Li Yanli, Liu Lanqun, Yang Zufu, Xu Jimin
Department of Traditional Chinese Medicine, Beijing Boai Hospital, China Rehabilitation Research Center, School of Rehabilitation Medicine, Capital Medical University, Beijing, China.
Front Neurol. 2024 Jul 5;15:1404570. doi: 10.3389/fneur.2024.1404570. eCollection 2024.
The study aimed to investigate the interaction effect between blood selenium levels and stroke history on all-cause mortality.
In this retrospective cohort study, participant data were obtained from the National Health and Nutrition Examination Survey (NHANES) 2011-2018. The covariates were screened via the backward selection method in weighted univariate and multivariate Cox regression models. Weighted univariate and multivariate Cox regression models were conducted to investigate the association of blood selenium and stroke history with all-cause mortality. The results were expressed as hazard ratios (HRs) and 95% confidence intervals (CIs). The synergy index (SI) was used to assess the assistive interaction. The association was further explored in different gender groups.
Totally, 8,989 participants were included, of whom 861 (9.57%) died. Participants with blood selenium ≥192.96 ug/L were associated with lower odds of all-cause mortality (HR = 0.70, 95% CI: 0.58-0.84), whereas those with a stroke history were associated with a higher risk of all-cause mortality (HR = 1.57, 95% CI: 1.15-2.16). Compared to participants with blood selenium ≥192.96 ug/L and non-stroke history, participants with both blood selenium < 192.96 ug/L and stroke history had a higher all-cause mortality risk (HR = 2.31, 95% CI: 1.62-3.29; SI = 0.713, 95% CI: 0.533-0.952). All participants with blood selenium < 192.96 ug/L and stroke history were related to higher all-cause mortality risk (HR = 1.61, 95% CI: 1.21-2.13). In males, the interaction effect of blood selenium and stroke history on all-cause mortality (HR = 2.27, 95% CI: 1.50-3.46; SI = 0.651, 95% CI: 0.430-0.986) increased twice.
Blood selenium and stroke history have an interaction effect on all-cause mortality. Increasing selenium-rich food or supplement intake, especially for individuals with a stroke history, may improve poor prognosis.
本研究旨在探讨血硒水平与中风病史对全因死亡率的交互作用。
在这项回顾性队列研究中，参与者数据来自2011 - 2018年美国国家健康与营养检查调查（NHANES）。通过加权单变量和多变量Cox回归模型中的向后选择方法筛选协变量。采用加权单变量和多变量Cox回归模型研究血硒和中风病史与全因死亡率的关联。结果以风险比（HRs）和95%置信区间（CIs）表示。协同指数（SI）用于评估辅助交互作用。在不同性别组中进一步探讨这种关联。
共纳入8989名参与者，其中861人（9.57%）死亡。血硒≥192.96微克/升的参与者全因死亡率较低（HR = 0.70，95% CI：0.58 - 0.84），而有中风病史的参与者全因死亡风险较高（HR = 1.57, 95% CI：1.15 - 2.16）。与血硒≥192.96微克/升且无中风病史的参与者相比，血硒< 192.96微克/升且有中风病史的参与者全因死亡风险更高（HR = 2.31, 95% CI：1.62 - 3.29；SI = 0.713, 95% CI：0.533 - 0.952）。所有血硒< 192.96微克/升且有中风病史的参与者全因死亡风险均较高（HR = 1.61, 95% CI：1.21 - 2.13）。在男性中，血硒和中风病史对全因死亡率的交互作用（HR = 2.27, 95% CI：1.50 - 3.46；SI = 0.651, 95% CI：0.430 - 0.986）增加了两倍。
血硒和中风病史对全因死亡率有交互作用。增加富硒食物或补充剂的摄入量，特别是对于有中风病史的个体，可能改善不良预后。
