Correlation between dietary selenium intake and stroke in the National Health and Nutrition Examination Survey 2003–2018

Abstract

Background Epidemiologic evidence of the effect of dietary selenium intake on stroke risk remains controversial. This study aimed to examine the cross-sectional correlation between dietary selenium intake and the risk of stroke in adults. Materials and methods We retrospectively analysed 39,438 participants from the National Health and Nutrition Examination Survey 2003–2018, aged 20–85 years. Participants were divided into quartiles depending on daily dietary selenium intake: quartile 1 (0–77 μg), quartile 2 (77–108 μg), quartile 3 (108–148 μg), and quartile 4 (148–400 μg). The dose-response relationship was assessed using the restricted cubic spline function. Results The adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of stroke were 0.70 (0.55, 0.88) for participants in quartile 2, 0.71 (0.53, 0.93) for quartile 3, and 0.61 (0.43, 0.85) for quartile 4 compared with that in quartile 1. p-Value for trend through quartiles was .007. A non-linear negative correlation between dietary selenium intake and stroke was observed in the threshold effect analysis and restricted cubic spline function (p-value for non-linearity < .001). An initial decrease in odds of stroke lower than 105 μg/day selenium intake (0.61 [0.44, 0.85], p = .004) was followed by a platform beyond 105 μg/day (0.97 [0.81, 1.16], p = .723). In the subgroup analysis, adjusted ORs (95% CIs) of stroke were 0.51 (0.36, 0.70) for female participants, 0.63 (0.40, 0.99) for participants with age <60 years, 0.63 (0.47, 0.85) for participants with poverty-income ratio < 2.14, 0.66 (0.50, 0.87) for participants with overweight and obesity, 0.66 (0.52, 0.84) for participants with hypertension, 0.72 (0.53, 0.97) for participants without diabetes, and 0.72 (0.56, 0.92) for non-anaemic participants. Conclusions Dietary selenium had a negative and non-linear correlation with the risk of stroke in adults. The correlation varied across different population subgroups. KEY MESSAGES Dietary selenium had a negative and non-linear correlation with the risk of stroke in adults. Non-linear negative correlation trends were observed in subpopulations of females, age <60 years, poverty-income ratio <2.14, overweight and obesity, hypertension, non-diabetes, and non-anaemia. Dietary selenium intake of approximately 105 μg per day has an optimum effect on stroke.