Department of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, 28029 Madrid, Spain.
Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), 28029 Madrid, Spain.
Nutrients. 2023 Nov 10;15(22):4750. doi: 10.3390/nu15224750.
Selenium is an essential trace element with an antioxidant and anti-inflammatory capacity that has been associated in experimental studies with beneficial effects on appetite control, the regulation of the gut microbiota, and control of the anabolic-catabolic balance. The main aim of the present study was to evaluate the association between circulating selenium concentrations and the risk of developing undernutrition in older adults.
This was a cohort study with 1398 well-nourished community-dwelling individuals aged ≥ 65 years residing in Spain in 2017, who were followed for a mean of 2.3 years. Whole blood selenium was measured at baseline using inductively coupled plasma-mass spectrometry. Undernutrition was assessed at baseline and at follow-up, and defined as having at least one of the three GLIM phenotypic criteria (involuntary weight loss, a low body mass index, and a reduced muscle mass) and at least one of the two etiologic criteria (reduced food consumption or nutrient assimilation and inflammation/disease burden).
During the follow-up, 142 participants (11%) developed moderate undernutrition and 113 (8.8%) severe undernutrition. The standardized relative risks of moderate and severe undernutrition at the 75th percentile of Se levels versus the 25th were 0.90 and 0.70, respectively. In dose-response analyses, the risk of severe undernutrition decreased linearly with increasing selenium concentrations. This association was independent of protein intake or diet quality and was stronger among participants with a diagnosis of a musculoskeletal disorder.
The results suggest that an adequate dietary selenium status is needed to prevent undernutrition in older adults. Also, this may open the door for clinical trials with selenium supplementation, at doses considered as safe, to prevent undernutrition.
硒是一种必需的微量元素,具有抗氧化和抗炎能力。在实验研究中,硒与控制食欲、调节肠道微生物群和控制合成代谢-分解代谢平衡有关。本研究的主要目的是评估循环硒浓度与老年人发生营养不良风险之间的关系。
这是一项队列研究,纳入了 2017 年居住在西班牙的 1398 名营养良好的社区居住的≥65 岁老年人,随访平均 2.3 年。使用电感耦合等离子体质谱法在基线时测量全血硒。在基线和随访时评估营养不良,并定义为至少符合 GLIM 表型标准(非自愿性体重减轻、低体重指数和肌肉量减少)中的一项和病因标准(减少食物摄入或营养吸收和炎症/疾病负担)中的一项。
在随访期间,142 名参与者(11%)发生中度营养不良,113 名参与者(8.8%)发生重度营养不良。与 Se 水平第 25 百分位数相比,第 75 百分位数的中度和重度营养不良的标准化相对风险分别为 0.90 和 0.70。在剂量反应分析中,随着硒浓度的增加,严重营养不良的风险呈线性下降。这种关联独立于蛋白质摄入量或饮食质量,在患有肌肉骨骼疾病的参与者中更为明显。
研究结果表明,老年人需要适当的饮食硒状态来预防营养不良。此外,这可能为硒补充剂的临床试验开辟道路,以安全剂量预防营养不良。