Department of Medicine, VA Boston Healthcare System and Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Am J Med Sci. 2013 Sep;346(3):216-20. doi: 10.1097/MAJ.0b013e3182638716.
Selenium is incorporated as the unique amino acid selenocysteine into selenoproteins, which regulate important biologic processes such as redox balance. The results of epidemiologic and clinical investigations are inconclusive regarding the relation of the plasma selenium level to cardiometabolic parameters and does not support the routine use of selenium supplements to prevent cancer or cardiovascular disease. Variability in the selenium status of the populations studied and lack of standardization of measures of selenium status may account for part of the confusion regarding selenium and cardiometabolic health. Another possibility is that differences in the effects of selenoproteins, as opposed to those of low-molecular-weight selenium compounds derived from in vivo metabolism of selenium, may explain the unusual phenomenon of a similar phenotype induced by both selenium deficiency and excess in experimental models and offer a plausible explanation for the lack of consistency in clinical studies. The epidemiologic, clinical, and experimental evidence, although inconclusive in terms of the precise relation of selenium to cardiometabolic health, is however very intriguing in terms of the urgent need for further mechanistic research to enable the clinical use of this potent micronutrient.
硒被作为独特的氨基酸——硒代半胱氨酸,掺入到硒蛋白中,这些硒蛋白调节着氧化还原平衡等重要的生物学过程。流行病学和临床研究的结果关于血浆硒水平与心血管代谢参数之间的关系尚无定论,也不支持常规使用硒补充剂来预防癌症或心血管疾病。研究人群的硒状态存在变异性,硒状态的测量方法缺乏标准化,这可能是导致关于硒与心血管代谢健康的混乱的部分原因。另一种可能性是,硒蛋白的作用不同于体内硒代谢产生的低分子量硒化合物的作用,这可能解释了在实验模型中硒缺乏和过量会引起类似表型的异常现象,并为临床研究中缺乏一致性提供了合理的解释。尽管关于硒与心血管代谢健康的确切关系的流行病学、临床和实验证据尚无定论,但就迫切需要进一步的机制研究以实现对这种强效微量营养素的临床应用而言,这些证据非常有趣。