Affiliations of authors: Department of Epidemiology, GROW School for Oncology and Developmental Biology, (MSG, BAJV, PAvdB) and Department of Toxicology, NUTRIM School for Nutrition, Toxicology, and Metabolism (FJvS), Maastricht University, Maastricht, the Netherlands; TNO, Leiden, the Netherlands (RAG).
J Natl Cancer Inst. 2013 Sep 18;105(18):1394-401. doi: 10.1093/jnci/djt186. Epub 2013 Jul 22.
Selenium may prevent advanced prostate cancer (PCa), but most studies on this topic were conducted in populations with moderate to high selenium status. We investigated the association of toenail selenium, reflecting long-term selenium exposure, and advanced PCa risk in a population from the Netherlands where low selenium status is widespread.
The analysis was conducted in the prospective Netherlands Cohort Study, which included 58 279 men aged 55 to 69 years at baseline in 1986. All cohort members completed a baseline questionnaire, and approximately 79% of participants provided toenail clippings, which were used for toenail selenium measurements using instrumental neutron activation analysis. Incident advanced PCa case subjects from the entire cohort were identified during 17.3 years of follow-up. The study employed a case-cohort design for which a random subcohort was sampled at baseline. Hazard ratios and 95% confidence intervals (CIs) were estimated using Cox proportional hazards regression models. All tests were two-sided.
Complete toenail selenium data were available for 898 advanced (International Union Against Cancer stage III/IV) PCa case subjects and 1176 subcohort members. The average toenail selenium concentration of subcohort members was 0.550 µg/g. Toenail selenium was associated with a reduced risk of advanced PCa; adjusted hazard ratio for the highest vs lowest quintile was 0.37 (95% CI = 0.27 to 0.51; P trend < .001). For stage IV PCa, men in the highest vs lowest quintile of toenail selenium had an adjusted hazard ratio of 0.30 (95% CI = 0.21 to 0.45; P trend < .001).
Toenail selenium was associated with a substantial decrease in risk of advanced PCa.
硒可能预防晚期前列腺癌（PCa），但该主题的大多数研究都是在中等到高硒状态的人群中进行的。我们研究了反映长期硒暴露的趾甲硒与荷兰普遍存在低硒状态人群中晚期 PCa 风险的相关性。
该分析是在前瞻性荷兰队列研究中进行的，该研究纳入了 1986 年基线时年龄为 55 至 69 岁的 58279 名男性。所有队列成员都完成了基线问卷调查，约 79%的参与者提供了趾甲屑，用于使用仪器中子活化分析测量趾甲硒。在 17.3 年的随访期间，从整个队列中确定了晚期 PCa 病例患者。该研究采用病例-队列设计，在基线时随机抽取了一个亚队列。使用 Cox 比例风险回归模型估计风险比和 95%置信区间（CI）。所有检验均为双侧。
共有 898 例晚期（国际抗癌联盟 III/IV 期）PCa 病例患者和 1176 名亚队列成员可获得完整的趾甲硒数据。亚队列成员的平均趾甲硒浓度为 0.550µg/g。趾甲硒与晚期 PCa 风险降低相关；最高与最低五分位组的调整后 HR 为 0.37（95%CI=0.27 至 0.51；P 趋势<.001）。对于 IV 期 PCa，趾甲硒最高与最低五分位组的男性调整后 HR 为 0.30（95%CI=0.21 至 0.45；P 趋势<.001）。
趾甲硒与晚期 PCa 风险的大幅降低相关。
