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在美国患有慢性肾脏病的成年人中,较高的血硒水平与较高的血清脂质水平相关:2013 - 2018年美国国家健康与营养检查调查结果

Higher Levels of Blood Selenium are Associated with Higher Levels of Serum Lipid Profile in US Adults with CKD: Results from NHANES 2013-2018.

作者信息

Li Ziyuan, Lai Jiahui, Wen Luona, Chen Qiongmei, Tan Rongshao, Zhong Xiaoshi, Liu Yun, Liu Yan

机构信息

Department of Nephrology, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, China.

Department of Nephrology, The Third Affiliated Hospital of Sun Yat-Sen-University, Guangzhou, China.

出版信息

Biol Trace Elem Res. 2023 Dec;201(12):5501-5511. doi: 10.1007/s12011-023-03608-0. Epub 2023 Mar 27.

Abstract

The association between selenium (Se) and lipid profile has been controversial in different populations, and the aim of the study was to investigate the relationship between Se and lipid profile in patients with chronic kidney disease (CKD). A total of 861 US adult patients with CKD (male: female = 404:457) from the National Health and Nutrition Examination Survey database were enrolled in this cross-sectional study. We used smoothing spline plots and multivariate binary logistic regression analyses to elucidate the relationships between blood Se and lipid profile. Multivariate adjusted smoothing spline plots showed that higher levels of blood Se were associated with higher levels of serum remnant cholesterol (RC), total cholesterol (TC), triglycerides (TG), and low-density lipoprotein cholesterol (LDL-C) levels. Threshold and saturation effects were also observed between serum RC, TC, TG, LDL-C, and blood Se. In multivariate binary logistic regression analyses, the fully adjusted model showed that as blood Se increases by every 1 µg/L, the OR of high RC, high TG and high LDL-C in patients was 1.012 (95% CI: 1.001, 1.023 P = 0.046), 1.011 (95% CI: 1.001, 1.021 P = 0.043) and 1.009 (95% CI: 1.003, 1.016 P = 0.012), respectively. Furthermore, stratified analyses showed that the associations between blood Se and high RC/high TG were significantly stronger in patients aged < 65 years. Higher levels of blood Se were associated with increased serum lipid profile levels and increased risk of high RC, high TC, high LDL-C, and low HDL-C dyslipidemia in adult patients with CKD in the US. However, the real associations between blood Se and lipid profiles in this population should be verified in future prospective and randomized trials.

摘要

在不同人群中,硒(Se)与血脂谱之间的关联一直存在争议,本研究旨在调查慢性肾脏病(CKD)患者中硒与血脂谱的关系。本横断面研究纳入了来自美国国家健康与营养检查调查数据库的861例成年CKD患者(男性:女性 = 404:457)。我们使用平滑样条图和多变量二元逻辑回归分析来阐明血硒与血脂谱之间的关系。多变量调整后的平滑样条图显示,较高的血硒水平与较高的血清残余胆固醇(RC)、总胆固醇(TC)、甘油三酯(TG)和低密度脂蛋白胆固醇(LDL-C)水平相关。在血清RC、TC、TG、LDL-C和血硒之间也观察到阈值和饱和效应。在多变量二元逻辑回归分析中,完全调整模型显示,血硒每增加1 μg/L,患者出现高RC、高TG和高LDL-C的OR分别为1.012(95%CI:1.001,1.023;P = 0.046)、1.011(95%CI:1.001,1.021;P = 0.043)和1.009(95%CI:1.003,1.016;P = 0.012)。此外,分层分析显示,在年龄<65岁的患者中,血硒与高RC/高TG之间的关联显著更强。在美国成年CKD患者中,较高的血硒水平与血清血脂谱水平升高以及高RC、高TC、高LDL-C和低HDL-C血脂异常风险增加相关。然而,该人群中血硒与血脂谱之间的真正关联应在未来的前瞻性和随机试验中得到验证。

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