Abstract
Anemia is common among older adults, and a substantial proportion of anemia in the older population is of indeterminate cause. Low selenium levels have been associated with anemia in animals, but this relationship has not been well characterized in humans. The objective was to determine whether low serum selenium concentrations are associated with anemia among older women. We conducted a cross-sectional analysis of participants in the Women's Health and Aging Studies, a population-based sample of women living in the community in Baltimore, MD, USA. Of 632 women, aged 70–79 yr, 14.1% of women were anemic (hemoglobin <120 g/L). The prevalence of anemia among women in the lowest to highest quartile of serum selenium was 22.4%, 14.6%, 11.9% and 6.6%, respectively (p<0.0001). An increase in log e selenium was associated with a reduced risk of anemia (odds ratio per 1 SD increase=0.63,95% confidence interval=0.47–0.84), adjusting for age, education, chronic disease, iron status, and serum interleukin-6. We conclude that low serum selenium is independently associated with anemia among older women living in the community.
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J. M. Guralnik, R. S. Eisenstaedt, L. Ferrucci, H. G. Klein, and R. C. Woodman, Prevalence of anemia in persons 65 years and older in the United States: evidence for a high rate of unexplained anemia, Blood 104, 2263–2268 (2004).
S. Fishbane, Anemia treatment in chronic renal insufficiency, Semin. Nephrol. 22, 474–478 (2002).
G. Weiss and L. T. Goodnough. Anemia of chronic disease, N. Engl. J. Med. 352, 1011–1023 (2005).
M. S. Aapro, D. Cella, and M. Zagari, Age, anemia, and fatigue, Semin. Oncol. 29(3 Suppl. 8), 55–59 (2002).
B. W. J. H. Penninx, M. Pahor, M. Cesari, et al., Anemia is associated with disability and decreased physical performance and muscle strength in the elderly, J. Am. Geriatr. Soc. 52, 719–724 (2004).
M. Cesari, B. W. J. H. Penninx, F. Lauretani, et al., Hemoglobin levels and skeletal muscle: results from the InCHIANTI study. J. Gerontol. A: Biol. Sci. Med. Sci. 59, 249–254 (2004).
B. W. J. H. Penninx, J. M. Guralnik, G. Onder, L. Ferrucci, R. B. Wallace, and M. Pahor, Anemia and decline in physical performance among older persons, Am. J. Med. 115, 104–110 (2003).
P. H. M. Chaves, R. D. Semba, S. X. Leng, et al., Impact of anemia and cardiovascular disease on frailty status of community-dwelling older women: the Women's Health and Aging Studies I and II, J. Gerontol. A: Biol. Sci. Med. Sci. 60, 729–735 (2005).
G. J. Izaks, R. G. J. Westendorp, and D. L. Knook, The definition of anemia in older persons, JAMA 281, 1714–1717 (1999).
E. A. Klein, Selenium: epidemiology and basic science, J. Urol. 171, S50-S53 (2004).
L. Savarino, D. Granchi, G. Ciapetti, et al., Serum concentrations of zinc and selenium in elderly people: results in healthy nonagenarians/centenarians, Exp. Gerontol. 36, 327–339 (2001).
C. J. Bates, C. W. Thane, A. Prentice, and H. T. Delves, Selenium status and its correlates in a British national diet and nutrition survey: people aged 65 years and over, J. Trace Elements Med. Biol. 16, 1–8 (2002).
F. J. Kok, A. M. de Bruijn, R. Vermeeren, et al., Serum selenium, vitamin antioxidants, and cardiovascular mortality: a 9-year follow-up study in the Netherlands, Am. J. Clin. Nutr. 45, 462–468 (1987).
M. Kornitzer, F. Valente, D. De Bacquer, J. Neve, and G. De Backer, Serum selenium and cancer mortality: a nested case-control study within an age- and sex-stratified sample of the Belgian adult population, Eur. J. Clin. Nutr. 58, 98–104 (2004).
S. Blankenberg, H. J. Rupprecht, C. Bickel, et al., Glutathione peroxidase 1 activity and cardiovascular events in patients with coronary artery disease, N. Engl. J. Med. 349, 1605–1613 (2003).
J. D. Latshaw, J. F. Ort, and C. D. Diesem, The selenium requirements of the hen and effects of a deficiency, Poult. Sci. 56, 1876–1881 (1977).
J. G. Morris, W. S. Cripe, H. L. Chapman, Jr., et al., Selenium deficiency in cattle associated with Heinz bodies and anemia, Science 223, 491–493 (1984).
M. L. Hu, C. Chung, and J. E. Spallholz, Hematologic data of selenium-deficient and selenium-supplemented rats, J. Inorg. Biochem. 22, 165–173 (1984).
G. Hampel, K. H. Schaller, M. Rosenmüller, and C. Oefele, Selenium-deficiency as contributing factor to anemia and thrombocytopenia in dialysis patients, Life Support Syst. 3(Suppl. 1), 36–40 (1985).
M. van Lettow, C. E. West, J. W. M. van der Meer, F. T. Wieringa, and R. D. Semba, Low plasma selenium concentrations, high plasma human immunodeficiency virus load and high interleukin-6 concentrations are risk factors associated with anemia in adults presenting with pulmonary tuberculosis in Zomba district, Malawi, Eur. J. Clin. Nutr. 59, 526–532 (2005).
J. M. Guralnik, L. P. Fried, E. M. Simonsick, D. Kasper, and M. E. Lafferty, The Women's Health and Aging Study: Health and Social Characteristics of Older Women with Disability. National Institute on Aging, Bethesda, MD (1995).
L. P. Fried, K. Bandeen-Roche, J. D. Kasper, and J. M. Guralnik, Association of comorbidity with disability in older women: the Women's Health and Aging Study. J. Clin. Epidemiol. 52, 27–37 (1999).
A. R. Cappola, K. Bandeen-Roche, G. S. Wand, S. Volpato, and L. P. Fried, Association of IGF-1 levels with muscle, strength and mobility in older women, J. Clin. Endocrinol. Metab. 86, 4139–4146 (2001).
R. D. Semba, C. Blaum, J. M. Guralnik, D. Totin, M. O. Ricks, and L. P. Fried, Low carotenoid and vitamin E status are associated with indicators of sarcopenia among older women living in the community, Aging Clin. Exp. Res. 15, 482–487 (2003).
C. S. Blaum, Q. L. Xue, E. Michelon, R. D. Semba, and L. P. Fried, The association between obesity and the frailty syndrome in older women: the Women's Health and Aging studies, J. Am. Geriatr. Soc. 53, 1–8 (2005).
S. P. Stabler, R. H. Allen, L. P. Fried, et al., Racial differences in prevalence of cobalamin and folate deficiencies in disabled elderly women, Am. J. Clin. Nutr. 70, 911–919 (1999).
H. E. Sauberlich, Laboratory Tests for the Assessment of Nutritional Status, 2nd ed., CRC, Boca Raton, FL (1999).
SAS Institute, SAS Languages and Procedures: Introduction, Version 6, SAS Institute, Cary, NC (1990).
Stata Corporation, Stata Use's Guide, Stata Press College Station, TX (1996).
E. Michelon, C. Blaum, R. D. Semba, Q. L. Xue, M. O. Ricks, and L. P. Fried, Vitamin and carotenoid status in older women: associations with the frailty syndrome, J. Gerontol. A: Biol. Sci. Med. Sci. 61, 600–607 (2006).
L. Balducci, Epidemiology of anemia in the elderly: information on diagnostic evaluation, J. Am. Geriatr. Soc. 51, S2-S9 (2003).
C. K. Chow and C. J. Chen, Dietary selenium and age-related susceptibility of rat erythrocytes to oxidative damage, J. Nutr. 110, 2460–2466 (1980).
E. Nagababu, F. J. Chrest, and J. M. Rifkind, Hydrogen-peroxide-induced heme degradation in red blood cells: the protective roles of catalase and glutathione peroxidase, Biochim. Biophys. Acta 1620, 211–217 (2003).
D. B. McPhail and A. M. Sibbald, The role of free radicals in brassica-induced anaemia of sheep: an ESR spin trapping study, Free Radical Res. Commun. 16, 277–284 (1992).
S. Prache, Haemolytic anaemia in ruminants fed forage brassicas: a review, Vet. Res. 25, 497–520 (1994).
J. T. Rotruck, A. L. Pope, H. E. Ganther, and W. G. Hoekstra, Prevention of oxidative damage to rat erythrocytes by dietary selenium, J. Nutr. 102, 689–696 (1972).
A. Gutzwiller, Einfluss der Selenversorgungslage der Ziege die Resistenz der Erythrozyten gegen oxidative Schädigung, Schweiz. Arch. Tierheilk 133, 157–161 (1991).
A. Gutzwiller, Erythrocyte resistance to oxidative damage and leucocyte capacity to reduce nitroblue tetrazolium in selenium-deficient cattle, Zentralbl. Veterinarmed. A 45, 271–278 (1998).
Food and Nutrition Board, Institute of Medicine, Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids, National Academy Press, Washington, DC (2000).
C. D. Thomson, Assessment of requirements for selenium and adequacy of selenium status: a review, Eur. J. Clin. Nutr. 58, 391–402 (2004).
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Semba, R.D., Ferrucci, L., Cappola, A.R. et al. Low serum selenium is associated with anemia among older women living in the community. Biol Trace Elem Res 112, 97–107 (2006). https://doi.org/10.1385/BTER:112:2:97
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DOI: https://doi.org/10.1385/BTER:112:2:97