Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; Department of Epidemiology, Boston University School of Public Health, Boston, USA.
Department of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli, IS, Italy.
Nutr Metab Cardiovasc Dis. 2021 Jun 7;31(6):1738-1746. doi: 10.1016/j.numecd.2021.02.016. Epub 2021 Feb 25.
Experimental and non-experimental human studies have consistently shown a positive association between exposure to the trace element selenium, which occurs primarily through diet, and risk of type 2 diabetes mellitus. Plausible biological mechanisms include adverse effects of selenium and selenium-containing proteins on glucose metabolism. However, the levels of exposure above which risk increases are uncertain.
We examined the association between selenium intake and first hospitalization for type 2 diabetes during a median follow-up period of 8.2 years among 21,335 diabetes-free participants in the Moli-sani cohort, Italy. Selenium intake was ascertained at baseline using a food frequency questionnaire, showing a median value of 59 μg/day. During follow-up, we identified 135 incident cases of hospitalization for diabetes, based on population-based hospital discharge data. We used a Cox proportional hazards model to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for hospitalization for diabetes, adjusting for potential confounders. HRs (95% CIs) were 1.01 (0.60-1.70), 1.13 (0.66-1.96) and 1.75 (0.99-3.10) comparing the second, third, and fourth sex-specific quartiles with the first quartile, respectively. Risk was 64% greater in the fourth quartile as compared with the previous three. Spline regression analysis also indicated a steeper increase in risk occurring among men compared with women.
In a large population of Italian adults free of type 2 diabetes at cohort entry, high dietary selenium intake was associated with increased risk of hospitalization for diabetes.
实验和非实验性人体研究均一致表明，痕量元素硒的暴露与 2 型糖尿病的风险呈正相关，而这种暴露主要通过饮食发生。合理的生物学机制包括硒和含硒蛋白对葡萄糖代谢的不良影响。然而，风险增加的暴露水平尚不确定。
我们在意大利莫利萨尼队列中，对 21335 例无 2 型糖尿病的参与者进行了中位随访 8.2 年的研究，评估了硒摄入量与 2 型糖尿病首次住院之间的相关性。在基线时，我们使用食物频率问卷来确定硒的摄入量，中位数为 59μg/天。在随访期间，我们根据基于人群的住院数据确定了 135 例糖尿病住院病例。我们使用 Cox 比例风险模型来估计住院的风险比（HRs）和 95%置信区间（CIs），调整了潜在的混杂因素。与第一四分位相比，第二四分位（HRs（95% CIs）为 1.01（0.60-1.70））、第三四分位（HRs（95% CIs）为 1.13（0.66-1.96））和第四四分位（HRs（95% CIs）为 1.75（0.99-3.10））的住院风险分别为 1.01、1.13 和 1.75，第四四分位的风险比前三个四分位高 64%。样条回归分析还表明，男性的风险增加比女性更为陡峭。
在一个以意大利成年人为研究对象的大型队列中，进入队列时无 2 型糖尿病的个体，高膳食硒摄入量与糖尿病住院风险增加相关。
