|Laclaustra, Martin -|
|Navas-Acien, Ana -|
|Stranges, Saverio -|
|Ordovas, Jose -|
|Guallar, Eliseo -|
Submitted to: Environmental Health Perspectives
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: May 14, 2009
Publication Date: September 20, 2009
Citation: Laclaustra, M., Navas-Acien, A., Stranges, S., Ordovas, J., Guallar, E. 2009. Serum selenium concentrations and diabetes in U.S. adults: National Health and Nutrition Examination Survey (NHANES) 2003-2004. Environmental Health Perspectives. 117(9):1409-1413. Interpretive Summary: Selenium is a trace mineral that is essential to good health, but required only in small amounts. Selenium is incorporated into proteins to make selenoproteins, which are important antioxidant enzymes that help prevent cellular damage from free radicals that may contribute to the development of chronic diseases such as cancer and heart disease. However, increasing evidence suggests that high selenium levels are associated with diabetes and other cardiovascular risk factors. To verify this evidence, we evaluated the association of serum selenium concentrations with fasting plasma glucose and diabetes in the most recently available representative sample of the U.S. population (917 adults greater than or equal to 40 years of age participants the National Health and Nutrition Examination Survey 2003-2004). Our analysis shows that in U.S. adults, high serum selenium concentrations were associated with higher prevalence of diabetes and higher fasting plasma glucose. Given the normal high selenium intake in the U.S. population, caution should be exerted about recommending selenium supplementation to increase their antioxidant status.
Technical Abstract: BACKGROUND: Increasing evidence suggests that high selenium levels are associated with diabetes and other cardiometabolic risk factors. OBJECTIVES: We evaluated the association of serum selenium concentrations with fasting plasma glucose, glycosylated hemoglobin levels, and diabetes in the most recently available representative sample of the U.S. population. METHODS: We used a cross-sectional analysis of 917 adults greater than or equal to 40 years of age who had a fasting morning blood sample in the National Health and Nutrition Examination Survey 2003-2004. We evaluated the association of serum selenium, measured by inductively coupled plasma-dynamic reaction cell-mass spectrometry, and diabetes, defined as a self-report of current use of hypoglycemic agents or insulin or as fasting plasma glucose greater than or equal to 126 milligrams per deciliter. RESULTS: Mean serum selenium was 137.1 micrograms per liter. The multivariable adjusted odds ratio [95% confidence interval (CI)] for diabetes comparing the highest quartile of serum selenium greater than or equal to 147 micrograms per liter) with the lowest (less than 124 micrograms per liter) was 7.64 (3.34-17.46). The corresponding average differences (95% CI) in fasting plasma glucose and glycosylated hemoglobin were 9.5 milligrams per deciliter (3.4-15.6 milligrams per deciliter) and 0.30% (0.14-0.46%), respectively. In spline regression models, the prevalence of diabetes as well as glucose and glycosylated hemoglobin levels increased with increasing selenium concentrations up to 160 micrograms per liter. CONCLUSIONS: In U.S. adults, high serum selenium concentrations were associated with higher prevalence of diabetes and higher fasting plasma glucose and glycosylated hemoglobin levels. Given high selenium intake in the U.S. population, further research is needed to determine the role of excess selenium levels in the development or the progression of diabetes.