Institute of Medical Information/Library, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100020, China.
Biol Trace Elem Res. 2024 Aug;202(8):3413-3424. doi: 10.1007/s12011-023-03933-4. Epub 2023 Nov 23.
Selenium is an essential trace element closely related to human health; however, the relationship between blood selenium levels, diabetes, and heart failure remains inconclusive. Therefore, this study aimed to explore the relationship between blood selenium levels and the prevalence of diabetes as well as heart failure in American general adults aged 20 years or older. This study utilized data from four survey cycles from NHANES 2011-2020 pre. Blood selenium levels were considered as both a continuous variable and quartiles, and logistic regression was employed to investigate the associations between blood selenium levels with diabetes and heart failure. Nonlinear relationships were examined by restricted cubic spline regression. The analysis included a total of 16311 participants aged 20 years or older. After adjustment for all potential confounder, we found when the blood selenium levels increased by 10 ug/L, the average risk of diabetes increased by 4.2% (95% CI: 1.5%, 7.0%), and the average risk of heart failure decreased by 5.0% (95% CI: 0.1%, 9.8%). In addition, compared with the lowest reference group, blood selenium levels were significantly positively associated with risk of diabetes in participants in the fourth quartile (OR=1.458, 95% CI: 1.173, 1.812), while significantly negatively associated with the risk of heart failure in participants in the second, third and fourth quartiles (Q2, OR=0.677, 95% CI: 0.471, 0.974) (Q3, OR=0.609, 95% CI: 0.426, 0.870) (Q4, OR=0.653, 95% CI: 0.443, 0.961). There was a nonlinear and reverse L-shaped association between blood selenium and diabetes, while a negative dose-response association between blood selenium and heart failure. Furthermore, the association between blood selenium levels and heart failure was more pronounced in participants with poor glycemic control, rather than diabetic patients. High blood selenium levels may be positively related to diabetes, while low blood selenium levels may be associated to heart failure. Appropriate blood selenium levels may help prevent diabetes and heart failure.
硒是一种与人类健康密切相关的必需微量元素，但血液硒水平与糖尿病和心力衰竭之间的关系仍不确定。因此，本研究旨在探讨美国 20 岁及以上成年人的血液硒水平与糖尿病和心力衰竭患病率之间的关系。本研究利用了 NHANES 2011-2020 年期间四个调查周期的数据。血液硒水平被视为连续变量和四分位间距，并采用 logistic 回归来研究血液硒水平与糖尿病和心力衰竭之间的关系。非线性关系通过限制性立方样条回归进行检验。该分析共纳入了 16311 名 20 岁及以上的参与者。在调整了所有潜在混杂因素后，我们发现当血液硒水平增加 10μg/L 时，糖尿病的平均风险增加 4.2%（95%CI：1.5%，7.0%），心力衰竭的平均风险降低 5.0%（95%CI：0.1%，9.8%）。此外，与最低参考组相比，血液硒水平与第四四分位组参与者的糖尿病风险显著正相关（OR=1.458，95%CI：1.173，1.812），而与第二、第三和第四四分位组参与者的心力衰竭风险显著负相关（Q2，OR=0.677，95%CI：0.471，0.974）（Q3，OR=0.609，95%CI：0.426，0.870）（Q4，OR=0.653，95%CI：0.443，0.961）。血液硒与糖尿病之间存在非线性和反向 L 形关联，而血液硒与心力衰竭之间存在负剂量反应关联。此外，在血糖控制不佳的参与者中，血液硒水平与心力衰竭之间的关联更为明显，而不是糖尿病患者。高血液硒水平可能与糖尿病呈正相关，而低血液硒水平可能与心力衰竭有关。适当的血液硒水平可能有助于预防糖尿病和心力衰竭。
