Serum selenium and serum lipids in US adults: National Health and Nutrition Examination Survey (NHANES) 2003–2004

doi:10.1016/j.atherosclerosis.2010.01.005

Atherosclerosis

Volume 210, Issue 2, June 2010, Pages 643-648

https://doi.org/10.1016/j.atherosclerosis.2010.01.005 Get rights and content

Abstract

Objective

High selenium has been recently associated with several cardiovascular and metabolic risk factors including diabetes, blood pressure and lipid levels. We evaluated the association of serum selenium with fasting serum lipid levels in the National Health and Nutrition Examination Survey (NHANES) 2003–2004, the most recently available representative sample of the US population that measured selenium levels.

Methods

Cross-sectional analysis of 1159 adults ≥40 years old from NHANES 2003–2004. Serum selenium was measured by inductively coupled plasma-dynamic reaction cell-mass spectrometry. Fasting serum total cholesterol, triglycerides, and HDL cholesterol were measured enzymatically and LDL cholesterol was calculated.

Results

Mean serum selenium was 136.7 μg/L. The multivariable adjusted average differences (95% confidence interval) comparing the highest (≥147 μg/L) to the lowest (<124 μg/L) selenium quartiles were 18.9 (9.9, 28.0) mg/dL for total cholesterol, 12.7 (3.3, 22.2) mg/dL for LDL cholesterol, 3.9 (0.4, 7.5) mg/dL for HDL cholesterol, and 11.5 (−7.6, 30.7) mg/dL for triglycerides. In spline regression models, total and LDL cholesterol levels increased progressively with increasing selenium concentrations. HDL cholesterol increased with selenium but reached a plateau above 120 μg/L of serum selenium (20th percentile). The triglyceride–selenium relationship was U-shaped.

Conclusion

In US adults, high serum selenium concentrations were associated with increased serum concentrations of total and LDL cholesterol. Selenium was associated with increasing HDL cholesterol only at low selenium levels. Given increasing trends in dietary selenium intake and supplementation, the causal mechanisms underlying these associations need to be fully characterized.

Introduction

Selenium is involved in several important biological pathways, particularly in the defense system against oxidative stress. Because of this potential to protect against oxidative stress, high expectations were raised for selenium as a preventive factor for several chronic diseases including cancer, cardiovascular disease (CVD), and type 2 diabetes, conditions associated with oxidative stress [1]. However, recent epidemiological evidence has raised concerns about the safety and health effects of selenium intake above the Recommended Dietary Allowance (55 μg/d) [2]. In the US, a country in which virtually all the population has selenium intake above 55 μg/d, increasing selenium levels have been associated with higher prevalence of diabetes and hypertension [3], [4], [5]. Furthermore, selenium supplementation in clinical trials has failed to reduce the risk of cardiovascular events and may increase the risk of diabetes [6], [7], [8].

In the US Third National Health and Nutrition Examination Survey (NHANES III), conducted between 1988 and 1994, high serum selenium concentrations were positively associated with serum total, LDL, and HDL cholesterol and with serum triglycerides [9]. Widespread increases in use of selenium-containing supplements and of lipid lowering medications since the early 1990s have likely changed the distribution of both selenium and lipids. However, there is no recent data on these associations. The objective of this study was to evaluate the association of serum selenium with the concentrations of serum lipid fractions using recently available NHANES data collected in 2003–2004.

Section snippets

Materials and methods

The National Center for Health Statistics conducts periodic NHANES surveys using a complex multistage sampling design to obtain a representative sample of the civilian non-institutionalized US population. We used data from NHANES 2003–2004 [10], the most recent release with selenium data available in adults. Participants aged ≥40 years (N = 3299) were eligible for selenium measurement according to NHANES protocol. Among them, 1302 participated in the morning examination and had a fasting blood

Results

The mean (standard deviation) serum selenium concentration in the study population was 136.7 (18.9) μg/L. Mean total, LDL, HDL cholesterol, and triglyceride concentrations were 204.8 (38.8), 121.3 (34.8), 55.2 (16.3), and 141.8 (72.6) mg/dL, respectively, and mean total to HDL cholesterol ratio was 3.98 (1.23). Men had higher mean serum selenium levels than women (139.0 μg/L vs. 134.7 μg/L). Non-Hispanic Blacks had lower mean serum selenium (128.4 μg/L) than Non-Hispanic Whites (137.5 μg/L) or

Discussion

Findings from the present study corroborate growing evidence suggesting that high selenium exposure is associated with increased serum lipid levels. In the present study, high serum selenium concentrations were associated with higher serum lipids in a representative survey of US adults ≥40 years old conducted in 2003–2004. The associations of selenium with total and LDL cholesterol levels were strong and linear. HDL cholesterol levels were also positively associated with selenium concentrations

Conflict of interest

The authors do not have potential conflicts of interest regarding this manuscript.

Acknowledgments

Supported by grants ES012673 from the National Institute of Environmental Health Sciences, DK075030 from the National Institute of Diabetes, Digestive, and Kidney Disease, 0230232N from the American Heart Association.

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Serum selenium and serum lipids in US adults: National Health and Nutrition Examination Survey (NHANES) 2003–2004

Abstract

Objective

Methods

Results

Conclusion

Introduction

Section snippets

Materials and methods

Results

Discussion

Conflict of interest

Acknowledgments

Lancet

Am J Clin Nutr

J Nutr

Atherosclerosis

Atherosclerosis

Am J Clin Nutr

J Inorg Biochem

Biochim Biophys Acta

Biochim Biophys Acta

J Biol Chem

Biochem Biophys Res Commun

Lancet

J Trace Elem Med Biol

Panel on dietary antioxidants and related compounds

Serum selenium and diabetes in U.S. adults

Diabetes Care