skin cancer (RR 1.16, 95% CI 0.30 to 4.42; 2 studies, 2027 participants), lung cancer (RR 1.16, 95% CI 0.89 to 1.50; 2 studies, 19,009 participants), breast cancer (RR 2.04, 95% CI 0.44 to 9.55; 1 study, 802 participants), bladder cancer (RR 1.07, 95% CI 0.76 to 1.52; 2 studies, 19,009 participants), and prostate cancer (RR 1.01, 95% CI 0.90 to 1.14; 4 studies, 18,942 participants). Certainty of the evidence was high for all of these cancer sites, except for breast cancer, which was of moderate certainty owing to imprecision, and non-melanoma skin cancer, which we judged as moderate certainty owing to high heterogeneity. RCTs with low risk of bias suggested increased melanoma risk.Results for most outcomes were similar when we included all RCTs in the meta-analysis, regardless of risk of bias. Selenium supplementation did not reduce overall cancer incidence (RR 0.99, 95% CI 0.86 to 1.14; 5 studies, 21,860 participants) nor mortality (RR 0.81, 95% CI 0.49 to 1.32; 2 studies, 18,698 participants). Summary RRs for site-specific cancers showed limited changes compared with estimates from high-quality studies alone, except for liver cancer, for which results were reversed.In the largest trial, the Selenium and Vitamin E Cancer Trial, selenium supplementation increased risks of alopecia and dermatitis, and for participants with highest background selenium status, supplementation also increased risk of high-grade prostate cancer. RCTs showed a slightly increased risk of type 2 diabetes associated with supplementation. A hypothesis generated by the Nutritional Prevention of Cancer Trial - that individuals with low blood selenium levels could reduce their risk of cancer (particularly prostate cancer) by increasing selenium intake - has not been confirmed. As RCT participants have been overwhelmingly male (88%), we could not assess the potential influence of sex or gender.We included 15 additional observational cohort studies (70 in total; over 2,360,000 participants). We found that lower cancer incidence (summary odds ratio (OR) 0.72, 95% CI 0.55 to 0.93; 7 studies, 76,239 participants) and lower cancer mortality (OR 0.76, 95% CI 0.59 to 0.97; 7 studies, 183,863 participants) were associated with the highest category of selenium exposure compared with the lowest. Cancer incidence was lower in men (OR 0.72, 95% CI 0.46 to 1.14, 4 studies, 29,365 men) than in women (OR 0.90, 95% CI 0.45 to 1.77, 2 studies, 18,244 women). Data show a decrease in risk of site-specific cancers for stomach, colorectal, lung, breast, bladder, and prostate cancers. However, these studies have major weaknesses due to study design, exposure misclassification, and potential unmeasured confounding due to lifestyle or nutritional factors covarying with selenium exposure beyond those taken into account in multi-variable analyses. In addition, no evidence of a dose-response relation between selenium status and cancer risk emerged. Certainty of evidence was very low for each outcome. Some studies suggested that genetic factors might modify the relation between selenium and cancer risk - an issue that merits further investigation. AUTHORS' CONCLUSIONS Well-designed and well-conducted RCTs have shown no beneficial effect of selenium supplements in reducing cancer risk (high certainty of evidence). Some RCTs have raised concerns by reporting a higher incidence of high-grade prostate cancer and type 2 diabetes in participants with selenium supplementation. No clear evidence of an influence of baseline participant selenium status on outcomes has emerged in these studies.Observational longitudinal studies have shown an inverse association between selenium exposure and risk of some cancer types, but null and direct relations have also been reported, and no systematic pattern suggesting dose-response relations has emerged. These studies suffer from limitations inherent to the observational design, including exposure misclassification and unmeasured confounding.Overall, there is no evidence to suggest that increasing selenium intake through diet or supplementation prevents cancer in humans. However, more research is needed to assess whether selenium may modify the risk of cancer in individuals with a specific genetic background or nutritional status, and to investigate possible differential effects of various forms of selenium.
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Affiliation(s)
- Marco Vinceti
- Boston University School of Public HealthDepartment of Epidemiology715 Albany StreetBoston, MAUSA02118
- University of Modena and Reggio EmiliaResearch Center in Environmental, Nutritional and Genetic Epidemiology (CREAGEN), Department of Biomedical, Metabolic and Neural SciencesVia Campi 287ModenaItaly41125
| | - Tommaso Filippini
- University of Modena and Reggio EmiliaResearch Center in Environmental, Nutritional and Genetic Epidemiology (CREAGEN), Department of Biomedical, Metabolic and Neural SciencesVia Campi 287ModenaItaly41125
| | - Cinzia Del Giovane
- University of BernInstitute of Primary Health Care (BIHAM)Gesellschaftsstrasse 49BernSwitzerland3012
- University of Modena and Reggio EmiliaCochrane Italy, Department of Diagnostic, Clinical and Public Health MedicineVia del Pozzo, 71ModenaItaly41100
| | - Gabriele Dennert
- University of Applied Sciences DortmundSocial Medicine and Public Health with Focus on Gender and Diversity, Department of Applied Social SciencesEmil‐Figge‐Str. 44DortmundGermanyD‐44227
| | - Marcel Zwahlen
- University of BernInstitute of Social and Preventive Medicine (ISPM)Finkelhubelweg11BernSwitzerland3012
| | - Maree Brinkman
- Nutrition Biomed Research InstituteDepartment of Nutritional Epidemiology and Clinical StudiesArgyle Place SouthMelbourneVictoriaAustralia3053
- Chairgroup of Complex Genetics and Epidemiology, School for Nutrition and Translational Research in Metabolism, Care and Public Health Research InstituteUnit of Nutritional and Cancer EpidemiologyMaastricht UniversityMaastrichtNetherlands
| | | | - Markus Horneber
- Paracelsus Medical University, Klinikum NurembergDepartment of Internal Medicine, Division of Oncology and HematologyProf.‐Ernst‐Nathan‐Str. 1NurembergGermanyD‐90419
| | - Roberto D'Amico
- University of Modena and Reggio EmiliaCochrane Italy, Department of Diagnostic, Clinical and Public Health MedicineVia del Pozzo, 71ModenaItaly41100
| | - Catherine M Crespi
- University of California Los AngelesBiostatisticsFielding School of Public Health650 Charles Young Drive South, A2‐125 CHS, Box 956900Los AngelesCaliforniaUSA90095‐6900
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18
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Di Dato C, Gianfrilli D, Greco E, Astolfi M, Canepari S, Lenzi A, Isidori AM, Giannetta E. Profiling of selenium absorption and accumulation in healthy subjects after prolonged L-selenomethionine supplementation. J Endocrinol Invest 2017; 40:1183-1190. [PMID: 28393316 DOI: 10.1007/s40618-017-0663-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 03/22/2017] [Indexed: 02/05/2023]
Abstract
PURPOSE Autoimmune thyroiditis and its complications for the reproductive system are a growing problem. Selenium is a common ingredient in numerous food supplements recommended for thyroiditis and pregnancy. A fast, simple method to measure serum selenium concentration will improve knowledge of its pharmacokinetics and toxicity. AIM To validate a useful method to measure serum selenium concentration and to study selenium absorption and accumulation in a prospective interventional study of prolonged treatment. METHODS Thirty healthy volunteers received a single dose of L-selenomethionine one tablet (83 mcg) (Phase 1), a single dose of two tablets (Phase 2), and two tablets daily for 14 days (Phase 3). Total selenium and selenium time profiles were generated by serial sampling (T0, T3, T6, T12, and T24 hours after ingestion-Phases 1 and 2; and T0 and T24 hours-Phase 3). Selenium concentration was investigated by open-vessel acid digestion of small serum volumes followed by hydride generation atomic fluorescence spectroscopy analysis. RESULTS There was a significant increase in serum selenium concentration (mcg/L) in all treatment phases. Significantly increased levels were reached at T3 in Phase 1 (baseline: 76.5 ± 2.47; T3: 82.8 ± 3.28) and at T6 in Phase 2 (83.8 ± 3.46). They remained significantly increased at T12 in Phase 1 and T24 in Phase 2 (79.03 ± 2.69). There was significant selenium accumulation after prolonged intake (14 days) (102.13 ± 5.61). CONCLUSIONS Prolonged selenomethionine administration increases circulating blood selenium concentration and hydride generation atomic fluorescence spectroscopy enables its accurate quantification.
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Affiliation(s)
- C Di Dato
- Department of Experimental Medicine, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - D Gianfrilli
- Department of Experimental Medicine, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - E Greco
- Center for Reproductive Medicine, European Hospital, Rome, Italy
| | - M Astolfi
- Chemistry Department, "Sapienza" University of Rome, Rome, Italy
| | - S Canepari
- Chemistry Department, "Sapienza" University of Rome, Rome, Italy
| | - A Lenzi
- Department of Experimental Medicine, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - A M Isidori
- Department of Experimental Medicine, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - E Giannetta
- Department of Experimental Medicine, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy.
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19
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Abstract
The relation between selenium and cancer has been one of the most hotly debated topics in human health over the last decades. Early observational studies reported an inverse relation between selenium exposure and cancer risk. Subsequently, randomized controlled trials showed that selenium supplementation does not reduce the risk of cancer and may even increase it for some types, including advanced prostate cancer and skin cancer. An increased risk of diabetes has also been reported. These findings have been consistent in the most methodologically sound trials, suggesting that the early observational studies were misleading. Other studies have investigated selenium compounds as adjuvant therapy for cancer. Though there is currently insufficient evidence regarding the utility and safety of selenium compounds for such treatments, this issue is worthy of further investigation. The study of selenium and cancer is complicated by the existence of a diverse array of organic and inorganic selenium compounds, each with distinct biological properties, and this must be taken into consideration in the interpretation of both observational and experimental human studies.
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Affiliation(s)
- Marco Vinceti
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), University of Modena and Reggio Emilia, Modena, Italy; Boston University School of Public Health, Boston, MA, United States.
| | - Tommaso Filippini
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), University of Modena and Reggio Emilia, Modena, Italy
| | - Silvia Cilloni
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), University of Modena and Reggio Emilia, Modena, Italy
| | - Catherine M Crespi
- Jonsson Comprehensive Cancer Center, UCLA Fielding School of Public Health, University of California, Los Angeles, CA, United States
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20
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Vinceti M, Grioni S, Alber D, Consonni D, Malagoli C, Agnoli C, Malavolti M, Pala V, Krogh V, Sieri S. Toenail selenium and risk of type 2 diabetes: the ORDET cohort study. J Trace Elem Med Biol 2015; 29:145-50. [PMID: 25169979 DOI: 10.1016/j.jtemb.2014.07.017] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Revised: 07/16/2014] [Accepted: 07/21/2014] [Indexed: 12/20/2022]
Abstract
Epidemiologic studies, particularly randomized controlled trials, have shown a direct relation between dietary and environmental exposure to the metalloid selenium and risk of type 2 diabetes. We investigated the association between baseline toenail selenium levels and diabetes occurrence in a case-control study nested in ORDET, a population-based female cohort in Northern Italy. After a median follow-up of 16 years, we identified 226 cases of type 2 diabetes cases and 395 age-matched control women with available toenail samples at baseline. The multivariate odds ratios of diabetes in increasing a priori defined categories of toenail selenium exposure were 1.09 (95% confidence interval 0.61, 1.96), 0.71 (0.38, 1.34) and 1.14 (0.46, 2.80) compared with the lowest category. The results were not substantially altered when quartile distribution of toenail selenium in controls was used to define exposure categories. Spline regression analysis did not show homogeneous risk trends. Overall, we did not find an association between toenail selenium and subsequent development of diabetes. Since the diabetogenic activity of selenium is strongly supported by experimental studies and some observational investigations, our null results might be explained by the limitations of overall selenium toenail content to assess environmental exposure to selenium species of etiologic relevance in the study population.
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Affiliation(s)
- Marco Vinceti
- Centro di Ricerca in Epidemiologia Ambientale, Genetica e Nutrizionale (CREAGEN), University of Modena and Reggio Emilia, Modena, Via Campi, 287, 41125 Modena, Italy.
| | - Sara Grioni
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133 Milano, Italy
| | - Dorothea Alber
- Helmholtz-Zentrum Berlin für Materialien und Energie GmbH, Berlin, Hahn-Meitner-Platz 1, 14109 Berlin, Germany
| | - Dario Consonni
- Epidemiology Unit, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Via San Barnaba, 8, 20122 Milan, Italy
| | - Carlotta Malagoli
- Centro di Ricerca in Epidemiologia Ambientale, Genetica e Nutrizionale (CREAGEN), University of Modena and Reggio Emilia, Modena, Via Campi, 287, 41125 Modena, Italy
| | - Claudia Agnoli
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133 Milano, Italy
| | - Marcella Malavolti
- Centro di Ricerca in Epidemiologia Ambientale, Genetica e Nutrizionale (CREAGEN), University of Modena and Reggio Emilia, Modena, Via Campi, 287, 41125 Modena, Italy
| | - Valeria Pala
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133 Milano, Italy
| | - Vittorio Krogh
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133 Milano, Italy
| | - Sabina Sieri
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133 Milano, Italy
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Vinceti M, Grill P, Malagoli C, Filippini T, Storani S, Malavolti M, Michalke B. Selenium speciation in human serum and its implications for epidemiologic research: a cross-sectional study. J Trace Elem Med Biol 2015; 31:1-10. [PMID: 26004885 DOI: 10.1016/j.jtemb.2015.02.001] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Revised: 02/10/2015] [Accepted: 02/13/2015] [Indexed: 12/27/2022]
Abstract
Observational studies addressing the relation between selenium and human health, particularly cancer risk, yielded inconsistent results, while most recent randomized trials showed a fairly consistent pattern suggesting null or adverse effects of the metalloid. One of the most plausible explanations for such inconsistencies is inadequate exposure assessment in observational studies, commonly carried out by measuring total Se content without taking into account the specific exposure to the individual chemical forms of the metalloid, whose toxic and nutritional properties may vary greatly. Data on the distribution of these species in human blood and their correlation with overall selenium levels are very limited. The concentrations of organic and inorganic selenium species were analyzed in serum of fifty subjects sampled from the general population of the municipality of Modena, northern Italy, aged from 35 to 70 years. Samples were collected during a 30-month period, and determinations of selenium species were carried out using high pressure liquid chromatography coupled with inductively coupled plasma dynamic reaction cell mass spectrometry. The majority of selenium was found to be present as organic species, but the inorganic forms showed higher levels than expected. These species showed limited correlations with age, sex and body mass index, while the organic forms increased in subjects consuming selenium-containing dietary supplements and decreased in smokers. The length of the sample storage period strongly influenced the distribution of selenium compounds, with a clear tendency towards higher inorganic and lower organic selenium levels over time. In multivariate analysis adjusting for potential confounders, total serum selenium correlated with human serum albumin-bound selenium and, in males, with two organic species of the metalloid (selenocysteine and glutathione peroxidase-bound selenium), while little association existed with the other organic forms and the inorganic ones. These findings highlight the potential for exposure misclassification of observational epidemiologic investigations based on overall selenium content in blood and possibly other tissues, and the critical role of the storage conditions for speciation analysis.
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Affiliation(s)
- Marco Vinceti
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Reggio Emilia, Italy.
| | - Peter Grill
- Research Unit Analytical BioGeoChemistry, Helmholtz Zentrum München - German Research Center for Environmental Health GmbH, Munich, Germany
| | - Carlotta Malagoli
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Reggio Emilia, Italy
| | - Tommaso Filippini
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Reggio Emilia, Italy
| | - Simone Storani
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Reggio Emilia, Italy
| | - Marcella Malavolti
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Reggio Emilia, Italy
| | - Bernhard Michalke
- Research Unit Analytical BioGeoChemistry, Helmholtz Zentrum München - German Research Center for Environmental Health GmbH, Munich, Germany
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22
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Kokarnig S, Tsirigotaki A, Wiesenhofer T, Lackner V, Francesconi KA, Pergantis SA, Kuehnelt D. Concurrent quantitative HPLC-mass spectrometry profiling of small selenium species in human serum and urine after ingestion of selenium supplements. J Trace Elem Med Biol 2015; 29:83-90. [PMID: 25063689 DOI: 10.1016/j.jtemb.2014.06.012] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Revised: 06/24/2014] [Accepted: 06/25/2014] [Indexed: 02/07/2023]
Abstract
Selenium metabolic patterns in the human body originating from five distinct selenium dietary sources, selenate, selenite, selenomethionine (SeMet), methylselenocysteine (MeSeCys) and selenized yeast, were investigated by performing concurrent HPLC-mass spectrometric analysis of human serum and urine. Total selenium and selenium species time profiles were generated by sampling and analyzing serum and urine from volunteers treated with selenium supplements, up to 5 and 24h following ingestion, respectively. We found that an increase in total serum selenium levels, accompanied by elevated selenium urinary excretion, was the common pattern for all treatments, except for that of selenite supplementation. Selenosugar 1 was a universal serum metabolite in all treatments, indicating that ingested selenium is favorably metabolized to the sugar. Except for selenite and selenized yeast ingestion, these patterns were reflected in the urine time series of the different treatments. Selenosugar 1 was the major selenium species present in urine in all treatments except for the selenate treatment, accounting for about 80% of the identified excreted species within 24h of ingestion. Furthermore, the urinary metabolite trimethylselenonium ion (TMSe) was detected for the first time in human background serum by using HPLC coupled to elemental and molecular mass spectrometry. The concurrent monitoring of non-protein selenium species in both body fluids provides the relation between bioavailability and excretion of the individual ingested species and of their metabolic products, while the combined use of elemental and molecular mass spectrometry enables the accurate quantitation of structurally confirmed species. This successfully applied approach is anticipated to be a useful tool for more extensive future studies into human selenium metabolism.
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Affiliation(s)
- Sabine Kokarnig
- University of Graz, Institute of Chemistry, Analytical Chemistry, NAWI Graz, Universitaetsplatz 1, A-8010 Graz, Austria
| | - Alexandra Tsirigotaki
- University of Crete, Department of Chemistry, Voutes Campus, GR-71003 Heraklion, Crete, Greece
| | - Tanja Wiesenhofer
- University of Graz, Institute of Chemistry, Analytical Chemistry, NAWI Graz, Universitaetsplatz 1, A-8010 Graz, Austria
| | - Verena Lackner
- University of Graz, Buero für ArbeitnehmerInnenschutz und Sicherheit, Halbaerthgasse 6, A-8010 Graz, Austria
| | - Kevin A Francesconi
- University of Graz, Institute of Chemistry, Analytical Chemistry, NAWI Graz, Universitaetsplatz 1, A-8010 Graz, Austria
| | - Spiros A Pergantis
- University of Crete, Department of Chemistry, Voutes Campus, GR-71003 Heraklion, Crete, Greece
| | - Doris Kuehnelt
- University of Graz, Institute of Chemistry, Analytical Chemistry, NAWI Graz, Universitaetsplatz 1, A-8010 Graz, Austria.
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Jablonska E, Vinceti M. Selenium and Human Health: Witnessing a Copernican Revolution? JOURNAL OF ENVIRONMENTAL SCIENCE AND HEALTH. PART C, ENVIRONMENTAL CARCINOGENESIS & ECOTOXICOLOGY REVIEWS 2015; 33:328-68. [PMID: 26074278 DOI: 10.1080/10590501.2015.1055163] [Citation(s) in RCA: 95] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
In humans, selenium was hypothesized to lower the risk of several chronic diseases, mainly due to the antioxidant activity of selenium-containing proteins. Recent epidemiologic and laboratory studies, however, are changing our perception of the biological effects of this nutritionally essential trace element. We reviewed the most recent epidemiologic and biochemical literature on selenium, synthesizing the findings from these studies into a unifying view. Randomized trials have shown that selenium did not protect against cancer and other chronic diseases, but even increased the risk of specific neoplasms such as advanced prostate cancer and skin cancer, in addition to type 2 diabetes. Biochemical studies indicate that selenium may exert a broad pattern of toxic effects at unexpectedly low concentrations. Furthermore, its upregulation of antioxidant proteins (selenium-dependent and selenium-independent) may be a manifestation of self-induced oxidative stress. In conclusion, toxic effects of selenium species occur at lower concentrations than previously believed. Those effects may include a large range of proteomic changes and adverse health effects in humans. Since the effects of environmental exposure to this element on human health still remain partially unknown, but are potentially serious, the toxicity of selenium exposure should be further investigated and considered as a public health priority.
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Affiliation(s)
- Ewa Jablonska
- a Department of Toxicology and Carcinogenesis , Nofer Institute of Occupational Medicine , Lodz , Poland
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24
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Study of selenium intake and disposition in various matrices based on mathematical algorithms derived from pooled biomonitoring data. Int J Hyg Environ Health 2014; 217:796-804. [PMID: 24891224 DOI: 10.1016/j.ijheh.2014.04.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Revised: 04/25/2014] [Accepted: 04/29/2014] [Indexed: 11/23/2022]
Abstract
Biomonitoring is increasingly used to assess exposure to selenium (Se) in the population. However, there is little harmonization among protocols used in the different studies (varying biological matrices, differences in expression of results (concentrations versus amounts, units)). This makes inter-comparison of biomonitoring results across studies difficult. From a public health risk perspective, it also becomes challenging to estimate baseline levels in biological matrices for populations exposed by various sources. The aim of this study was thus to perform a systematic analysis of the relationship between Se intakes and biological concentrations based on published data. Inclusion and exclusion criteria were used and led to select 75 published biomonitoring data in humans from an extended review of Se biomonitoring studies. This represents 8 628 individuals who provided biological samples aiming at documenting Se exposure and/or Se concentrations in two or more biological matrices. Mathematical algorithms that relate Se intakes to biological concentrations and establish matrix-to-matrix associations were derived from these pooled biomonitoring data. Logarithmic regressions showed good correlations between Se intakes and whole blood concentrations (R(2)=0.884), plasma concentrations (R(2)=0.863) and urinary excretion rates (R(2)=0.958). Blood and plasma concentrations were also strongly related (R(2)=0.874), as were whole blood concentrations and urinary excretion rates (R(2)=0.953). The interpretation of the log-regression coefficients allowed illustrating Se physiology. Se concentrations in plasma tend to plateau when daily intake exceed 150 μg/d, whereas Se in urine increases rapidly above this threshold. The application of the algorithms to other independent data sets in order to reconstruct past Se intakes confirmed that interpretation of results on the basis of Se in integuments may be misleading if external contamination is not avoided. This approach based on pooled data covered a wide range of exposure and the large number of data integrated increased the level of confidence of results.
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25
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Vinceti M, Dennert G, Crespi CM, Zwahlen M, Brinkman M, Zeegers MPA, Horneber M, D'Amico R, Del Giovane C. Selenium for preventing cancer. Cochrane Database Syst Rev 2014; 2014:CD005195. [PMID: 24683040 PMCID: PMC4441528 DOI: 10.1002/14651858.cd005195.pub3] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND This review is an update of the first Cochrane publication on selenium for preventing cancer (Dennert 2011).Selenium is a metalloid with both nutritional and toxicological properties. Higher selenium exposure and selenium supplements have been suggested to protect against several types of cancers. OBJECTIVES Two research questions were addressed in this review: What is the evidence for:1. an aetiological relation between selenium exposure and cancer risk in humans? and2. the efficacy of selenium supplementation for cancer prevention in humans? SEARCH METHODS We conducted electronic searches of the Cochrane Central Register of Controlled Trials (CENTRAL, 2013, Issue 1), MEDLINE (Ovid, 1966 to February 2013 week 1), EMBASE (1980 to 2013 week 6), CancerLit (February 2004) and CCMed (February 2011). As MEDLINE now includes the journals indexed in CancerLit, no further searches were conducted in this database after 2004. SELECTION CRITERIA We included prospective observational studies (cohort studies including sub-cohort controlled studies and nested case-control studies) and randomised controlled trials (RCTs) with healthy adult participants (18 years of age and older). DATA COLLECTION AND ANALYSIS For observational studies, we conducted random effects meta-analyses when five or more studies were retrieved for a specific outcome. For RCTs, we performed random effects meta-analyses when two or more studies were available. The risk of bias in observational studies was assessed using forms adapted from the Newcastle-Ottawa Quality Assessment Scale for cohort and case-control studies; the criteria specified in the Cochrane Handbook for Systematic Reviews of Interventions were used to evaluate the risk of bias in RCTs. MAIN RESULTS We included 55 prospective observational studies (including more than 1,100,000 participants) and eight RCTs (with a total of 44,743 participants). For the observational studies, we found lower cancer incidence (summary odds ratio (OR) 0.69, 95% confidence interval (CI) 0.53 to 0.91, N = 8) and cancer mortality (OR 0.60, 95% CI 0.39 to 0.93, N = 6) associated with higher selenium exposure. Gender-specific subgroup analysis provided no clear evidence of different effects in men and women (P value 0.47), although cancer incidence was lower in men (OR 0.66, 95% CI 0.42 to 1.05, N = 6) than in women (OR 0.90, 95% CI 0.45 to 1.77, N = 2). The most pronounced decreases in risk of site-specific cancers were seen for stomach, bladder and prostate cancers. However, these findings have limitations due to study design, quality and heterogeneity that complicate interpretation of the summary statistics. Some studies suggested that genetic factors may modify the relation between selenium and cancer risk-a hypothesis that deserves further investigation.In RCTs, we found no clear evidence that selenium supplementation reduced the risk of any cancer (risk ratio (RR) 0.90, 95% CI 0.70 to 1.17, two studies, N = 4765) or cancer-related mortality (RR 0.81, 95% CI 0.49 to 1.32, two studies, N = 18,698), and this finding was confirmed when the analysis was restricted to studies with low risk of bias. The effect on prostate cancer was imprecise (RR 0.90, 95% CI 0.71 to 1.14, four studies, N = 19,110), and when the analysis was limited to trials with low risk of bias, the interventions showed no effect (RR 1.02, 95% CI 0.90 to 1.14, three studies, N = 18,183). The risk of non-melanoma skin cancer was increased (RR 1.44, 95% CI 0.95 to 1.17, three studies, N = 1900). Results of two trials-the Nutritional Prevention of Cancer Trial (NPCT) and the Selenium and Vitamin E Cancer Trial (SELECT)-also raised concerns about possible increased risk of type 2 diabetes, alopecia and dermatitis due to selenium supplements. An early hypothesis generated by NPCT that individuals with the lowest blood selenium levels at baseline could reduce their risk of cancer, particularly of prostate cancer, by increasing selenium intake has not been confirmed by subsequent trials. As the RCT participants were overwhelmingly male (94%), gender differences could not be systematically assessed. AUTHORS' CONCLUSIONS Although an inverse association between selenium exposure and the risk of some types of cancer was found in some observational studies, this cannot be taken as evidence of a causal relation, and these results should be interpreted with caution. These studies have many limitations, including issues with assessment of exposure to selenium and to its various chemical forms, heterogeneity, confounding and other biases. Conflicting results including inverse, null and direct associations have been reported for some cancer types.RCTs assessing the effects of selenium supplementation on cancer risk have yielded inconsistent results, although the most recent studies, characterised by a low risk of bias, found no beneficial effect on cancer risk, more specifically on risk of prostate cancer, as well as little evidence of any influence of baseline selenium status. Rather, some trials suggest harmful effects of selenium exposure. To date, no convincing evidence suggests that selenium supplements can prevent cancer in humans.
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Affiliation(s)
- Marco Vinceti
- University of Modena and Reggio EmiliaDepartment of Diagnostic, Clinical and Public Health MedicineVia Campi 287ModenaItaly41125
| | - Gabriele Dennert
- University of Applied Sciences DortmundSocial Medicine and Public Health with Focus on Gender and Diversity, Department of Applied Social SciencesEmil‐Figge‐Str. 44DortmundGermanyD‐44227
| | - Catherine M Crespi
- University of California Los AngelesBiostatisticsFielding School of Public Health650 Charles Young Drive South, A2‐125 CHS, Box 95690090095‐6900USALos Angeles
| | - Marcel Zwahlen
- University of BernInstitute of Social and Preventive MedicineFinkelhubelweg11BernSwitzerland3012
| | - Maree Brinkman
- Cancer Council VictoriaCancer Epidemiology Centre615 St Kilda RdMelbourneAustralia3004
| | | | - Markus Horneber
- Paracelsus Medical University, Klinikum NurembergDepartment of Internal Medicine, Division of Oncology and HematologyProf.‐Ernst‐Nathan‐Str. 1NurembergGermanyD‐90419
| | - Roberto D'Amico
- University of Modena and Reggio EmiliaItalian Cochrane Centre, Department of Diagnostic, Clinical and Public Health MedicineVia del Pozzo 71ModenaItaly41124
| | - Cinzia Del Giovane
- University of Modena and Reggio EmiliaItalian Cochrane Centre, Department of Diagnostic, Clinical and Public Health MedicineVia del Pozzo 71ModenaItaly41124
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26
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Vinceti M, Crespi CM, Malagoli C, Del Giovane C, Krogh V. Friend or foe? The current epidemiologic evidence on selenium and human cancer risk. JOURNAL OF ENVIRONMENTAL SCIENCE AND HEALTH. PART C, ENVIRONMENTAL CARCINOGENESIS & ECOTOXICOLOGY REVIEWS 2013; 31:305-41. [PMID: 24171437 PMCID: PMC3827666 DOI: 10.1080/10590501.2013.844757] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Scientific opinion on the relationship between selenium and the risk of cancer has undergone radical change over the years, with selenium first viewed as a possible carcinogen in the 1940s then as a possible cancer preventive agent in the 1960s-2000s. More recently, randomized controlled trials have found no effect on cancer risk but suggest possible low-dose dermatologic and endocrine toxicity, and animal studies indicate both carcinogenic and cancer-preventive effects. A growing body of evidence from human and laboratory studies indicates dramatically different biological effects of the various inorganic and organic chemical forms of selenium, which may explain apparent inconsistencies across studies. These chemical form-specific effects also have important implications for exposure and health risk assessment. Overall, available epidemiologic evidence suggests no cancer preventive effect of increased selenium intake in healthy individuals and possible increased risk of other diseases and disorders.
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Affiliation(s)
- Marco Vinceti
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), University of Modena and Reggio Emilia, Modena, Italy
- Department of Diagnostic, Clinical Medicine and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Catherine M. Crespi
- Department of Biostatistics, University of California Los Angeles Fielding School of Public Health, Los Angeles, California, USA
| | - Carlotta Malagoli
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), University of Modena and Reggio Emilia, Modena, Italy
- Department of Diagnostic, Clinical Medicine and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Cinzia Del Giovane
- Department of Diagnostic, Clinical Medicine and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
- Italian Cochrane Centre, University of Modena and Reggio Emilia, Modena, Modena, Italy
| | - Vittorio Krogh
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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Vinceti M, Crespi CM, Malagoli C, Bottecchi I, Ferrari A, Sieri S, Krogh V, Alber D, Bergomi M, Seidenari S, Pellacani G. A case-control study of the risk of cutaneous melanoma associated with three selenium exposure indicators. TUMORI JOURNAL 2012. [PMID: 22825502 DOI: 10.1700/1125.12394] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIMS AND BACKGROUND A direct association between exposure to the metalloid selenium and risk of cutaneous melanoma has been suggested by some observational and experimental cohort studies, whereas other studies have yielded inconsistent results. Since some of the inconsistencies may be due to exposure misclassification arising from the use of exposure indicators that do not adequately reflect body tissue selenium content or the levels of the biologically relevant species of this metalloid, we examined this issue using multiple indicators of exposure. METHODS We analyzed the relation of selenium exposure with risk of cutaneous melanoma using two different biomarkers, plasma and toenail selenium concentration, and estimated dietary selenium intake in a population-based case-control series (54 cases, 56 controls) from an Italian community. RESULTS In unmatched and matched logistic regression models as well as nonparametric generalized additive models, higher plasma selenium levels were strongly associated with excess disease risk. In contrast, toenail and dietary selenium exhibited little relation with melanoma risk. The pattern of correlation among indicators of exposure differed by disease status, with dietary intake associated with plasma selenium levels in patients but not in controls. CONCLUSIONS Our data showed that different selenium exposure indicators can yield different inferences about melanoma risk. Although the series was small, our results are consistent with a positive association between circulating levels of selenium and melanoma risk. Further investigation of the exposure classification performance of various selenium biomarkers and of metabolic patterns of the metalloid and of its speciation are needed to help elucidate the relation between selenium exposure and human health.
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Affiliation(s)
- Marco Vinceti
- Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Public Health Sciences, University of Modena and Reggio Emilia, Reggio Emilia, Italy.
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Khan MS, Dilawar S, Ali I, Rauf N. The possible role of selenium concentration in hepatitis B and C patients. Saudi J Gastroenterol 2012; 18:106-10. [PMID: 22421715 PMCID: PMC3326970 DOI: 10.4103/1319-3767.93811] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND/AIM The compelling evidence reported that selenium is an essential trace mineral for human beings. Selenium plays a pivotal role in the restoration of immune functions. High rates of hepatitis B and C are present in Pakistan. Epidemiologic surveys demonstrated an inverse association between selenium (Se) level and regional cancer incidence, as well as viral infection. The present study was designed to evaluate the concentration of selenium in the serum of patients suffering from hepatitis B and C. PATIENTS AND METHODS In this cross-sectional descriptive analytical study, serum selenium concentration of 150 patients suffering from hepatitis B and C, along with 26 healthy controls, was determined by atomic absorption spectrophotometer equipped with hydride generation system, model Analytic Jena (Vario III). RESULTS The mean and standard deviation of serum selenium concentration observed in male and female patients with hepatitis C were 101.60 ± 0.55 and 77.43 ± 0.47 μ g/L, respectively, whereas the mean and standard deviation of serum selenium concentration observed in male and female patients with hepatitis B were 107.58 ± 0.44 and 137.8 ± 0.36 μg/L. Analysis of t test showed significant difference between C and B (P<0.001) patients in serum selenium concentration, when compared with the control. CONCLUSION The obtained results indicate that serum selenium concentration of hepatitis B and C patients is less than serum selenium concentration of healthy individuals. However, serum selenium decline is relative to severity of disease. Based on findings of this study, it is proposed that selenium should be supplemented in such patients in order to optimize nutritional support and to get better treatment response.
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Affiliation(s)
- Mohammad S. Khan
- Department of Biochemistry, Bannu Medical College, Khyber Pakhtunkhwa, Bannu, Pakistan,Address for correspondence: Dr. Mohammad Shoaib Khan, Department of Biochemistry, Bannu Medical College, Khyber Pakhtunkhwa, Bannu, Pakistan. E-mail:
| | - Shahnaz Dilawar
- Department of Biochemistry, Bannu Medical College, Khyber Pakhtunkhwa, Bannu, Pakistan
| | - Irshad Ali
- Department of Biochemistry, Gomal University Dera Ismail Khan Khyber Pakhtunkhwa, Pakistan
| | - Naseem Rauf
- National Physical Standard laboratories, Islamabad, Pakistan
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29
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Petrovski BÉ, Pataki V, Jenei T, Adány R, Vokó Z. Selenium levels in men with liver disease in Hungary. J Trace Elem Med Biol 2012; 26:31-5. [PMID: 22365072 DOI: 10.1016/j.jtemb.2012.01.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2011] [Revised: 11/14/2011] [Accepted: 01/10/2012] [Indexed: 11/26/2022]
Abstract
PROJECT We studied the relationship between selenium (Se) levels and chronic liver disease (CLD) severity and the association between socioeconomic and lifestyle factors and serum Se levels. PROCEDURE We performed a case-control study in Hungarian men, examining 281 patients with CLD and 778 controls. Liver function was evaluated using biochemical markers, and liver disease was verified with physical examination and blood tests. Linear regression analysis was performed to study the association of serum Se level with biochemical markers in cases and controls. In control participants we examined the relationship between Se levels and age, financial status, education, alcohol consumption, cigarette smoking, type of fat used for cooking and body mass index. RESULTS Serum Se levels were lower in cases (median 0.87 μmol/L (IQR: 0.77-1.03)) than in controls (median 1.08 μmol/L (IQR: 0.97-1.19)). In controls, increases in bilirubin and glutamic-oxaloacetic transaminase (GOT) were associated with decreases in Se levels. In patients with CLD, a statistically significant relationship was found between serum Se and the GOT/GPT ratio, albumin and bilirubin. Younger, better-educated controls had significantly higher, and regular smokers and heavy drinkers had significantly lower Se levels. The use of vegetable oil/fat was also associated with higher Se levels. Se level was associated with the severity of liver injury in people even in patients who did not exhibit signs and symptoms of CLD. CONCLUSIONS Serum Se level is strongly associated with the severity of liver damage in people with CLD from the early stage on.
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Affiliation(s)
- Beáta Éva Petrovski
- Department of Preventive Medicine, Faculty of Public Health, Medical & Health Science Centre, University of Debrecen, Kassai út 26/b, Debrecen H-4012, Hungary.
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Vinceti M, Bonvicini F, Rothman KJ, Vescovi L, Wang F. The relation between amyotrophic lateral sclerosis and inorganic selenium in drinking water: a population-based case-control study. Environ Health 2010; 9:77. [PMID: 21134276 PMCID: PMC3023780 DOI: 10.1186/1476-069x-9-77] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2010] [Accepted: 12/06/2010] [Indexed: 05/24/2023]
Abstract
BACKGROUND A community in northern Italy was previously reported to have an excess incidence of amyotrophic lateral sclerosis among residents exposed to high levels of inorganic selenium in their drinking water. METHODS To assess the extent to which such association persisted in the decade following its initial observation, we conducted a population-based case-control study encompassing forty-one newly-diagnosed cases of amyotrophic lateral sclerosis and eighty-two age- and sex-matched controls. We measured long-term intake of inorganic selenium along with other potentially neurotoxic trace elements. RESULTS We found that consumption of drinking water containing ≥ 1 μg/l of inorganic selenium was associated with a relative risk for amyotrophic lateral sclerosis of 5.4 (95% confidence interval 1.1-26) after adjustment for confounding factors. Greater amounts of cumulative inorganic selenium intake were associated with progressively increasing effects, with a relative risk of 2.1 (95% confidence interval 0.5-9.1) for intermediate levels of cumulative intake and 6.4 (95% confidence interval 1.3-31) for high intake. CONCLUSION Based on these results, coupled with other epidemiologic data and with findings from animal studies that show specific toxicity of the trace element on motor neurons, we hypothesize that dietary intake of inorganic selenium through drinking water increases the risk for amyotrophic lateral sclerosis.
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Affiliation(s)
- Marco Vinceti
- CREAGEN - Environmental, Genetic and Nutritional Epidemiology Research Center, University of Modena and Reggio Emilia, Reggio Emilia, Italy
| | - Francesca Bonvicini
- CREAGEN - Environmental, Genetic and Nutritional Epidemiology Research Center, University of Modena and Reggio Emilia, Reggio Emilia, Italy
- Department of Public Health, Local Health Unit of Reggio Emilia, Reggio Emilia, Italy
| | - Kenneth J Rothman
- RTI Health Solutions, Research Triangle Park, NC, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Luciano Vescovi
- Laboratory of Environmental Chemistry, IREN, Reggio Emilia, Italy
| | - Feiyue Wang
- Department of Environment and Geography & Department of Chemistry, University of Manitoba, Winnipeg, Canada
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31
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Jenny-Burri J, Haldimann M, Dudler V. Estimation of selenium intake in Switzerland in relation to selected food groups. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2010; 27:1516-31. [DOI: 10.1080/19440049.2010.506603] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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32
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Giray B, Arnaud J, Sayek I, Favier A, Hincal F. Trace elements status in multinodular goiter. J Trace Elem Med Biol 2010; 24:106-10. [PMID: 20413068 DOI: 10.1016/j.jtemb.2009.11.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2009] [Revised: 10/11/2009] [Accepted: 10/26/2009] [Indexed: 10/20/2022]
Abstract
Importance of iodine and selenium in thyroid metabolism is well known, but the roles of other essential trace elements including copper, zinc, manganese and iron on thyroid hormone homeostasis remain unclear. The aim of this study was to investigate the status of those trace elements in benign thyroid diseases and evaluate possible links between trace element concentrations and thyroid hormones. The study group was composed of 25 patients with multinodular goiter. Concentrations of thyroid hormones (plasma-free thyroxine, FT(4); free triiodothyronine, FT(3); and thyrotropin, TSH), selenium, copper, zinc, manganese and iron in plasma, and urinary iodine were determined. The results were compared with those of a healthy control group (n=20) with no thyroid disorder. A mild iodine deficiency was observed in the patients with multinodular goiter whereas urinary iodine levels were in the range of "normal" values in healthy controls. All patients were euthyroid, and their thyroid hormone concentrations were not significantly different from the control group. Plasma selenium, zinc and iron concentrations did not differ from controls, while copper and manganese levels were found to be significantly higher in the patients with multinodular goiter indicating links between these trace elements and thyroid function and possibly in development of goiter. Besides iodine, there was a significant correlation between plasma copper concentration and FT(3)/FT(4) ratio.
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Affiliation(s)
- Belma Giray
- Hacettepe University, Faculty of Pharmacy, Department of Toxicology, Ankara 06100, Turkey.
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33
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Asfour IA, El-kholy NM, Ayoub MS, Ahmed MB, Bakarman AA. Selenium and glutathione peroxidase status in adult Egyptian patients with acute myeloid leukemia. Biol Trace Elem Res 2009; 132:85-92. [PMID: 19458925 DOI: 10.1007/s12011-009-8401-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2009] [Accepted: 04/30/2009] [Indexed: 11/28/2022]
Abstract
This study was undertaken to evaluate selenium (Se) and glutathione peroxidase (GPX) status in patients with newly diagnosed acute myeloid leukemia (AML) before and after induction therapy. Twenty-five patients with newly diagnosed AML and 15 healthy age- and sex-matched control subjects were included in this study. Serum Se level by the graphite furnace atomic absorption spectrometric technique and GPX activity by an adaptation of Beutler method was performed for the patients before and after receiving the induction therapy. Serum Se level was significantly lower in patients with AML versus control subjects (63.1 ± 8.8 versus 77 ± 8.8 μg/L before therapy with a P value <0.01 and 69 ± 6.8 versus 77 ± 8.8 μg/L after therapy with a P value <0.01).GPX activity was significantly lower in patients with AML versus control subjects (1.6 ± 0.4 versus 3.4 ± 0.7 μ/g protein pretreatment with a P value <0.01 and 1.9 ± 0.6 versus 3.4 ± 0.7 μ/g protein post induction treatment with P value <0.01).Se level and GPX activity significantly increased in AML patients after treatment. Patients who accomplished complete remission after induction harbored significantly higher Se levels than resistant patients before and after treatment. There was no significant correlation between serum Se level and GPX activity. Decreased Se level and reduced GPX activity in AML patients support the association of carcinogenesis and subnormal Se states.
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Affiliation(s)
- Inas A Asfour
- Clinical Hematology and Bone Marrow Transplantation Unit, Department of Internal Medicine, Ain Shams University, Cairo, Egypt
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34
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Vinceti M, Maraldi T, Bergomi M, Malagoli C. Risk of chronic low-dose selenium overexposure in humans: insights from epidemiology and biochemistry. REVIEWS ON ENVIRONMENTAL HEALTH 2009; 24:231-248. [PMID: 19891121 DOI: 10.1515/reveh.2009.24.3.231] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The latest developments of epidemiologic and biochemical research suggest that current upper limits of intake for dietary selenium and for overall selenium exposure may be inadequate to protect human health. In particular, recent experimental and observational prospective studies indicate a diabetogenic effect of selenium at unexpectedly low levels of intake. Experimental evidence from laboratory studies and veterinary medicine appears to confirm previous epidemiologic observations that selenium overexposure is associated with an increased risk of amyotrophic lateral sclerosis, and a recent large trial indicated no beneficial effect in preventing prostate cancer. Moreover, the pro-oxidant properties of selenium species and the observation that the selenium-containing enzymes glutathione peroxidases are induced by oxidative stress imply that the increase in enzymatic activity induced by this metalloid may represent at least in part a compensatory response. Taken together, the data indicate that the upper safe limit of organic and inorganic selenium intake in humans may be lower than has been thought and that low-dose chronic overexposure to selenium may be considerably more widespread than supposed.
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Affiliation(s)
- Marco Vinceti
- CREAGEN-Environmental, Genetic & Nutritional Epidemiology Research Center, Department of Public Health Sciences, University of Modena and Reggio Emilia, Modena, Italy.
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Abstract
BACKGROUND Selenium is of fundamental importance to human health, and selenium deficiency is associated with disease conditions. OBJECTIVE The objective of this study was to investigate the serum level of selenium in women of childbearing age and postmenopausal women living in Tabriz, Iran. METHODS In this cross-sectional study, 60 healthy women of childbearing age and 60 healthy postmenopausal women were studied with the use of biochemical methods (measurement of serum selenium by graphite furnace atomic absorption spectrometry), anthropometric measurements (weight and height), and interviews. RESULTS The average serum selenium was 76.67 +/- 17.98 microg/L (range, 42.00 to 166.61 microg/L). This level was lower than those reported in other provinces of Iran and some other countries. Sixty-nine women (57.5%) had serum selenium concentrations under 80 microg/L. There was no significant difference in selenium level between the two groups of women. Serum selenium level did not vary with age and body mass index. CONCLUSIONS Some Iranian women are of borderline selenium status and as a consequence are more susceptible to selenium-deficiency diseases. There is a need for community-based programs to encourage people to increase consumption of selenium-rich sources, such as marine foods.
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Affiliation(s)
- Maryam Rafraf
- Faculty of Health and Nutrition, Nutritional Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
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36
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Burri J, Haldimann M, Dudler V. Selenium status of the Swiss population: assessment and change over a decade. J Trace Elem Med Biol 2008; 22:112-9. [PMID: 18565423 DOI: 10.1016/j.jtemb.2007.11.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2007] [Accepted: 11/17/2007] [Indexed: 11/28/2022]
Abstract
A monitoring study of serum selenium concentration was carried out on healthy blood donors from different regions of Switzerland. With an overall mean serum concentration of 98 microg/L (n=1847), the selenium status of the healthy adults can be assessed as adequate. The lowest measured concentration of 62 microg/L denotes that the risk of a marginal selenium deficiency in the Swiss population is small. Compared to a similar study carried out in 1993, the status improved for both genders, although the increase is higher among women. It is noteworthy that the supplementation practice has increased during this period with ca. 2% of the population taking Se-micronutrients. No correlation between the age and the serum concentration is detected, even though the age-range was enlarged in this study to 18-68 years for the women and to 19-72 years for the men. The place of residence only marginally influences the selenium concentration, which implies a certain uniformity of the dietary habits between the various regions of the country.
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Affiliation(s)
- Judith Burri
- Federal Office of Public Health, Food Safety Division, Chemical Risks Section, 3003 Bern, Switzerland
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37
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Burri J, Haldimann M. Direct determination of selenium in human serum by inductively coupled plasma-collision cell-mass spectrometry. ACTA ACUST UNITED AC 2007; 45:895-8. [PMID: 17617034 DOI: 10.1515/cclm.2007.153] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AbstractClin Chem Lab Med 2007;45:895–8.
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Affiliation(s)
- Judith Burri
- Swiss Federal Office of Public Health, Division of Food Safety, Section Chemical Risks, Bern, Switzerland.
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38
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Hincal F. Trace elements in growth: iodine and selenium status of Turkish children. J Trace Elem Med Biol 2007; 21 Suppl 1:40-3. [PMID: 18039495 DOI: 10.1016/j.jtemb.2007.09.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2007] [Accepted: 08/31/2007] [Indexed: 11/20/2022]
Abstract
Starting from the fetal life and increasing the need throughout the childhood, adequate intake of micronutrients is of great importance for the proper development of structure and function of the body, and the well being. However, micronutrient deficiency is widespread in many populations of the world mainly due to nutritional insufficiencies and/or inadequate and unbalanced nutrition. While iodine and selenium (Se) are inadequately available for men and live stock in many parts of the world, Turkey is one of those countries where iodine deficiency (ID) is widespread, Se levels are marginal. In this communication, importance of adequate iodine and Se nutrition and status of Turkish children is summarized.
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Affiliation(s)
- Filiz Hincal
- Department of Toxicology, Faculty of Pharmacy, Hacettepe University, Ankara 06100, Turkey.
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39
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Van Cauwenbergh R, Robberecht H, Van Vlaslaer V, Deelstra H. Comparison of the serum selenium content of healthy adults living in the Antwerp region (Belgium) with recent literature data. J Trace Elem Med Biol 2004; 18:99-112. [PMID: 15487770 DOI: 10.1016/j.jtemb.2004.04.004] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Graphite furnace atomic absorption spectrometry, after improved matrix modification and using Zeeman background correction, was used to measure the serum selenium content of healthy adults living in the Antwerp region (Belgium). The mean serum concentration of 13 men and 13 women, sampled once a month during 1 year, was 84.3 +/- 9.4ng/ml with a broad range of 51.4-121.7 ng/ml. The intra-individual variation was remarkably high. Recent literature on selenium concentrations is reviewed and values are tabulated, with limitation to healthy adults and European countries. The mean serum selenium concentration measured corresponded well to older literature data for Belgium. The obtained values were found to be in the medium range compared with the literature data for other European countries.
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Affiliation(s)
- Rudy Van Cauwenbergh
- Laboratory of Food Sciences, Department of Pharmaceutical Sciences, University of Antwerp, Universiteitsplein 1, B-2610 Antwerp, Belgium
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40
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Magalhães CG, Lelis KLA, Rocha CA, da Silva JBB. Direct determination of aluminium in serum and urine by electrothermal atomic absorption spectrometry using ruthenium as permanent modifier. Anal Chim Acta 2002. [DOI: 10.1016/s0003-2670(02)00479-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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41
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Sabé R, Rubio R, García-Beltrán L. Reference values of selenium in plasma in population from Barcelona. Comparison with several pathologies. J Trace Elem Med Biol 2002; 16:231-7. [PMID: 12530585 DOI: 10.1016/s0946-672x(02)80050-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Plasma selenium reference values from healthy donors in the metropolitan area of Barcelona are determined. A random sample from 156 healthy adults (control group) is analysed by using electrothermal atomic absorption spectrometry with Zeeman effect background correction. The relationship between several pathologies and Se content is also evaluated. Se content from 64 samples from subjects with chronic renal failure and 54 from subjects suffering from several malignancies are determined and the results are compared to the reference values. Moreover, Se contents are determined and compared in two groups of children, healthy (19 samples) and children of mothers infected with HIV-1 (16 samples). In the control group, Se plasma concentration ranges between 50 and 145 microg x L(-1) (82.2 +/- 17.5 microg x L(-1)). Significantly lower values are found in the two pathologies studied (malignancy and chronic renal failure), compared to the control group. However, no significant differences in Se content are found between the two groups studied regarding malignancy and chronic renal failure. In children of mothers infected with HIV-1, Se status is significantly lower than that of healthy children.
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Affiliation(s)
- Rosa Sabé
- Departament de Química Analítica, Universitat de Barcelona, Barcelona, Spain
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42
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Tsalev DL, Lampugnani L, D'Ulivo A, Petrov II, Georgieva R, Marcucci K, Zamboni R. Electrothermal atomic absorption spectrometric determination of selenium in biological fluids with rhodium modifier compared with hydride generation atomic spectrometric techniques. Microchem J 2001. [DOI: 10.1016/s0026-265x(01)00105-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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43
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Diaz Romero C, López Blanco F, Henríquez Sánchez P, Rodríguez E, Serra Majem L. Serum selenium concentration in a representative sample of the Canarian population. THE SCIENCE OF THE TOTAL ENVIRONMENT 2001; 269:65-73. [PMID: 11305344 DOI: 10.1016/s0048-9697(00)00815-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The concentration of serum selenium in 395 individuals (187 males + 218 females) living in the Canary Islands, Spain was determined by hydride generation atomic absorption spectrometry. The mean selenium concentration was 74.7 +/- 25.2 microg/l ranging between 7.86 and 182.3 microg/l. Twenty-two adults (7.2% of the total) had serum selenium concentrations under 45 microg/l. It is widely accepted that below this selenium serum concentration (45 microg/l) there is an increased risk of cardiovascular disease and cancer. Our results fall within data recently published in other Spanish and European regions and are much lower than data observed in USA or seleniferous regions. The estimated Se intakes of our population were lower than the Recommended Dietary Allowances for American people. Individuals from Lanzarote had a mean Se concentration significantly higher than individuals from the other islands. This could be attributed to differences in Se content of soil and/or differences in dietary habits of the populations. Serum selenium concentration did not vary with the sex of the subjects. Individuals younger than 14 years old had a serum selenium concentration significantly lower than the rest of the individuals. No relationship with socio-economic status, educational level, smoking habits, physical exercise or beer consumption was found. However, individuals who consume wine more than three times a week showed higher selenium concentrations than individuals with lower consumption. Also, individuals with consumption above seven units of spirit drinks a week had the highest mean selenium concentration.
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Affiliation(s)
- C Diaz Romero
- Department of Analytical Chemistry, Nutrition and Food Science, University of La Laguna, Santa Cruz de Tenerife, Spain
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44
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Sabé R, Rubio R, Garcı́a-Beltrán L. Determination of selenium in human blood specimens by electrothermal atomic absorption. Anal Chim Acta 2000. [DOI: 10.1016/s0003-2670(00)01008-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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45
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Komaromy-Hiller G, Ash KO, Costa R, Howerton K. Comparison of representative ranges based on U.S. patient population and literature reference intervals for urinary trace elements. Clin Chim Acta 2000; 296:71-90. [PMID: 10807972 DOI: 10.1016/s0009-8981(00)00205-9] [Citation(s) in RCA: 66] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Reference intervals for trace elements are very hard to obtain because of the difficulty of defining a nonexposed reference population. However, representative ranges for trace elements obtained from a general patient population can provide useful information in interpreting laboratory results. We have used urine specimens submitted for trace metal analysis from patients residing in the United States to calculate representative ranges for 25 urinary trace elements, and to compare them to reference values taken from the literature. All urine analytes were measured by inductively-coupled plasma-mass spectrometry except chromium, which was measured by graphite furnace atomic absorption spectroscopy. For representative range calculation two approaches were used. In the non-parametric calculation first, the top 10% of results were discarded assuming that those specimens came from individuals with unusually high trace element exposures. Next the central 95% of the remaining data was taken as the reference interval. In the parametric calculation the specimens from exposed or not healthy individuals were assumed to appear as outliers and were discarded. The mean and S.D. were calculated, and used to determine representative ranges. The two approaches yielded very similar results, and worked remarkably well for 14 analytes. There were minor discrepancies for 7 analytes, and major for 4 analytes. All analyses of urinary trace elements included a urine creatinine value, which was used to express urinary trace element concentrations in terms of creatinine ratio. This corrects for differences in urine concentration that affects the results for random specimens.
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Affiliation(s)
- G Komaromy-Hiller
- University of Utah School of Medicine, Department of Pathology, 50 North Medical Drive, Salt Lake City, UT 84132, USA
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46
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Winklhofer-Roob BM, Tiran B, Tuchschmid PE, van't Hof MA, Shmerling DH. Effects of pancreatic enzyme preparations on erythrocyte glutathione peroxidase activities and plasma selenium concentrations in cystic fibrosis. Free Radic Biol Med 1998; 25:242-9. [PMID: 9667502 DOI: 10.1016/s0891-5849(98)00061-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
To substitute for exocrine pancreatic insufficiency, patients with cystic fibrosis (CF) take pancreatic enzymes (PE) originating from porcine pancreas. Five different pancreatic enzyme preparations used by our patients contained 0.5-1.4 microg selenium per g tablet. In patients taking PE in doses that were gradually increased to improve fat absorption during a 48-month period, the effects of PE dose on erythrocyte selenium-dependent glutathione peroxidase (SeGSH-Px) activities and plasma selenium concentrations were studied. At baseline, erythrocyte SeGSH-Px activities were significantly lower in patients (p=.01), while plasma selenium concentrations did not differ between patients and healthy subjects. When PE dose and, consequently, selenium intake from PE was increased, erythrocyte SeGSH-Px activities (p < .001) and plasma selenium concentrations (p=.02) increased. Changes in SeGSH-Px activities during the initial 8 months correlated with those in selenium intake from PE (r=0.67, p < .001). Plasma selenium concentrations plateaued at 12 months and erythrocyte SeGSH-Px activities did so at 36 months, when patients had reached SeGSH-Px activities similar to those of healthy subjects. At 48 months, patients took an average lipase dose of 17400 U x kg(-1) x d(-1) and selenium dose from PE of 0.53 microg x kg(-1) x d(-1). We conclude that selenium content of PE preparations has a significant effect on SeGSH-Px activity in patients with CF. This form of selenium supply needs to be taken into account when selenium supplements are given to patients with CF.
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47
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White MA, Sabbioni E. Trace element reference values in tissues from inhabitants of the European Union. X. A study of 13 elements in blood and urine of a United Kingdom population. THE SCIENCE OF THE TOTAL ENVIRONMENT 1998; 216:253-270. [PMID: 9646532 DOI: 10.1016/s0048-9697(98)00156-9] [Citation(s) in RCA: 65] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Electrothermal atomic absorption spectrophotometry (ETAAS), inductively coupled plasma mass spectrometry (ICP-MS) and neutron activation analysis (NAA) were used for the quantitative determination of 13 trace elements in urine and seven trace elements in whole blood of healthy unexposed British subjects living in three regions of the United Kingdom. Careful control of pre-analytical and analytical factors have enabled the results obtained from more than 200 individuals to be used in proposing reference intervals for the following elements; Al, As, Cd, Co, Cr, Cu, Hg, Mn, Mo, Ni, Pb, Se, Tl in urine, and Cd, Cr, Hg, Mn, Pb, Se and Tl in blood.
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Affiliation(s)
- M A White
- Environment Institute, European Commission Joint Research Centre, Varese, Italy
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48
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Haldimann M, Zimmerli B, Als C, Gerber H. Direct determination of urinary iodine by inductively coupled plasma mass spectrometry using isotope dilution with iodine-129. Clin Chem 1998. [DOI: 10.1093/clinchem/44.4.817] [Citation(s) in RCA: 124] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
An inductively coupled mass spectrometric method was developed for the direct determination of iodine in urine. The application of isotope dilution analysis with added 129I offers new possibilities for automatic and accurate determinations. The sample preparation consists of dilution with an ammonia solution containing 129I. The validation was made by comparison with the results obtained in another laboratory by a spectrophotometric method based on the Sandell–Kolthoff reaction. Different regression models, including maximum likelihood estimation, were used to compare the methods. None of the models revealed analytical bias between the two methods. The urine samples analyzed for validation were from three persons previously exposed to an iodine bath and covered a concentration range of 0.2 to 2.8 μmol/L. A detection limit of 0.02 μmol/L, a within-run CV of 2.5%, and a between-run CV of 11.9% were estimated for the proposed method.
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Affiliation(s)
- Max Haldimann
- Swiss Federal Office of Public Health, Division of Food Science, Section of Food Chemistry and Analysis, 3003 Bern, Switzerland
| | - Bernhard Zimmerli
- Swiss Federal Office of Public Health, Division of Food Science, Section of Food Chemistry and Analysis, 3003 Bern, Switzerland
| | - Claudine Als
- University of Bern, Inselspital, Department of Pathology, 3010 Bern, Switzerland
| | - Hans Gerber
- University Hospital, Inselspital, Department of Clinical Chemistry, 3010 Bern, Switzerland
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