Health Sciences Research Institute, University of Warwick Medical School, Coventry, UK.
J Intern Med. 2011 Nov;270(5):469-77. doi: 10.1111/j.1365-2796.2011.02398.x. Epub 2011 Jun 1.
Concern has been recently raised about possible adverse cardio-metabolic effects of high selenium status, such as increased risks of diabetes and hyperlipidaemia. However, most of the evidence comes from selenium-replete populations such as that of the United States.
To examine cross-sectional and longitudinal associations of serum selenium with cardiovascular risk factors in Finland where selenium levels were amongst the lowest in the world until the early 1980s before the implementation of a nationwide selenium fertilization programme.
Serum selenium was measured in 1235 young Finns aged 3-18 years at baseline in 1980 (prefertilization) and in a subgroup (N = 262) at the 6-year follow-up (1986, postfertilization). During the 27-year follow-up, serum lipids, blood pressure, body mass index and smoking were assessed five times (1980, 1983, 1986, 2001 and 2007).
Mean (±SD) serum selenium concentrations were 74.3 ± 14.0 ng mL(-1) in 1980 and 106.6 ± 12.5 ng mL(-1) in 1986 (average increase 32.3 ng mL(-1); 95% CI: 30.3 to 34.3, P < 0.0001). In univariate and multivariable cross-sectional models in 1980 and 1986, increased serum selenium levels were consistently associated with increased total, HDL and Low-density lipoprotein (LDL) cholesterol. However, the average longitudinal changes in lipids were -0.20 mmol L(-1) (95% CI: -0.30 to -0.10, P < 0.0001) for total cholesterol, 0.06 mmol L(-1) (95% CI: 0.03 to 0.10, P < 0.0001) for HDL cholesterol, and -0.23 mmol L(-1) (95% CI: -0.31 to -0.14, P < 0.0001) for LDL cholesterol. Selenium measured in 1986 was not associated with lipids assessed in 2001 and 2007.
Cross-sectional findings from the Young Finns study corroborate positive associations of selenium status with serum lipids. However, longitudinal evidence does not support the causality of this link.
最近有人担心高硒状态可能会对心血管代谢产生不良影响,例如增加糖尿病和高脂血症的风险。然而,大多数证据来自硒充足的人群,例如美国。
在芬兰,血清硒与心血管危险因素的横断面和纵向关联。在实施全国范围内的硒施肥计划之前,芬兰的硒水平在 20 世纪 80 年代初之前一直处于世界最低水平之一。
1980 年(施肥前),在 1235 名年龄在 3-18 岁的年轻芬兰人(n = 1235)中测量了血清硒,在其中一组(n = 262)中进行了 6 年的随访(1986 年,施肥后)。在 27 年的随访期间,五次评估了血清脂质、血压、体重指数和吸烟情况(1980 年、1983 年、1986 年、2001 年和 2007 年)。
1980 年和 1986 年平均(±SD)血清硒浓度分别为 74.3±14.0ng/mL 和 106.6±12.5ng/mL(平均增加 32.3ng/mL;95%CI:30.3 至 34.3,P<0.0001)。在 1980 年和 1986 年的单变量和多变量横断面模型中,血清硒水平升高与总胆固醇、高密度脂蛋白(HDL)和低密度脂蛋白(LDL)胆固醇升高呈一致性相关。然而,脂质的平均纵向变化为总胆固醇-0.20mmol/L(95%CI:-0.30 至-0.10,P<0.0001)、HDL 胆固醇 0.06mmol/L(95%CI:0.03 至 0.10,P<0.0001)和 LDL 胆固醇-0.23mmol/L(95%CI:-0.31 至-0.14,P<0.0001)。1986 年测量的硒与 2001 年和 2007 年评估的脂质没有关联。
年轻芬兰人的横断面研究结果证实了硒状态与血清脂质之间存在正相关。然而,纵向证据并不支持这种联系的因果关系。