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硒补充对糖化血红蛋白变化的影响:一项多剂量、随机对照试验的结果。

Effect of selenium supplementation on changes in HbA1c: Results from a multiple-dose, randomized controlled trial.

机构信息

Department of Epidemiology & Biostatistics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, Canada.

Department of Family Medicine, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, Canada.

出版信息

Diabetes Obes Metab. 2019 Mar;21(3):541-549. doi: 10.1111/dom.13549. Epub 2018 Oct 29.

Abstract

AIM

To investigate the effect of selenium supplementation at different dose levels on changes in HbA1c after 6 months and 2 years in a population of low selenium status.

MATERIALS AND METHODS

The Denmark PRECISE study was a single-centre, randomized, double-blinded, placebo-controlled, multi-arm, parallel clinical trial with four groups. In total, 491 volunteers aged 60 to 74 years were randomly assigned to treatment with 100, 200 or 300 μg selenium/day as selenium-enriched yeast or placebo-yeast. HbA1c measurements were available for 489 participants at baseline, 435 at 6 months, and 369 after 2 years of selenium supplementation. Analyses were performed by intention to treat.

RESULTS

The mean (SD) age, plasma-selenium concentration, and blood HbA1c at baseline were 66.1 (4.1) years, 86.5 (16.3) ng/g and 36.6 (7.0) mmol/mol, respectively. During the initial 6-month intervention period, mean HbA1c (95% CI) decreased by 1.5 (-2.8 to -0.2) mmol/mol for 100 μg/d of selenium supplementation and by 0.7 (-2.0 to 0.6) mmol/mol for the 200 and 300 μg/d groups compared with placebo (P = 0.16 for homogeneity of changes across the four groups). After 2 years of selenium supplementation, HbA1c had decreased significantly in all treatment groups, with no difference between active treatment and placebo.

CONCLUSIONS

Selenium supplementation in an elderly European population of low selenium status did not significantly affect HbA1c levels after 2 years. Our findings corroborate a possible U-shaped response of selenium supplementation on glucose metabolism.

摘要

目的

研究不同剂量硒补充剂对低硒人群 HbA1c 在 6 个月和 2 年内变化的影响。

材料和方法

丹麦 PRECISE 研究是一项单中心、随机、双盲、安慰剂对照、多臂、平行临床试验,共分为四组。共有 491 名年龄在 60 至 74 岁的志愿者被随机分配接受每天 100、200 或 300μg 硒的硒酵母或安慰剂酵母治疗。在基线时,489 名参与者可进行 HbA1c 测量,435 名参与者在 6 个月时,369 名参与者在 2 年硒补充后进行了 HbA1c 测量。分析采用意向治疗。

结果

平均(SD)年龄、血浆硒浓度和基线时的血液 HbA1c 分别为 66.1(4.1)岁、86.5(16.3)ng/g 和 36.6(7.0)mmol/mol。在最初的 6 个月干预期间,与安慰剂相比,每天补充 100μg 硒使平均 HbA1c(95%CI)降低 1.5(-2.8 至 -0.2)mmol/mol,200 和 300μg/d 组降低 0.7(-2.0 至 0.6)mmol/mol(四组间变化的一致性 P=0.16)。在 2 年的硒补充后,所有治疗组的 HbA1c 均显著降低,活性治疗与安慰剂之间无差异。

结论

在低硒的欧洲老年人群中补充硒 2 年后,HbA1c 水平无显著影响。我们的发现证实了硒补充对葡萄糖代谢可能存在 U 型反应。

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