Studies of safe maximal daily dietary Se-intake in a seleniferous area in China. Part II: Relation between Se-intake and the manifestation of clinical signs and certain biochemical alterations in blood and urine.

Selenosis occurs in areas of Enshi county because of the high Se content of the food. Morphological changes in finger-nails were used as the main criterion for clinical diagnosis of selenosis. Pathological nails were observed to occur almost only in adults, not at all in young children and very seldom in teenagers. Symptoms of selenosis in susceptible patients were found at or above an Se-intake of 910 micrograms/d, corresponding to a blood Se level of 1.05 mg/L. There was no evidence for an increased susceptibility to dental caries due to high Se consumption, and an increase in Se-intake seems unlikely to reduce the beneficial effects of fluoride on caries. No abnormalities of liver or heart were seen by supersonic B or electrocardiographic examinations. The biochemical investigations showed that with increasing whole blood Se the ratio of plasma Se to erythrocyte Se tended to decrease. As Se-intake increases to over 750 micrograms daily, the ratio decreases to near a minimal level. Reduced glutathione in whole blood decreases within a blood Se range of 1.01 to 2.28 micrograms in the high Se area. The amount of trimethylselenonium ion excreted in urine increased with the increase of urinary Se. Cases with prolonged prothrombin time occurred as blood Se increased to a level above 1 mg/L. The white blood cell count also increased significantly. Quantitative values were obtained only for ratio of plasma-Se to erythrocyte-Se for prothrombin time and for maintenance of nail Symptoms of susceptible patients. The overall results indicated that a daily Se-intake of 750-850 micrograms [corrected] might be the marginal level of safe intake. When other variable factors are also taken into consideration a daily Se-intake of 400 micrograms [corrected] is suggested as the maximum daily safe intake. At this level of Se-intake the corresponding approximate tissue Se levels are: whole blood 0.559 mg/L, plasma 0.327 mg/L, urine excretion 173 micrograms/d, hair 3.60 mg/kg, toe-nails 4.25 mg/kg, and finger-nails 4.70 mg/kg.