Abstract
The trace element selenium is of high importance for many of the body’s regulatory and metabolic functions. Balanced selenium levels are essential, whereas dysregulation can cause harm. A rapidly increasing number of studies characterizes the wide range of selenium dependent functions in the human body and elucidates the complex and multiple physiological and pathophysiological interactions of selenium and selenoproteins. For the majority of selenium dependent enzymes, several biological functions have already been identified, like regulation of the inflammatory response, antioxidant properties and the proliferation/differentiation of immune cells. Although the potential role of selenium in the development and progression of cardiovascular disease has been investigated for decades, both observational and interventional studies of selenium supplementation remain inconclusive and are considered in this review. This review covers current knowledge of the role of selenium and selenoproteins in the human body and its functional role in the cardiovascular system. The relationships between selenium intake/status and various health outcomes, in particular cardiomyopathy, myocardial ischemia/infarction and reperfusion injury are reviewed. We describe, in depth, selenium as a biomarker in coronary heart disease and highlight the significance of selenium supplementation for patients undergoing cardiac surgery.
Highlights
The essential trace element selenium (Se) is crucial for many biological functions including thyroid hormone metabolism, the body’s antioxidant defense systems, the adaptive and acquired immune system and prevention of certain cancers
An interesting Finnish report evaluated coronary heart disease (CHD) data from the nationwide supplementation of selenium-enriched fertilizers in Finland since the 1980s: serum selenium levels were raised to a level considered to be optimal (1.40 μmol L−1), rates of cardiovascular disease remained similar during the pre- and post-supplementation periods [90]
While two studies are still on-going, the results of a randomized controlled trial performed by Leong and colleagues demonstrated a significantly reduced incidence of myocardial injury in patients that received a metabolic therapy together with a dose of selenium
Summary
The essential trace element selenium (Se) is crucial for many biological functions including thyroid hormone metabolism, the body’s antioxidant defense systems, the adaptive and acquired immune system and prevention of certain cancers. Selenium content in foods and dietary supplements exists in different chemical forms (organic and inorganic selenocompounds) including selenomethionine (Se-Met), selenocysteine (Se-Cys), as well as selenite, selenious acid, and sodium selenite (mainly supplements). Se-Met is a less-efficient metabolic source than inorganic forms of selenium, since it needs to be reduced, via Se-Cys, to hydrogen selenide (H2Se), which is considered a key precursor in the metabolic interconversions of both organic and inorganic selenocompounds [19]. Despite this limitation, organic selenocompounds are frequently preferred in short-term therapy as they are less acutely toxic. Standardized formulations and protocols are still needed to enable a high-quality research comparison of selenium supplements and to determine the best form of selenium for cardiovascular diseases
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