The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China.
The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China. Email: Email:
Asia Pac J Clin Nutr. 2020;29(4):827-838. doi: 10.6133/apjcn.202012_29(4).0019.
The objective of this study was to explore the associations of dietary selenium and serum selenium concentration with coronary heart disease (CHD) prevalence and all-cause mortality among participants in United States.
Using data collected from the National Health and Nutrition Examination Survey (NHANES) 1999-2006, 17867 individuals were included. Logistic regression analyses were used to explore the associations between dietary selenium intake and serum selenium concentration and prevalent of CHD. Multivariable Cox regression was used to identify the association between dietary selenium intake and all-cause mortality. The nonlinear relationships were assessed using generalized additive models.
A U-shaped association between dietary intake of selenium and all-cause mortality was observed. Compared with the lowest quartile, the second quartile of dietary intake of selenium was inversely associated with all-cause mortality (Hazard ratio [HR]: 0.802, 95% confidence interval [CI]: 0.658, 0.977, p=0.029). There was no evidence of association between dietary selenium intake and CHD risk (Odds ratio [OR]: 1.001, 95% CI: 0.999, 1.003, p=0.206). Furthermore, serum selenium concentration was negatively associated with CHD risk (OR: 0.989, 95% CI: 0.981, 0.997, p=0.006). Comparing with the lowest quartile, participants with the highest serum selenium concentration had a statistically significant decreased prevalence of CHD, with OR (95% CI) of 0.417 (0.259, 0.669) (p<0.001). The smoothing curve also showed a non-linear relationship between serum selenium and risk of CHD.
This analysis suggested that a higher serum selenium concentration was associated with reduced risk of CHD, and that the relationship was non-linear. In addition, an appropriate dietary selenium intake might reduce all-cause mortality.
本研究旨在探讨美国人群中膳食硒及血清硒浓度与冠心病（CHD）患病率和全因死亡率的相关性。
利用 1999-2006 年全国健康与营养调查（NHANES）的数据，纳入 17867 名参与者。采用 logistic 回归分析探讨膳食硒摄入量和血清硒浓度与 CHD 患病率的相关性。采用多变量 Cox 回归分析探讨膳食硒摄入量与全因死亡率的相关性。采用广义加性模型评估非线性关系。
膳食硒摄入量与全因死亡率呈 U 型关系。与最低四分位组相比，第二四分位组的膳食硒摄入量与全因死亡率呈负相关（风险比[HR]：0.802，95%置信区间[CI]：0.658，0.977，p=0.029）。膳食硒摄入量与 CHD 风险无明显相关性（比值比[OR]：1.001，95%CI：0.999，1.003，p=0.206）。此外，血清硒浓度与 CHD 风险呈负相关（OR：0.989，95%CI：0.981，0.997，p=0.006）。与最低四分位组相比，血清硒浓度最高四分位组的 CHD 患病率显著降低，OR（95%CI）为 0.417（0.259，0.669）（p<0.001）。平滑曲线也显示血清硒与 CHD 风险之间存在非线性关系。
本分析表明，较高的血清硒浓度与 CHD 风险降低相关，且呈非线性关系。此外，适当的膳食硒摄入可能降低全因死亡率。
