中年及老年人群中硒暴露与胰岛素抵抗和β细胞功能的差异关联。
Differential association of selenium exposure with insulin resistance and β-cell function in middle age and older adults.
作者信息
Rodriguez-Hernandez Zulema, Bel-Aguilar Javier, Moreno-Franco Belen, Grau-Perez Maria, Redon Josep, Gomez-Ariza Jose L, Garcia-Barrera Tamara, Olmedo Pablo, Gil Fernando, Cenarro Ana, Civeira Fernando, Puzo Jose, Casasnovas Jose A, Banegas Jose R, Sotos-Prieto Mercedes, Ortola Rosario, Laclaustra Martin, Rodriguez-Artalejo Fernando, Garcia-Esquinas Esther, Tellez-Plaza Maria, Pastor-Barriuso Roberto
机构信息
Integrative Epidemiology Group, Department of Chronic Diseases Epidemiology, National Center for Epidemiology, Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
Department of Chronic Diseases Epidemiology, National Center for Epidemiology, Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
出版信息
Nutr Diabetes. 2025 Feb 13;15(1):5. doi: 10.1038/s41387-025-00361-2.
OBJECTIVE
To assess whether the role of selenium on pre-diabetes is differential by age, given comorbidities and decreased β-cell function in older adults.
RESEARCH DESIGN AND METHODS
We evaluated the cross-sectional association of blood selenium with the homeostatic model assessment for insulin resistance (HOMA-IR) and β-cell function (HOMA-β) in middle-aged (Aragon Workers Health Study [AWHS], N = 1186), and older (Seniors ENRICA [Study on Nutrition and Cardiovascular Risk in Spain]-2 [SEN-2], N = 915) diabetes-free adults. A subsample of participants from AWHS (N = 571) and SEN-2 (N = 603) had glucose and insulin repeated measurements for longitudinal analysis. We validated the cross-sectional dose-response associations in the 2011-2018 National Health and Nutrition Examination Survey (NHANES, N = 1317 middle age and N = 960 older) participants. Selenium was measured in whole blood with ICP-MS in AWHS, SEN-2 and NHANES.
RESULTS
The cross-sectional geometric mean ratios (95% confidence intervals) per two-fold selenium increase were 1.09 (1.01, 1.19) for HOMA-IR and 1.15 (1.06, 1.24) for HOMA-β in AWHS; and 1.13 (0.98, 1.31) and 1.03 (0.90, 1.18), in SEN-2. The cross-sectional dose-response associations were consistent in NHANES, with mostly increasingly positive trends for both HOMA endpoints in younger adults and a plateau at levels >~150 μg/L in older adults. The longitudinal dose-response consistently showed positive associations at high selenium dose for both HOMA endpoints in the younger, but not the older, study population.
CONCLUSIONS
Increased blood selenium was associated with increased insulin resistance and β-cell function in middle-aged, but not in older individuals, especially for β-cell function. The results suggest that selenium-associated insulin resistance might induce compensatory increased β-cell function at younger ages, being this compensatory capacity decreased with aging.
目的
鉴于老年人存在合并症且β细胞功能下降，评估硒对糖尿病前期的作用是否因年龄而异。
研究设计与方法
我们评估了中年（阿拉贡工人健康研究[AWHS]，N = 1186）和老年（西班牙老年人营养与心血管风险研究[SEN-2]，N = 915）无糖尿病成年人中血硒与胰岛素抵抗稳态模型评估（HOMA-IR）及β细胞功能（HOMA-β）的横断面关联。来自AWHS（N = 571）和SEN-2（N = 603）的参与者子样本进行了葡萄糖和胰岛素重复测量以进行纵向分析。我们在2011 - 2018年国家健康与营养检查调查（NHANES，中年N = 1317，老年N = 960）参与者中验证了横断面剂量反应关联。在AWHS、SEN-2和NHANES中，采用电感耦合等离子体质谱法测量全血中的硒。
结果
在AWHS中，每两倍硒增加时，HOMA-IR的横断面几何平均比（95%置信区间）为1.09（1.01，1.19），HOMA-β为1.15（1.06，1.24）；在SEN-2中分别为1.13（0.98，1.31）和1.03（0.90，1.18）。横断面剂量反应关联在NHANES中一致，年轻成年人中两个HOMA终点大多呈逐渐增强的正相关趋势，而老年成年人中在硒水平>~150μg/L时呈平台期。纵向剂量反应在年轻研究人群中两个HOMA终点在高硒剂量时均持续显示正相关，而老年人群中未显示。
结论
血硒升高与中年人的胰岛素抵抗增加及β细胞功能增加有关，但与老年人无关，尤其是β细胞功能。结果表明，硒相关的胰岛素抵抗可能在年轻时诱导β细胞功能代偿性增加，而这种代偿能力随年龄增长而降低。
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