The epidemiology of selenium deficiency in the etiological study of endemic diseases in China

Effects of dietary selenized glucose on intestinal microbiota and tryptophan metabolism in rats: Assessing skatole reduction potential

3-Methylindole (Skatole), a degradation product of tryptophan produced by intestinal microbial activity, significantly contributes to odor nuisance. Its adverse effects on animal welfare, human health, and environmental pollution have been noted. However, it is still unclear whether the intestinal microbiota mediates the impact of selenium (Se) on skatole production and what the underlying mechanisms remain elusive. A selenized glucose (SeGlu) derivative is a novel organic selenium compound. In this study, a diverse range of dietary SeGlu-treated levels, including SeGlu-deficient (CK), SeGlu-adequate (0.15 mg Se per L), and SeGlu-supranutritional (0.4 mg Se per L) conditions, were used to investigate the complex interaction of SeGlu on intestinal microbiome and serum metabolome changes in male Sprague-Dawley (SD) rats. The study showed that SeGlu supplementation enhanced the antioxidant ability in rats, significantly manifested in the increases of the activity of catalase (CAT) and glutathione peroxidase (GSH-Px), while no change in the level of malonaldehyde (MDA). Metagenomic sequencing analysis verified that the SeGlu treatment group significantly increased the abundance of beneficial microorganisms such as Clostridium, Ruminococcus, Faecalibacterium, Lactobacillus, and Alloprevotella while reducing the abundance of opportunistic pathogens such as Bacteroides and Alistipes significantly. Further metabolomic analysis revealed phenylalanine, tyrosine, and tryptophan biosynthesis changes in the SeGlu treatment group. Notably, the biosynthesis of indole, a critical pathway, was affected by SeGlu treatment, with several crucial enzymes implicated. Correlation analysis demonstrated strong associations between specific bacterial species - Treponema, Bacteroides, and Ruminococcus, and changes in indole and derivative concentrations. Moreover, the efficacy of SeGlu-treated fecal microbiota was confirmed through fecal microbiota transplantation, leading to a decrease in the concentration of skatole in rats. Collectively, the analysis of microbiota and metabolome response to diverse SeGlu levels suggests that SeGlu is a promising dietary additive in modulating intestinal microbiota and reducing odor nuisance in the livestock and poultry industry.

Preoperative serum selenium predicts acute kidney injury after adult cardiac surgery

BACKGROUND

The relationship between serum selenium (Se) and acute kidney injury after adult cardiac surgery (CSA-AKI) remains controversial. This study aimed to investigate the association of preoperative Se level with incident CSA-AKI.

METHOD AND RESULTS

A retrospective cohort study was conducted on patients who underwent cardiac surgery. The primary outcome was incident CSA-AKI. Multivariable logistic regression models and natural cubic splines were used to estimate the association of Se levels and primary outcome. A total of 453 patient with a mean age of 62.97 years were included. Among all patients, 159 (35.1%) incident cases of CSA-AKI were identified. The level of preoperative Se concentration in patients with CSA-AKI was significant lower than that in patients without CSA-AKI. The higher preoperative Se level was significantly associated with decreased risk of CSA-AKI (adjusted OR 0.91, 95% CI: 0.87-0.99). Dose-response relationship curve revealed a nearly L-shape correlation between serum Se selenium levels and incident CSA-AKI.

CONCLUSION

Our study suggested that a higher level of serum Se was significantly associated with lower risk of CSA-AKI. Further prospective studies are needed to clarify the causal relationship between serum Se level and incident CSA-AKI.

Review on the health-promoting effect of adequate selenium status

Selenium is an essential microelement involved in various biological processes. Selenium deficiency increases the risk of human immunodeficiency virus infection, cancer, cardiovascular disease, and inflammatory bowel disease. Selenium possesses anti-oxidant, anti-cancer, immunomodulatory, hypoglycemic, and intestinal microbiota-regulating properties. The non-linear dose-response relationship between selenium status and health effects is U-shaped; individuals with low baseline selenium levels may benefit from supplementation, whereas those with acceptable or high selenium levels may face possible health hazards. Selenium supplementation is beneficial in various populations and conditions; however, given its small safety window, the safety of selenium supplementation is still a subject of debate. This review summarizes the current understanding of the health-promoting effects of selenium on the human body, the dietary reference intake, and evidence of the association between selenium deficiency and disease.

Integrative analysis of multiomics data identifies selenium-related gene ALAD associating with keshan disease

Keshan disease is an endemic fatal dilated cardiomyopathy that can cause heart enlargement, heart failure, and cardiogenic death. Selenium deficiency is considered to be the main cause of Keshan disease. However, the molecular mechanism underlying Keshan disease remains unclear. Our whole-exome sequencing from 68 patients with Keshan disease and 100 controls found 199 candidate genes by gene-level burden tests. Interestingly, using multiomics data, the selenium-related gene ALAD (δ-aminolevulinic acid dehydratase) was the only candidate causative gene identified by three different analysis approaches. Based on single-cell transcriptome data, ALAD was highly expressed in cardiomyocytes and double mutations of human ALAD dramatically reduced its enzyme activity in vitro compared to negative control. Functional analysis of ALAD inhibition in mice resulted in a Keshan phenotype with left ventricular enlargement and cardiac dysfunction, whereas administration of sodium selenite markedly reversed the changes caused by ALAD inhibition. In addition, sodium selenite reversed Keshan phenotypes by affecting energy metabolism and mitochondrial function in mice as shown by the transcriptomic and proteomic data and the ultrastructure of cardiac myocytes. Our findings are the first to demonstrate that the selenium-related gene ALAD is essential for cardiac function by maintaining normal mitochondrial activity, providing strong molecular evidence supporting the hypothesis of selenium deficiency in Keshan disease. These results identified ALAD as a novel target for therapeutic intervention in Keshan disease and Keshan disease-related dilated cardiomyopathy.

Enrichment characteristics and dietary evaluation of selenium in navel orange fruit from the largest navel orange-producing area in China (southern Jiangxi)

Diet is the main intake source of selenium (Se) in the body. Southern Jiangxi is the largest navel orange-producing area in China, and 25.98% of its arable land is Se-rich. However, studies on the Se-rich characteristics and Se dietary evaluation of navel orange fruits in the natural environment of southern Jiangxi have not been reported. This study was large-scale and in situ samplings (n = 492) of navel oranges in southern Jiangxi with the goal of investigating the coupling relationships among Se, nutritional elements, and quality indicators in fruits and systematically evaluating Se dietary nutrition to the body. The results indicated that the average content of total Se in the flesh was 4.92 μg⋅kg^-1, and the percentage of Se-rich navel oranges (total Se ≥ 10 μg⋅kg^-1 in the flesh) was 7.93%, of which 66.74% of the total Se was distributed in the pericarp and 33.26% in the flesh. The average content of total Se in the flesh of Yudu County was the highest at 5.71 μg⋅kg^-1. There was a significant negative correlation (p < 0.05) between Se, Cu, and Zn in the Se-rich flesh. According to the Se content in the flesh, the Se dietary nutrition evaluation was carried out, and it was found that the Se-enriched navel orange provided a stronger Se nutritional potential for the human body. These findings will help to identify Se enrichment in navel orange fruit in China's largest navel orange-producing area and guide the selection of Se-rich soils for navel orange production in the future.

Characteristics of Se in water-soil-plant system and threshold of soil Se in seleniferous areas in Enshi, China

Se-enrichment characteristics in water-soil-plant system and dietary Se status of local residents in seleniferous areas were investigated. Results showed that Se in well water might mainly derived from Se-enriched shales and coals, and Se mobility in seleniferous soils was relatively low with less than 6.7% bioavailable forms in high-Se areas. Soil Se with irrigation, precipitation and fertilization sources contributed more to soil Se than Se-enriched shales and coals in low-Se areas, resulting in slightly higher mobility of Se in low-Se soils. Se concentration in edible parts of main crops ranged from 0.005 mg kg^-1 to 4.17 mg kg^-1, and cereal plants had a higher Se-enrichment ability than tuber plants. The probable dietary Se intake (PDI) in high-Se areas was decreased to 959.3 μg d^-1 in recent years, which might be attributed to tap water as drinking water in recent year rather than well water-dependent and changes in dietary structure, but still far above the permissible value of 400 μg d^-1. Reducing cereal-derived dietary Se intake is an important strategy to better Se nutrition status in high-Se areas. After synthesis considerations on soil Se bioavailability and PDI of Se, the soil total Se of 4 mg kg^-1 and the soil available Se content of 0.32 mg kg^-1 were proposed to be the reference threshold values of soil Se excess in high-Se areas in Enshi, respectively.

The dynamic change of urinary selenium concentration during pregnancy and influencing factors: A longitudinal study

BACKGROUND

Selenium concentration of one spot urine sample cannot reflect selenium status during whole pregnancy. Studies on variations of urinary selenium concentration at different stages of pregnancy are limited.

AIM

To assess variations of urinary selenium concentrations during three trimesters of pregnancy and to explore the influencing factors.

METHODS

This study included 2613 pregnant women from a birth cohort study (Wuhan, China) enrolled between October 2014 and October 2016. Selenium concentrations of urine samples collected at three trimesters were measured. We used a generalized linear mixed effects model to observe the changes in urinary selenium concentration during pregnancy and its influencing factors.

RESULTS

The median value (range) of gestational weeks at urine sample collection was 11 (9-14), 24 (15-27), and 34 (28-41) respectively. Urine selenium concentration varied across trimesters (geometric mean: 16.34, 17.65 and 18.83 μg/g creatinine, respectively), with an upward trend (β = -0.145, 95%CI: -0.164, -0.126) (β = -0.066, 95%CI: -0.083, -0.048). The concentrations of urinary selenium increased with the increasing of educational level [β (95%CI): ≤ 9 years = -0.105 (-0.163, -0.047); 10-12 years = -0.086(-0.126, -0.047); > 12 years = reference]. Pregnant women who rarely or only took multivitamins in the first trimester [β (95% CI): rarely = -0.076 (-0.144, -0.007); only in the first three months of pregnancy = -0.104 (-0.170, -0.038); always = reference], or were not exposed to passive smoking during pregnancy（β = -0.093, 95% CI: - 0.173, - 0.014), or exercised three to four days per week for the first three months before delivery（β = -0.074, 95% CI: - 0.140, - 0.008) had lower urinary selenium concentrations. Pregnant women who took calcium supplements after the third month of pregnancy had higher urinary selenium levels（β = 0.114, 95% CI: 0.059, 0.169).

CONCLUSIONS

Urine selenium concentrations of pregnant women showed an upward trend across trimesters. Educational level, calcium or multivitamin supplementation, passive smoking, and physical exercise might impact urine selenium levels.

Selenium Migration Mode in Coal Seams: Insights from Multivariate Analysis, Leaching Investigation, and Modelling

Processes controlling selenium concentrations ([Se]) in mine waters were studied at an operating coalmine district in Xuzhou city, China. The geochemistry and mobility of selenium was studied through leaching experiments, multivariate analysis, and numerical modeling. Results showed that selenium leaching was influenced by selenium occurrence in minerals, pH, electron activity (pe), and sulfur concentration in the water. Selenium occurrence in host rock was mainly sulfide minerals, and clay minerals in coal, respectively. Therefore, the oxidation and dissolution of sulfide minerals and transformation of clays may control the release of selenium. Experimental leaching experiments suggested selenium tends to leach more when the solution has more sulfur dissolved. A positive relationship is established between pH and the amount of Se released into solution with four times more Se released at pH 12 compared to pH 2 when leached with high-purity water. This release behavior is higher in O2-rich environments. The numerical modeling results showed that pH, pe, and sulfur presence in the solution play important roles in selenium adsorption. Selenium was desorbed from adsorbing surfaces under alkaline conditions, specifically when the solution pH was higher than 8. Higher pe values in the solution caused reduced selenium adsorption. In addition, dissolved sulfur competed with selenate for surfaces of adsorption, thus, selenium adsorption decreases as the sulfur concentration increased.

Selenium in selenium-rich rice sold in China and risk assessment

Selenium-rich rice samples of 52 brands were bought from supermarkets on line in China and analysed for Se with ICP-MS. The Se concentration of Se-rich rice in China ranged from 0.012 ± 0.001 to 0.558 ± 0.057 mg/kg with an average of 0.090 ± 0.092 mg/kg. Rice samples with Se concentrations below 0.04 mg/kg accounted for 36.5% of the total samples. Se concentrations between 0.04 and 0.3 mg/kg accounted for 61.6%. Taking the upper tolerable limit of 400 μg/d as the risk standard, the risk of selenium intake by selenium-rich rice was low and the risk index was far less than 100%. With the upper intake limit of 100 μg/d and the adequate intake of 70 μg/d as the risk standard, the maximum intake risk index was higher than 100%, indicating a certain risk in the consumption of selenium-rich rice.

Selenium Deficiency Induces Pathological Cardiac Lipid Metabolic Remodeling and Inflammation

SCOPE

Selenium (Se) disequilibrium is closely involved in many cardiac diseases, although its in vivo mechanism remains uncertain. Therefore, a pig model was created in order to generate a comprehensive picture of cardiac response to dietary Se deficiency.

METHODS AND RESULTS

A total of 24 pigs were divided into two equal groups, which were fed a diet with either 0.007 mg/kg Se or 0.3 mg/kg Se for 16 weeks. Se deficiency caused cardiac oxidative stress by blocking glutathione and thioredoxin systems and increased thioredoxin domain-containing protein S-nitrosylation. Energy production was disordered as free fatty acids were overloaded, the tricarboxylic acid cycle was strengthened, and three respiratory chain proteins enhanced S-nitrosylation. Excess free fatty acids led to increased synthesis of diacylglycerol, phosphatidylcholine, and phosphatidylethanolamine, where the latter two are vulnerable to oxidation and caused an increase in malondialdehyde. Moreover, increased palmitic acid enhanced de novo ceramide synthesis and accumulation. Additionally, Se deficiency initiated inflammation via cytosolic DNA-sensing pathways, which activated downstream interferon regulatory factor 7 and nuclear factor kappa B.

CONCLUSIONS

The present study identified a lipid metabolic vulnerability and inflammation initiation pathways via Se deficiency, which may provide targets for human redox imbalance-induced cardiac disease treatment. This article is protected by copyright. All rights reserved.

A Spatial Ecological Study on Hair Selenium Level of Residents in Keshan Disease Endemic and Non-endemic Areas in Heilongjiang Province, China

This study was aimed to provide, by mapping the spatial distribution of hair selenium levels of residents, visualized evidence for assessment of KD elimination from a perspective of selenium nutrition of the residents living in the KD-endemic and non-endemic areas. Using a spatial ecological research design, 401 male permanent residents in KD-endemic and non-endemic areas participated in this study. Demographic information and hair samples were obtained through a questionnaire survey and sample collection, respectively. Hair selenium was measured using hydride generation atomic fluorescence spectrometry. Thematic maps were created, and spatial analysis was conducted using ArcGIS 9.0. The median of hair selenium of the participants was 0.30 (IQR, 0.23-0.34) mg/kg. The median hair selenium of the residents in the KD-endemic areas was significantly lower than that of the residents of the non-endemic areas. The hair selenium levels of residents were spatially clustered, with cold spots and hot spots located in northwest and southwest regions respectively. Residents living in KD-endemic areas may still have selenium deficiency. Measuring hair selenium levels of residents in KD-endemic areas as a molecular marker of selenium nutritional status as part of KD surveillance could provide visualized evidence for the evaluation of KD elimination from a perspective of selenium nutrition of the residents living in the KD endemic areas.

Association of selenium levels with the prevention and control of Keshan disease: A cross-sectional study

PURPOSE

The prevalence of Keshan disease (KD) is low and has reached controlled or eliminated levels even in counties that had a high KD prevalence in the past. Few nationwide surveys on selenium levels in KD areas have been conducted in the past 2 decades. We conducted a cross-sectional study to investigate the selenium levels and their association with KD control and prevention in areas where KD is prevalent.

METHODS

We collected 2143 human-hair, 698 soil, 701 rice, 607 flour, 521 corn, and 330 other-food samples from 49 counties with KD and 19 non-KD counties of nine KD provinces of China. The selenium content of samples was examined with hydride generation atomic fluorescence spectrometry. The difference in selenium levels between the KD and non-KD areas was analyzed. Cochran-Armitage trend tests were used to evaluate the association between selenium levels and KD control.

RESULTS

The selenium levels in human hair, soil, staple foods, and other foods in the KD areas (0.2996 mg/kg, 0.1380 mg/kg, 0.0190 mg/kg and 0.0076 mg/kg, respectively) were lower than those in the non-KD areas (0.3700 mg/kg, 0.1930 mg/kg, 0.0240 mg/kg and 0.0165 mg/kg, respectively). The Cochran-Armitage tests showed that there was a trend for the selenium standard ratio in the counties to increase in the order of KD uncontrolled, to controlled, to eliminated (Z = 2.229, P < 0.05).

CONCLUSION

The residents in the KD areas were found to be selenium-deficient. Improving the supply of staple foods containing selenium levels exceeding 0.025 mg/kg and abundant foodstuffs might contribute to KD control and prevention.

The association between serum selenium concentration and prognosis in patients with heart failure in a Chinese population

Whether Selenium (Se) deficiency relates with adverse prognosis in Chinese patients with heart failure (HF) is still unknown. This study aimed to investigate the association of serum Se level and the outcomes of patients with HF in a Chinese population. Patients with HF and serum Se examination were retrospectively included. Baseline information were collected at patient’s first admission. The primary and secondary outcomes were all-cause mortality and rehospitalization for HF during follow-up, respectively. The study participants were divided into quartiles according to their serum Se concentrations. The Cox proportional hazard models were adopted to estimate the association of serum Se levels with observed outcomes. A total of 411 patients with HF with a mean age of 62.5 years were included. The mean serum level of Se was 68.3 ± 27.7 µg/L. There was nonsignificant difference of baseline characterizes between the four quartile groups. In comparison with patients in the highest quartile, those with the lowest quartile (17.40–44.35 µg/L) were associated with increased risk of all-cause mortality [adjusted hazard ratios (95% CI) 2.32 (1.43–3.77); P_trend = 0.001]. Our study suggested that a lower serum Se level was significantly associated with increased risk of all-cause mortality in patients with HF.

[Fatal nutrient deficiencies after gastric bypass]

INTRODUCTION

Bariatric surgery is a very effective treatment for obesity. After gastric bypass, micronutrient deficiencies frequently occur which can have dramatic consequences.

CASE REPORT

We report the case of a 55-year-old woman who was admitted for psychomotor retardation, bilateral leg pitting edema and psoriasis-like rash that had been ongoing for 3 months. Pancytopenia, encephalopathy and heart failure rapidly occurred leading to multiorgan dysfunction syndrome and death. We retrospectively identified severe selenium deficiency with possible secondary cardiomyopathy, niacin deficiency resulting in pellagrous encephalopathy with skin lesions and gelatinous transformation of bone marrow.

CONCLUSION

Micronutrient deficiency should systematically be assessed when new symptoms occur in a patient with a history of bariatric surgery. Selenium deficiency should be considered in the presence of any heart failure in this context.

A novel therapeutic strategy for hepatocellular carcinoma: Immunomodulatory mechanisms of selenium and/or selenoproteins on a shift towards anti-cancer

Selenium (Se) is an essential trace chemical element that is widely distributed worldwide. Se exerts its immunomodulatory and nutritional activities in the human body in the form of selenoproteins. Se has increasingly appeared as a potential trace element associated with many human diseases, including hepatocellular carcinoma (HCC). Recently, increasing evidence has suggested that Se and selenoproteins exert their immunomodulatory effects on HCC by regulating the molecules of oxidative stress, inflammation, immune response, cell proliferation and growth, angiogenesis, signaling pathways, apoptosis, and other processes in vitro cell studies and in vivo animal studies. Se concentrations are generally low in tissues of patients with HCC, such as blood, serum, scalp hair, and toenail. However, Se concentrations were higher in HCC patient tissues after Se supplementation than before supplementation. This review summarizes the significant relationship between Se and HCC, and details the role of Se as a novel immunomodulatory or immunotherapeutic approach against HCC.

Keshan Disease: A Potentially Fatal Endemic Cardiomyopathy in Remote Mountains of China

Keshan disease (KD) as an endemic, highly lethal cardiomyopathy, first reported in northeast China's Keshan County in 1935. The clinical manifestations of patients with KD include primarily congestive heart failure, acute heart failure, and cardiac arrhythmia. Even though some possible etiologies, such as viral infection, fungal infection, microelement deficiency, and malnutrition, have been reported, the exact causes of KD remain poorly known. The endemic areas where KD is found are remote and rural, and many are poor and mountainous places where people are the most socioeconomically disadvantaged in terms of housing, income, education, transportation, and utilization of health services. To date, KD is a huge burden to and severely restricts the economic development of the local residents and health systems of the endemic areas. Although efforts have been made by the government to control, treat, and interrupt disease transmission, the cure for or complete eradication of KD still requires global attention. For this reason, in this review, we systematically describe the etiological hypothesis, clinical manifestations, incidence characteristics, and treatment of KD, to facilitate the better understanding of and draw more attention to this non-representative cardiovascular disease, with the aim of accelerating its elimination.

Selenium deficiency risk in central Kenya highlands: an assessment from the soil to the body

Selenium (Se) deficiency is associated with increased risk of clinical disorders. Yet, it has not been considered as an important public health issue in Africa. The health burden of this 'hidden hunger' remains largely unknown. Using a case study of central Kenya highlands, a cross-sectional survey assesses Se status of agricultural soils, foods, hair, and actual average dietary Se intake of the local population and investigates the soil-food Se concentration and Se intake-individual Se status relationships. The survey examines eight locations characterized by different agricultural soil types and assesses average dietary Se intake among 159 children and 111 women based on 24-h dietary recall data. Soil Se concentration does not explain Se concentration in foods, which instead is associated with soil's pH, organic matter, and P and Fe content. Cereal grains, beans and potato/green banana form a large portion of the local diet while intake of animal-based foods is limited. This results in Se intake of 15 and 33 µg p^-1 d^-1 for children and women, respectively. On average, 87% of children and 97% of women have inadequate average daily dietary Se intake, and the hair Se concentration of 92% children and 94% women is below the reference values. Soil's characteristics contribute to variation in Se concentration in foods and consequently the dietary Se intake. A low diversified diet is a key contributing factor to inadequate dietary Se intake in the region. These findings call for the need to investigate potential intervention measure and the health burden of Se deficiency.

Sources, Fraction Distribution and Health Risk Assessment of Selenium (Se) in Dashan Village, a Se-Rich Area in Anhui Province, China

Soil, rock, potable water, animal food and human hair samples were collected from the Dashan village, a typical selenium (Se)-rich area of China. Se content and fraction distribution were determined to trace the source of soil Se and evaluate the potential health risk to humans. Total Se contents in soils ranged from 0.60 to 10.46 mg kg^- 1. The fractions of soil Se followed the order: residual Se (R-Se) > organic-bound Se (O-Se) > acid soluble Se (A-Se) > exchangeable Se (E-Se) > water soluble Se (W-Se). Total Se contents in rocks ranged from 0.07 to 24.8 mg kg^- 1. The dietary Se intake of local residents was estimated to be 261.2 µg day^- 1 and hair Se content varied from 0.34 to 1.35 mg kg^- 1, suggesting that the potential health risk should be concerned. Weathering of carbonaceous rock was speculated to be the primary source of soil Se according to the contents of Se in rocks, the distribution of Se in soil profiles and the relationships between Se and other elements in soils and parent rocks.

Nutraceutical support in heart failure: a position paper of the International Lipid Expert Panel (ILEP)

Heart failure (HF) is a complex clinical syndrome that represents a major cause of morbidity and mortality in Western countries. Several nutraceuticals have shown interesting clinical results in HF prevention as well as in the treatment of the early stages of the disease, alone or in combination with pharmacological therapy. The aim of the present expert opinion position paper is to summarise the available clinical evidence on the role of phytochemicals in HF prevention and/or treatment that might be considered in those patients not treated optimally as well as in those with low therapy adherence. The level of evidence and the strength of recommendation of particular HF treatment options were weighed up and graded according to predefined scales. A systematic search strategy was developed to identify trials in PubMed (January 1970 to June 2019). The terms 'nutraceuticals', 'dietary supplements', 'herbal drug' and 'heart failure' or 'left verntricular dysfunction' were used in the literature search. The experts discussed and agreed on the recommendation levels. Available clinical trials reported that the intake of some nutraceuticals (hawthorn, coenzyme Q10, l-carnitine, d-ribose, carnosine, vitamin D, probiotics, n-3 PUFA and beet nitrates) might be associated with improvements in self-perceived quality of life and/or functional parameters such as left ventricular ejection fraction, stroke volume and cardiac output in HF patients, with minimal or no side effects. Those benefits tended to be greater in earlier HF stages. Available clinical evidence supports the usefulness of supplementation with some nutraceuticals to improve HF management in addition to evidence-based pharmacological therapy.

Functional Biomarkers for the Selenium Status in a Human Nutritional Intervention Study

Soils in Germany are commonly low in selenium; consequently, a sufficient dietary supply is not always ensured. The extent of such provision adequacy is estimated by the optimal effect range of biomarkers, which often reflects the physiological requirement. Preceding epidemiological studies indicate that low selenium serum concentrations could be related to cardiovascular diseases. Inter alia, risk factors for cardiovascular diseases are physical inactivity, overweight, as well as disadvantageous eating habits. In order to assess whether these risk factors can be modulated, a cardio-protective diet comprising fixed menu plans combined with physical exercise was applied in the German MoKaRi (modulation of cardiovascular risk factors) intervention study. We analyzed serum samples of the MoKaRi cohort (51 participants) for total selenium, GPx activity, and selenoprotein P at different timepoints of the study (0, 10, 20, 40 weeks) to explore the suitability of these selenium-associated markers as indicators of selenium status. Overall, the time-dependent fluctuations in serum selenium concentration suggest a successful change in nutritional and lifestyle behavior. Compared to baseline, a pronounced increase in GPx activity and selenoprotein P was observed, while serum selenium decreased in participants with initially adequate serum selenium content. SELENOP concentration showed a moderate positive monotonic correlation (r = 0.467, p < 0.0001) to total Se concentration, while only a weak linear relationship was observed for GPx activity versus total Se concentration (r = 0.186, p = 0.021). Evidently, other factors apart from the available Se pool must have an impact on the GPx activity, leading to the conclusion that, without having identified these factors, GPx activity should not be used as a status marker for Se.

Using chemical fractionation and speciation to describe uptake of technetium, iodine and selenium by Agrostis capillaris and Lolium perenne

To understand the dynamic mechanisms governing soil-to-plant transfer of selenium (Se), technetium-99 (⁹⁹Tc) and iodine (I), a pot experiment was undertaken using 30 contrasting soils after spiking with ⁷⁷Se, ⁹⁹Tc and ¹²⁹I, and incubating for 2.5 years. Two grass species (Agrostis capillaris and Lolium perenne) were grown under controlled conditions for 4 months with 3 cuts at approximately monthly intervals. Native (soil-derived) ⁷⁸Se and¹²⁷I, as well as spiked ⁷⁷Se, ⁹⁹Tc and ¹²⁹I, were assayed in soil and plants by ICP-MS. The grasses exhibited similar behaviour with respect to uptake of all three elements. The greatest uptake observed was for ⁹⁹Tc, followed by ⁷⁷Se, with least uptake of ¹²⁹I, reflecting the transformations and interactions with soil of the three isotopes. Unlike soil-derived Se and I, the available pools of ⁷⁷Se, ⁹⁹Tc and ¹²⁹I were substantially depleted by plant uptake across the three cuts with lower concentrations observed in plant tissues in each subsequent cut. Comparison between total plant offtake and various soil species suggested that ⁷⁷SeO₄^2-, ⁹⁹TcO₄^- and ¹²⁹IO₃^-, in soluble and adsorbed fractions were the most likely plant-available species. A greater ratio of ¹²⁷I/¹²⁹I in the soil solid phase compared to the solution phase confirmed incomplete mixing of spiked ¹²⁹I with native ¹²⁷I in the soil, despite the extended incubation period, leading to poor buffering of the spiked available pools. Compared to traditional expressions of soil-plant transfer factor (TF_total), a transfer factor (TF_available) expressed using volumetric concentrations of speciated 'available' fractions of each element showed little variation with soil properties.

Genetic Disorders Associated with Metal Metabolism

Genetic disorders associated with metal metabolism form a large group of disorders and mostly result from defects in the proteins/enzymes involved in nutrient metabolism and energy production. These defects can affect different metabolic pathways and cause mild to severe disorders related to metal metabolism. Some disorders have moderate to severe clinical consequences. In severe cases, these elements accumulate in different tissues and organs, particularly the brain. As they are toxic and interfere with normal biological functions, the severity of the disorder increases. However, the human body requires a very small amount of these elements, and a deficiency of or increase in these elements can cause different genetic disorders to occur. Some of the metals discussed in the present review are copper, iron, manganese, zinc, and selenium. These elements may play a key role in the pathology and physiology of the nervous system.

Micronutrient Depletion in Heart Failure: Common, Clinically Relevant and Treatable

Heart failure (HF) is a chronic condition with many imbalances, including nutritional issues. Next to sarcopenia and cachexia which are clinically evident, micronutrient deficiency is also present in HF. It is involved in HF pathophysiology and has prognostic implications. In general, most widely known micronutrients are depleted in HF, which is associated with symptoms and adverse outcomes. Nutritional intake is important but is not the only factor reducing the micronutrient availability for bodily processes, because absorption, distribution, and patient comorbidity may play a major role. In this context, interventional studies with parenteral micronutrient supplementation provide evidence that normalization of micronutrients is associated with improvement in physical performance and quality of life. Outcome studies are underway and should be reported in the following years.

Systems Biology of Selenium and Complex Disease

Selenium is an essential trace element for maintenance of overall health, whose deficiency and dyshomeostasis have been linked to a variety of diseases and disorders. The majority of previous researches focused on characterization of genes encoding selenoproteins or proteins involved in selenium metabolism as well as their functions. Many studies in humans also investigated the relationship between selenium and complex diseases, but their results have been inconsistent. In recent years, systems biology and "-omics" approaches have been widely used to study complex and global variations of selenium metabolism and function in physiological and different pathological conditions. The present paper reviews recent progress in large-scale and systematic analyses of the relationship between selenium status or selenoproteins and several complex diseases, mainly including population-based cohort studies and meta-analyses, genetic association studies, and some other omics-based studies. Advances in ionomics and its application in studying the interaction between selenium and other trace elements in human health and diseases are also discussed.

Selenium Content and/or T-2 Toxin Contamination of Cereals, Soil, and Children's Hair in Some Areas of Heilongjiang and Gansu Provinces, China

It has been strongly suggested that selenium deficiency and T-2 contamination in cereals are responsible for the development of Kashin-Beck disease (KBD). In order to assess these risk factors of KBD in the internal and external environments, our team undertook a two-stage survey in some areas of Heilongjiang and Gansu Provinces, China. The selenium content in children's hair (293), cereal (192), and soil (46) samples were determined using the 2, 3-diamino-naphthalene fluorometric assay technique. The T-2 toxin contamination level in the cereal samples (704) was assayed using an ELISA kit. There were no clinical KBD cases identified in this survey. The selenium statuses of the children in all the investigated regions during the first phase were at the medium selenium nutrition level. During the second phase, the selenium status of the children in Weiyuan County, Ning County, and Shangzhi City was at the medium selenium nutrition level, at the edge of selenium deficiency, and selenium deficient, respectively. Furthermore, the selenium contents in the cereal and soil samples were low. During the first phase, the average T-2 toxin contamination level in the family staple food samples for all the investigated regions was about 10 ng/g. However, the T-2 toxin contamination levels in eight homegrown corn samples were higher than 100 ng/g. During the second phase, all the average T-2 toxin contamination levels in the flour and corn samples from the three investigated regions were less than 10 ng/g. Risk factors that affect the prevalence of KBD still remain in the internal and external environments of some areas in Heilongjiang and Gansu Provinces.

Selenium Accumulation, Speciation and Localization in Brazil Nuts (Bertholletia excelsa H.B.K.)

More than a billion people worldwide may be selenium (Se) deficient, and supplementation with Se-rich Brazil nuts may be a good strategy to prevent deficiency. Since different forms of Se have different nutritional value, and Se is toxic at elevated levels, careful seed characterization is important. Variation in Se concentration and correlations of this element with other nutrients were found in two batches of commercially available nuts. Selenium tissue localization and speciation were further determined. Mean Se levels were between 28 and 49 mg kg⁻¹, with up to 8-fold seed-to-seed variation (n = 13) within batches. Brazil nut Se was mainly in organic form. While present throughout the seed, Se was most concentrated in a ring 1 to 2 mm below the surface. While healthy, Brazil nuts should be consumed in moderation. Consumption of one seed (5 g) from a high-Se area meets its recommended daily allowance; the recommended serving size of 30 g may exceed the allowable daily intake (400 μg) or even its toxicity threshold (1200 μg). Based on these findings, the recommended serving size may be re-evaluated, consumers should be warned not to exceed the serving size and the seed may be sold as part of mixed nuts, to avoid excess Se intake.

Development and application of a HPLC-ICP-MS method to determine selenium speciation in muscle of pigs treated with different selenium supplements

Dietary selenium deficiency is recognized as a global problem. Pork is the most widely consumed meat throughout the world and an important source of selenium for humans. In this study, a reliable approach was developed for analyzing selenium and its speciation in the muscles of pigs after different selenium treatments. The selenium source deposition efficiency was ranked as: selenomethionine > methylselenocysteine > selenite, and the muscle selenium content had a dose effect with selenomethionine supplementation. In total, four species of selenium were detected in the muscles of pigs and the distributions of these selenium species were greatly affected by the dietary selenium supplementation forms and levels. Selenomethionine (>70% of total selenium) and selenocystine (>11%) were the major selenium species, followed by methylselenocysteine and selenourea. Therefore, selenium-enriched pork produced from selenomethionine is a good source for improving human dietary selenium intake.

Synbiotic supplementation is not effective on breast milk selenium concentrations and growth of exclusively breast fed infants: a pilot study

In this randomized, double-blind, placebo-controlled trial, 57 lactating mothers were randomly allocated into two groups to receive a daily supplement of synbiotic (n = 30) which contained different probiotic strains (2.0 × 10⁸ CFU) and fructooligosaccharide (394 mg) or a placebo (n = 27) for 30 days. Dietary intake was collected from lactating women by 24-hour recall method. Breast milk selenium contents were determined by atomic absorption spectrometry with graphite furnace. Weight for age Z-score (WAZ) and Height for age Z-score (HAZ) were evaluated for infants. Data analyses were assessed using nutritionist IV, Epi Info and SPSS software and presented as mean ± sd or SEM. The total mean breast milk selenium levels were 50.1 ± 16.1 mcg L^-1. At the baseline, the mean breast milk selenium concentrations in the synbiotic and placebo groups were 51.7 ± 20.2 and 48.5 ± 12.1 mcg L^-1. The mean breast milk selenium levels increased and decreased in the symbiotic and placebo groups respectively, which were not significant (p > 0.05). Also, comparison of the changes in breast milk selenium concentration showed no significant difference between the two study groups after the intervention. At the baseline, the mean WAZ and HAZ of infants whose mothers' milk selenium was more than 60 mcg/l was significantly (P < 0.05) higher than for others. In this pilot study, no significant effect was observed by synbiotic supplementation, however, for concise conclusion, more human studies with higher doses of supplements and longer duration of supplementation are needed to determine the effects of synbiotic supplementation on breast milk selenium contents and infants' growth.

A comprehensive review on environmental transformation of selenium: recent advances and research perspectives

Selenium (Se) is an important micronutrient and essential trace element for both humans and animals, which exist in the environment ubiquitously. Selenium deficiency is an important issue worldwide, with various reported cases of its deficiency. Low selenium contents in some specific terrestrial environments have resulted in its deficiency in humans. However, high levels of selenium in the geochemical environment may have harmful influences and can cause a severe toxicity to living things. Due to its extremely narrow deficiency and toxicity limits, selenium is becoming a serious matter of discussion for the scientists who deals with selenium-related environmental and health issues. Based on available relevant literature, this review provides a comprehensive data about Se sources, levels, production and factors affecting selenium bioavailability/speciation in soil, characteristics of Se, biogeochemical cycling, deficiency and toxicity, and its environmental transformation to know the Se distribution in the environment. Further research should focus on thoroughly understanding the concentration, speciation, Se cycling in the environment and food chain to effectively utilize Se resources, remediate Se deficiency/toxicity, and evaluate the Se states and eco-effects on human health.

Effects of selenium on oxidative damage and antioxidant enzymes of eukaryotic cells: wine Saccharomyces cerevisiae

AIM

To clarify the effects of selenium (Se), parameters related to oxidative issues, as well as the antioxidant response were investigated on an autochthonous wine yeast strain.

METHODS AND RESULTS

Antioxidant enzyme activity, gel electrophoresis, Western blot and MDA level were used to investigate the effects of different concentration of Se in wine yeast. We found that Se is able to affect the enzymatic activities of catalase (CAT), glutathione peroxidase (GPx) and superoxide dismutase (SOD). An increase in lipid peroxidation was observed in a dose-dependent manner of (Se), thus, indicating the occurrence of cell membrane damage. Additionally, Se induced post-translational oxidative modifications of proteins, especially oxidation of thiol groups (both reversible and irreversible) and protein carbonylation (irreversible oxidation).

CONCLUSION

These results obtained could further the understanding the effect of different concentration of Se in wine yeast strain with which Se affect the enzymatic activities and induces some post-translational modifications of proteins.

SIGNIFICANCE AND IMPACT OF THE STUDY

The understanding of mechanisms regulating the response of wine yeast to Se is important for future work using selenized yeast as enriched Se supplements in human nutrition.

Cross-sectional Study: Relationship Between Serum Selenium and Hypertension in the Shandong Province of China

Although selenium, which is a necessary trace element for the human body, has been considered to be beneficial to the cardiovascular system and helpful to lower blood pressure, more and more evidence shows that high amounts of selenium are a risk factor for hypertension. A random multistage sampling which included the cluster method was performed; a total of 9076 urban and rural residents between 18 and 80 years old in the Shandong province of China were investigated by questionnaire, physical examination, and laboratory tests. The prevalence of hypertension was 42.1% in males and 35.3% in females. The mean (standard deviation) selenium concentration was 124.68 (36.32) μg/l in males and 119.54 (31.88) μg/l in females. After adjusting for potential confounders, logistic regression analysis showed that the highest selenium levels were associated with a risk of hypertension (OR = 1.192; 95% CI 1.009-1.407) in females, while there was no significant difference in males (OR = 1.043; 95% CI 0.864-1.259). Our findings suggest that high selenium levels in females are more likely to increase the risk of hypertension compared to similar levels in males. More attention should be paid to the metabolic mechanisms and physiological effects of selenium in females.

Associations and interactions between variants in selenoprotein genes, selenoprotein levels and the development of abdominal aortic aneurysm, peripheral arterial disease, and heart failure

Background

Little is known on the role of selenoprotein genes in cardiovascular disease. This study examines the associations of the SEPP1, SELENOS, TXNRD1, TXNRD2, GPX4, and SOD2 polymorphisms and selenoprotein P (SeP) and thioredoxin concentrations with the development of abdominal aortic aneurysm (AAA) and aortoiliac occlusive disease (AOID), as well as their influence on cardiac phenotype.

Methods

564 patients with AAA, 400 patients with AIOD, and 543 controls were enrolled and characterized for coronary artery disease, myocardial infarction, and systolic heart failure (HF) occurrence. In AAA, the coexistence of peripheral arterial disease (PAD) was examined. Genotypes were determined using TaqMan-based assays. Selenoprotein concentration was assessed using the ELISA method.

Results

The SELENOS rs34713741T, SEPP1 rs3877899A, and GPX4 rs713041T alleles were related to a 30–60% increase in the AIOD/PAD risk in the recessive or dominant model (all associations at P < .05). The SEPP1 rs3877899A allele was a protective factor for the development of AAA without concomitant PAD (OR = 0.68 for the dominant model, P = .014), but not AAA with concomitant PAD. The cumulative two-locus effects of selenoprotein genes on the AAA/AIOD risk were observed, including the multiplicative interaction between the SELENOS rs34713741T and GPX4 rs713041T alleles (both in the recessive model) affecting the AIOD risk (OR = 5.27, P = .001) and its clinical phenotype. Coexistence of HF in aortic diseases was related to both the SEPP1 rs7579A allele (OR = 1.83 for carriers, P = .013) and increased SeP concentrations; SeP level ≥8.5 mg/mL caused a 3.5-fold increase in the risk of HF. In AAA, SeP levels were correlated with BMI (r = -0.575, P < .0001).

Conclusions

Our results provide evidence that selenoprotein polymorphisms constitute a risk factor for HF and peripheral atherosclerosis, but prevent the development of AAA. Excessive weight might result in reduced antioxidant reserve efficiency in AAA. Validation studies are required to establish whether SeP concentration may be a marker for HF.

Selenium supplementation lowers insulin resistance and markers of cardio-metabolic risk in patients with congestive heart failure: a randomised, double-blind, placebo-controlled trial

This study was carried out to evaluate the effects of Se supplementation on metabolic profiles in patients with congestive heart failure (CHF). This randomised double-blind, placebo-controlled trial was performed among fifty-three subjects with CHF, aged 45–85 years old. Subjects were randomly allocated into two groups to take either 200 µg/d of Se as Se yeast (n 26) or placebo (n 27) for 12 weeks. Metabolic profiles were assessed at baseline and at the end of trial. Compared with the placebo, Se supplementation led to significant reductions in serum insulin (−18·41 (sd 27·53) v. +13·73 (sd 23·63) pmol/l, P<0·001), homoeostatic model of assessment for insulin resistance (−1·01 (sd 1·61) v. +0·55 (sd 1·20), P<0·001) and a significant increase in quantitative insulin sensitivity check index (QUICKI) (+0·007 (sd 0·03) v. −0·01 (sd 0·01), P=0·007). In addition, Se supplementation significantly decreased LDL-cholesterol (−0·23 (sd 0·29) v. −0·04 (sd 0·28) mmol/l, P=0·03) and total-:HDL-cholesterol ratio (−0·47 (sd 0·31) v. −0·06 (sd 0·42), P<0·001), and significantly increased HDL-cholesterol levels (+0·18 (sd 0·19) v. +0·02 (sd 0·13) mmol/l, P=0·001) compared with the placebo. In addition, taking Se supplements was associated with a significant reduction in high-sensitivity C-reactive protein (hs-CRP) (−1880·8 (sd 3437·5) v. +415·3 (sd 2116·5) ng/ml, P=0·01), and a significant elevation in plasma total antioxidant capacity (TAC) (+30·9 (sd 118·0) v. −187·9 (sd 412·7) mmol/l, P=0·004) and total glutathione levels (+33·7 (sd 130·4) v. −39·2 (sd 132·8) µmol/l, P=0·003) compared with the placebo. When we applied Bonferroni correction for multiple outcome testing, QUICKI (P=0·11), LDL-cholesterol (P=0·51), hs-CRP (P=0·17), TAC (P=0·06) and GSH (P=0·05) became non-significant, and other metabolic profiles did not alter. Overall, our study supported that Se supplementation for 12 weeks to patients with CHF had beneficial effects on insulin metabolism and few markers of cardio-metabolic risk.

Selenium fortification of infant formulas: does selenium form matter?

Selenium is a trace element essential for the health and development of the growing infant. It is a necessary component of proteins and enzymes required for a variety of functions, including antioxidant defense, modulation of the inflammatory response, and production of thyroid hormones. In breast-fed infants, selenium stores depend on the selenium content of the mother's diet. In formula-fed infants, selenium levels are correlated to the residual selenium stores accumulated in utero and the level and type of selenium fortification used in the formula. Today, the United States Food and Drug Administration (FDA) recommends that infant formulas contain selenium at levels between 2.0 and 7.0 μg per 100 kcal. While the US FDA does not recommend a particular selenium form for fortification, evidence indicates that organically bound selenium forms (e.g., selenomethionine and selenium-enriched yeast) are better absorbed and retained than inorganic forms (e.g., selenite and selenate). Preliminary data from studies in adults do suggest that fortification with standardized selenium-enriched yeast may offer benefits compared to fortification with other organically bound selenium forms. However, because most studies evaluating the impact of selenium fortification of infant formula have assessed inorganic selenium supplements, additional research into the bioavailability and outcomes associated with the use of selenium-enriched yeast in infants is needed.

Relationship between lifespan indicators and elemental background values: A case study in Guangdong Province, China

There was a significant difference in the distribution of centenarians at county-level in Guangdong Province, China. To carry out an integrated analysis on elemental background values and their relation to lifespan level, samples of environmental media such as drinking water, staple rice and soil were collected in ten counties (non-longevity and longevity areas) in Guangdong Province. Meanwhile, lifespan indicators were calculated based on census data in 2010: the percentage of population aged 80 to 90years (octogenarian index, 80-90%, OI%), the percentage of population aged 90 to 100years (longevity index, 90-100%, LI%), centenarians per one hundred thousand inhabitants (CH). Grey relational analysis (GRA) and stepwise multiple linear regression analysis (SMLR) were conducted. The major results show that the contents of Se, Mo, Ni, K and Zn in drinking water and rice and the content of Se in soil in longevity areas are significantly higher than those in non-longevity areas. Significantly positive correlation between elemental background values (Se, K, Mo, Ni and Zn) and three lifespan indicators shows an increasing trend in the order of OI, LI and CH. However, element Al in rice and soil shows a negative correlation with CH. In addition, the influence degree of elemental background values on LI and CH can be ranked as Se>Mo>K>Zn>Ni. The explanatory power of elemental background values (Se, K, Mo, Ni and Zn) to difference in LI/CH in longevity and non-longevity areas can be ranked: drinking water>rice>soil. The elemental background values (Se, K, Mo, Ni and Zn) have a positive impact on human lifespan, especially for those who live longer than 90years old.

Emerging roles of endoplasmic reticulum-resident selenoproteins in the regulation of cellular stress responses and the implications for metabolic disease

Chronic metabolic stress leads to cellular dysfunction, characterized by excessive reactive oxygen species, endoplasmic reticulum (ER) stress and inflammation, which has been implicated in the pathogenesis of obesity, type 2 diabetes and cardiovascular disease. The ER is gaining recognition as a key organelle in integrating cellular stress responses. ER homeostasis is tightly regulated by a complex antioxidant system, which includes the seven ER-resident selenoproteins - 15 kDa selenoprotein, type 2 iodothyronine deiodinase and selenoproteins S, N, K, M and T. Here, the findings from biochemical, cell-based and mouse studies investigating the function of ER-resident selenoproteins are reviewed. Human experimental and genetic studies are drawn upon to highlight the relevance of these selenoproteins to the pathogenesis of metabolic disease. ER-resident selenoproteins have discrete roles in the regulation of oxidative, ER and inflammatory stress responses, as well as intracellular calcium homeostasis. To date, only two of these ER-resident selenoproteins, selenoproteins S and N have been implicated in human disease. Nonetheless, the potential of all seven ER-resident selenoproteins to ameliorate metabolic dysfunction warrants further investigation.

Selenium-loaded cellulose film derived from Styela clava tunic accelerates the healing process of cutaneous wounds in streptozotocin-induced diabetic Sprague-Dawley rats

PURPOSE

Aims of this study is to evaluate the therapeutic effects and toxicity of Se-loaded cellulose film originated from Styela clava tunic (SeSCTF) on cutaneous wounds during diabetic conditions.

MATERIALS AND METHODS

Alterations in skin regeneration, angiogenesis and toxicity were examined using streptozotocine (STZ)-induced diabetic Sprague Dawley^® (SD) rats with surgical skin wounds after application of SeSCTF for 12 days.

RESULTS

SCTF showed high tensile strength (1.64 MPa), low elongation (28.59%), low water vapor transmission rate (WVTR) and outstanding porous structure. Although SeSCTF application did not induce any significant alterations in glucose concentration or toxicity, wound morphology was rapidly recovered in the SeSCTF treated group relative to the gauze (GZ) and SCTF treated group. Moreover, recovery of re-epithelization, wound contraction and number of blood vessel was observed in SeSCTF treated groups when compared with all other groups. Furthermore, the SeSCTF treated group showed complete recovery of key protein expressions of the downstream signaling pathway of vascular endothelial growth factor (VEGF), angiopoietin-2/1 (Ang-2/1), the signaling pathway of insulin receptors and anti-oxidative status.

CONCLUSIONS

Overall, the results of this study suggest that SeSCTF accelerates the healing process of cutaneous wounds in STZ-induced diabetic SD rats through stimulation of angiogenesis and the glucose receptor signaling pathway.

Selenium protein identification and profiling by mass spectrometry: A tool to assess progression of cardiomyopathy in a whale model

Non-ischemic cardiomyopathy is a leading cause of congestive heart failure and sudden cardiac death in humans and in some cases the etiology of cardiomyopathy can include the downstream effects of an essential element deficiency. Of all mammal species, pygmy sperm whales (Kogia breviceps) present the greatest known prevalence of cardiomyopathy with more than half of examined individuals indicating the presence of cardiomyopathy from gross and histo-pathology. Several factors such as genetics, infectious agents, contaminants, biotoxins, and inappropriate dietary intake (vitamins, selenium, mercury, and pro-oxidants), may contribute to the development of idiopathic cardiomyopathy in K. breviceps. Due to the important role Se can play in antioxidant biochemistry and protein formation, Se protein presence and relative abundance were explored in cardiomyopathy related cases. Selenium proteins were separated and detected by multi-dimension liquid chromatography inductively coupled plasma mass spectrometry (LC-ICP-MS), Se protein identification was performed by liquid chromatography electrospray tandem mass spectrometry (LC-ESI-MS/MS), and Se protein profiles were examined in liver (n=30) and heart tissue (n=5) by SEC/UV/ICP-MS detection. Data collected on selenium proteins was evaluated in the context of individual animal trace element concentration, life history, and histological information. Selenium containing protein peak profiles varied in presence and intensity between animals with no pathological findings of cardiomyopathy and animals exhibiting evidence of cardiomyopathy. In particular, one class of proteins, metallothioneins, was found to be associated with Se and was in greater abundance in animals with cardiomyopathy than those with no pathological findings. Profiling Se species with SEC/ICP-MS proved to be a useful tool to identify Se protein pattern differences between heart disease stages in K. breviceps and an approach similar to this may be applied to other species to study Se protein associations with cardiomyopathy.

Relationships among Environment, Climate, and Longevity in China

Human longevity is influenced by environment and nutrition. We considered environmental and nutritional factors relating to longevity in Chinese cities. We found higher 85+/65+ distribution ratios, indicating enhanced longevity, in the coastal and southern regions of China. These areas also featured higher humidity, low standard deviation of monthly temperature, higher levels of selenium (Se) distribution in soil, and greater sea fish consumption. Moderate climate is more conducive to longevity, however, there is no significant difference in longevity between different sub-climatic types within moderate climate; the relation between humidity and longevity is not always positive, the relation between altitude and longevity is not always negative. Nutritional factors like Se and omega-3 fatty acids contained in sea fish were crucial to longevity. In contrast, the consumption of meat and freshwater fish were less related to longevity. Taken together, humidity, altitude, and per capita sea fish consumption, when evaluated via geographically weighted regression, explained 66% and 68% of longevity among Chinese individuals in 2000 and 2010, respectively. Other factors require further discussion.

Reliability and validity of the 12-item WHODAS 2.0 in patients with Kashin-Beck disease

The purpose of this study was to check the reliability and validity of the 12-item Chinese version of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) for the assessment of disability in patients with Kashin-Beck disease (KBD). We recruited 219 patients with KBD from the high-risk KBD area in the Shaanxi province, using stratified multistage random sampling. We assessed each patient using the Chinese version of the 12-item WHODAS 2.0 and the Western Ontario and McMaster Universities Index of Osteoarthritis (WOMAC). Statistical evaluations of the instruments consisted of Cronbach's alpha, intraclass correlation coefficient (ICC), confirmatory factor analysis (CFA), and Pearson's correlation coefficient. Cronbach's alpha and ICC for the six domains ranged from 0.704 to 0.906 and 0.690 to 0.852, respectively. A six-factor structure fits the data well (CFI = 0.967, TLI = 0.944, RMSEA = 0.08). Regarding convergent validity, the four domains of the 12-item WHODAS 2.0 (getting around, self-care, life activity, and participation) showed moderate-to-strong correlation for all three domains of the WOMAC (0.428 < |r| < 0.804). Regarding divergent validity, the two domains of the 12-item WHODAS 2.0 (understanding and communication, and getting along with people) showed weak correlation for the three domains of WOMAC (0.182 < |r| < 0.295). The Chinese version of 12-item WHODAS 2.0 questionnaire is a reliable and valid instrument when administered to KBD patients.

Integrative Multivariate Logistic Regression Analysis of Risk Factors for Kashin-Beck disease

To determine the current evidence on risk factors for Kashin-Beck disease (KBD) using an integrative meta-analysis. We searched five English and three Chinese databases from inception to September 2015, to identify case-control studies that examined risk factors for KBD using multivariate logistic analysis. DerSimonian and Laird effective models are applied in processing data using pooled odds ratios (ORs) and 95 % confidence intervals (CI). Seven studies were identified with 3087 cases and 6402 controls. The main risk factors found to be significantly associated with the onset of KBD were age (OR 1.19, 95 % CI 1.10-1.28), parents prevalence (OR 5.16, 2.51-7.80), family hygiene (OR 1.68, 1.42-1.93), food source (OR 3.29, 2.38-4.19), wheat (OR 1.12, 1.08-1.16), wheat germ necrosis rate (OR 6.03, 1.87-12.92), total volatile basic nitrogen (OR 6.85, 1.01-28.67), low selenium in hair (OR 2.29, 1.08-3.50) were found to be significant risks factors. The pooled ORs (95 % CI) of protein intake and rice were 0.79 (0.66-0.93) and 0.90 (0.86-0.95), respectively, indicating that the two factors may be protective for KBD. We found that the combination of low protein intake, polluted grain, and selenium deficiency may contribute to be onset of KBD together.

Effects of sodium selenite on c-Jun N-terminal kinase signalling pathway induced by oxidative stress in human chondrocytes and c-Jun N-terminal kinase expression in patients with Kashin-Beck disease, an endemic osteoarthritis

The c-Jun N-terminal kinases (JNK) are members of the mitogen-activated protein kinase family and are activated by environmental stress. Se plays an important role in the biological pathways by forming selenoprotein. Selenoproteins have been shown to exhibit a variety of biological functions including antioxidant functions and maintaining cellular redox balance, and compromise of such important proteins would lead to oxidative stress and apoptosis. We examined the expression levels of JNK in Kashin-Beck disease (KBD) patients, tested the potential protective effects of sodium selenite on tert-butyl hydroperoxide (tBHP)-induced oxidative injury and apoptosis in human chondrocytes as well as its underlying mechanism in this study. We produced an oxidative damage model induced by tBHP in C28/I2 human chondrocytes to test the essential anti-apoptosis effects of Se in vitro. The results indicated that the expression level of phosphorylated JNK was significantly increased in KBD patients. Cell apoptosis was increased and molecule expressions of the JNK signalling pathway were activated in the tBHP-injured chondrocytes. Na2SeO3 protected against tBHP-induced oxidative stress and apoptosis in cells by increasing cell viability, reducing reactive oxygen species generation, increasing Glutathione peroxidase (GPx) activity and down-regulating the JNK pathway. These results demonstrate that apoptosis induced by tBHP in chondrocytes might be mediated via up-regulation of the JNK pathway; Na2SeO3 has an effect of anti-apoptosis by down-regulating the JNK signalling pathway.