Department of Cardiovascular Medicine, Xiangya Hospital, Central South University, Changsha, China.
Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, China.
Ann Med. 2022 Dec;54(1):2259-2268. doi: 10.1080/07853890.2022.2110277.
BACKGROUND & OBJECTIVE: Selenium was one of the essential trace elements that played a pivotal role in human health. Although previous studies have investigated the relationship between selenium and non-alcoholic fatty liver disease (NAFLD) and fibrosis, these findings were still inconclusive. Our study was aimed to explore the association between blood selenium level and NAFLD and advanced liver fibrosis diagnosed by vibration controlled transient elastography (VCTE) in US adults.
All data were extracted from National Health and Nutrition Examination Survey database (2017-2018). Participants were divided into four groups according to quartile of blood selenium level. Liver stiffness and controlled attenuation parameter (CAP) were measured by VCTE. Multiple logistic regression models and subgroup analyses were conducted to determine the association between blood selenium level and NAFLD and advanced liver fibrosis diagnosed by a variety of methods.
A total of 3336 participants were enrolled in main analysis. In multiple logistic regression models, the higher blood selenium level (>205.32, ≤453.62 μg/L) had a significant positive association with NAFLD (β = 1.31). Moreover, high blood selenium level had significantly inversely association to advanced liver fibrosis (β = 0.61). In subgroup analysis, the main inversely correlation between blood selenium and advanced liver fibrosis was found in males with high blood selenium level. Despite dietary selenium intake being adjusted or in different subgroups, the associations between blood selenium level and NAFLD/advanced liver fibrosis remained significant.
This study showed that blood selenium level were positively association with NAFLD among US population. Participants with lower blood selenium level showed a higher percentage of advanced liver fibrosis. Blood selenium is more likely to cause NAFLD and liver fibrosis due to imbalances in selenium homeostasis rather than dietary selenium intake.Key messagesHigh blood selenium level was association with NAFLD diagnosed by vibration controlled transient elastography.Participants with lower blood selenium level had high percentage of advanced liver fibrosis.NAFLD and liver fibrosis are caused by an imbalance of selenium homeostasis, not by dietary selenium intake.
硒是人体健康所必需的微量元素之一，具有重要作用。尽管先前的研究已经探讨了硒与非酒精性脂肪性肝病（NAFLD）和纤维化之间的关系，但这些研究结果仍存在争议。本研究旨在探讨美国成年人血硒水平与经超声瞬时弹性成像（VCTE）诊断的 NAFLD 和进展性肝纤维化之间的关系。
所有数据均来自国家健康和营养调查数据库（2017-2018 年）。根据血硒四分位水平将参与者分为四组。采用 VCTE 测量肝硬度和受控衰减参数（CAP）。采用多因素逻辑回归模型和亚组分析，确定血硒水平与各种方法诊断的 NAFLD 和进展性肝纤维化之间的关系。
共纳入 3336 名参与者进行主要分析。在多因素逻辑回归模型中，较高的血硒水平（＞205.32μg/L，≤453.62μg/L）与 NAFLD 显著正相关（β=1.31）。此外，高血硒水平与进展性肝纤维化呈显著负相关（β=0.61）。在亚组分析中，在高血硒水平的男性中发现了血硒与进展性肝纤维化之间的主要负相关关系。尽管调整了饮食硒摄入量或在不同亚组中，血硒水平与 NAFLD/进展性肝纤维化之间的相关性仍然显著。
本研究表明，美国人群中血硒水平与 NAFLD 呈正相关。血硒水平较低的参与者进展性肝纤维化的比例较高。血硒更可能导致 NAFLD 和肝纤维化，这是由于硒内稳态失衡，而不是饮食硒摄入。
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