Department of Cardiovascular Medicine, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
PLoS One. 2024 May 20;19(5):e0303140. doi: 10.1371/journal.pone.0303140. eCollection 2024.
Limited evidence exists regarding the association of selenium with risk of death in individuals with nonalcoholic fatty liver disease (NAFLD). This study was designed to investigate the relationship between dietary selenium intake with mortality in a nationally representative sample of United States adults with NAFLD.
Dietary selenium intake was assessed in 2274 NAFLD adults younger than 60 years of age from the National Health and Nutrition Examination Survey (NHANES) III through a 24-hour dietary recall. NAFLD was diagnosed by liver ultrasound after excluding liver disease due to other causes. Cox proportional hazards models were utilized to assess the effect of dietary selenium intake on all-cause and cardiovascular mortality among individuals with NAFLD.
At a median follow-up of 27.4 years, 577 deaths occurred in individuals with NAFLD, including 152 cardiovascular deaths. The U-shaped associations were discovered between selenium intake with all-cause (Pnolinear = 0.008) and cardiovascular mortality (Pnolinear < 0.001) in adults with NAFLD after multivariate adjustment, with the lowest risk around selenium intake of 121.7 or 125.9 μg/day, respectively. Selenium intake in the range of 104.1-142.4 μg/day was associated with a reduced risk of all-cause mortality and, otherwise, an increased risk. Selenium intake in the range of 104.1-150.6 μg/day was associated with a reduced risk of cardiovascular death and, otherwise, an increased risk.
Both high and low selenium intake increased the risk of all-cause and cardiovascular death in adults younger than 60 years of age with NAFLD, which may help guide dietary adjustments and improve outcomes in adults with NAFLD.
关于非酒精性脂肪性肝病（NAFLD）患者的硒摄入与死亡风险之间的关联，目前证据有限。本研究旨在调查美国年龄在 60 岁以下的具有代表性的 NAFLD 成人样本中，饮食硒摄入量与死亡率之间的关系。
通过 24 小时膳食回忆，在国家健康和营养检查调查（NHANES）III 中评估了 2274 名年龄小于 60 岁的 NAFLD 成人的饮食硒摄入量。通过排除因其他原因引起的肝病后，用肝脏超声诊断 NAFLD。利用 Cox 比例风险模型评估 NAFLD 患者饮食硒摄入量对全因和心血管死亡率的影响。
在中位数为 27.4 年的随访期间，在有 NAFLD 的人群中发生了 577 例死亡，其中包括 152 例心血管死亡。多变量调整后，在 NAFLD 成人中发现了硒摄入与全因（Pnolinear = 0.008）和心血管死亡率（Pnolinear < 0.001）之间的 U 型关联，最低风险分别约为硒摄入量为 121.7 或 125.9 μg/天。硒摄入量在 104.1-142.4 μg/天范围内与全因死亡率降低相关，否则风险增加。硒摄入量在 104.1-150.6 μg/天范围内与心血管死亡风险降低相关，否则风险增加。
在年龄小于 60 岁的具有 NAFLD 的成人中，高硒和低硒摄入均增加了全因和心血管死亡的风险，这可能有助于指导饮食调整并改善 NAFLD 成人的结局。
