Department of Spinal Trauma, Beijing Tongzhou District Hospital of Integrated Traditional Chinese and Western Medicine, Beijing, China.
Front Endocrinol (Lausanne). 2023 Sep 29;14:1251838. doi: 10.3389/fendo.2023.1251838. eCollection 2023.
Osteoporosis (OP) is a systemic metabolic skeletal disorder characterized by a decrease in bone mineral density (BMD) and an increase in the risk of fracture. The level of selenium (Se) in serum is associated with BMD. However, the relationship between dietary and total selenium intake and parameters such as osteoporosis and BMD is unclear. By conducting National Health and Nutritional Examination Surveys (NHANES), in this study, we assessed the association of Se intake with BMD and the risk of OP among general middle-aged and elderly people.
The data were collected from three cycles of NHANES [2009-2010, 2013-2014, and 2017-2020]. Information on the dietary and supplementary Se intake was obtained from 24-h dietary recall interviews. Additionally, dual-energy X-ray absorptiometry (DXA) was performed to measure BMD, which was later transformed into T-scores; OP was diagnosed when the T-score was ≤ -2.5. We constructed a logistic regression model for the association between selenium intake and the risk of OP based on the estimated odds ratios (ORs) and the 95% confidence intervals (CIs). We also constructed a multivariable linear regression model to analyze the relationship between selenium intake and BMD.
In this study, 3,250 individuals (average age: 60.01 ± 10.09 years; 51.88% females) participated. The incidence of OP was 9.35% (3.30% for males and 17.75% for females). In the logistic regression model adjusted for every interested covariate, a higher quartile of dietary Se intake (OR for quartile 4 . quartile 1: 0.63; 95% CI: 0.41-0.96; P for trend = 0.027) was related to a lower risk of OP relative to the lowest quartile. The total selenium intake also exhibited a consistent trend (OR for quartile 4 . quartile 1: 0.67; 95% CI: 0.44-1.01; P for trend = 0.049). The results of the adjusted multivariate linear regression model showed that the participants with the highest quartile of dietary Se intake (Q4) had higher BMD in the total femur (β = 0.069, P = 0.001; P for trend = 0.001), femoral neck (β = 0.064, P = 0.001; P for trend = 0.001), and total spine (β = 0.030, P = 0.136; P for trend = 0.064) compared to those in quintile 1 (Q1). A similar trend of associations was observed for the total selenium intake with BMD, which was more prominent among females, as determined by the subgroup analysis.
In this study, the dietary intake and total intake of selenium were positively associated with BMD, whereas they were negatively associated with the risk of OP among adults in the US. Further studies are required to verify our results and elucidate the associated biological mechanism.
骨质疏松症（OP）是一种以骨矿物质密度（BMD）降低和骨折风险增加为特征的全身性代谢性骨骼疾病。血清中的硒（Se）水平与 BMD 有关。然而，膳食和总硒摄入量与骨质疏松症和 BMD 等参数之间的关系尚不清楚。本研究通过开展全国健康和营养检查调查（NHANES），评估了 Se 摄入量与中老年人 BMD 和 OP 风险之间的关系。
本研究的数据来自 NHANES 的三个周期[2009-2010 年、2013-2014 年和 2017-2020 年]。通过 24 小时膳食回顾访谈获得膳食和补充 Se 的摄入量信息。此外，还通过双能 X 射线吸收法（DXA）测量 BMD，并将其转换为 T 评分；T 评分≤-2.5 时诊断为 OP。我们基于估计的比值比（OR）和 95%置信区间（CI）构建了一个 logistic 回归模型，以评估硒摄入量与 OP 风险之间的关联。我们还构建了一个多变量线性回归模型来分析硒摄入量与 BMD 之间的关系。
本研究共纳入 3250 名参与者（平均年龄：60.01±10.09 岁；51.88%为女性）。OP 的发病率为 9.35%（男性为 3.30%，女性为 17.75%）。在调整了所有感兴趣的协变量的 logistic 回归模型中，与最低四分位数相比，较高四分位数的膳食 Se 摄入量（四分位数 4 与四分位数 1 的 OR：0.63；95%CI：0.41-0.96；P 趋势=0.027）与 OP 风险降低相关。总硒摄入量也呈现出一致的趋势（四分位数 4 与四分位数 1 的 OR：0.67；95%CI：0.44-1.01；P 趋势=0.049）。调整后的多变量线性回归模型结果显示，膳食 Se 摄入量最高四分位数（Q4）的参与者在全股骨（β=0.069，P=0.001；P 趋势=0.001）、股骨颈（β=0.064，P=0.001；P 趋势=0.001）和全脊柱（β=0.030，P=0.136；P 趋势=0.064）的 BMD 更高，与 Q1 相比。亚组分析表明，总硒摄入量与 BMD 之间也存在类似的关联趋势，在女性中更为明显。
本研究表明，美国成年人的膳食和总硒摄入量与 BMD 呈正相关，与 OP 风险呈负相关。需要进一步的研究来验证我们的结果并阐明相关的生物学机制。
