Abstract
Although literature has been consistently showing an increased risk of type 2 diabetes (T2DM) in populations with high exposure to selenium, there is a lack of information quantifying the association between diabetes-related markers and the nutritional status of selenium. Therefore, we aimed to investigate the association between blood selenium concentration and glucose markers in a representative sample of the US population, which is known to have moderate to high exposure to selenium. This cross-sectional analysis included 4,339 participants ≥18 years from the 2013 to 2018 National Health and Nutrition Examination Survey (NHANES). All participants were assessed for whole blood selenium concentration, fasting plasma insulin and glucose, HbA1c, and HOMA-IR (Homeostatic Model Assessment for Insulin Resistance). In this cohort, all participants presented with adequate selenium status [196.2 (SD: 0.9) μg/L] and 867 (15%) had diabetes mellitus. Selenium was positively associated with insulin, glucose and HOMA-IR in models adjusted for age and sex. When the models were further adjusted for smoking status, physical activity, metabolic syndrome and BMI, the associations with insulin and HOMA-IR remained but the association with glucose was no longer significant. A 10 μg/L increase in selenium was associated with 1.5% (95% CI: 0.4–2.6%) increase in insulin and 1.7% (95% CI: 0.5–2.9%) increase in HOMA-IR in fully adjusted models. There was no evidence of an association between selenium and diabetes prevalence. Our findings corroborate the notion that selenium supplementation should not be encouraged in populations with high dietary intake of selenium.
Highlights
Selenium is an essential micronutrient to human life, as it is required for the synthesis of the 21st amino acid selenocysteine, the defining feature of 25 selenoproteins identified in humans
After further adjustment for smoking status, physical activity and presence of metabolic syndrome, a 10 μg/L increase in selenium was associated with 1.5% increase in insulin and 1.7% increase in HOMA-IR (Table 2; Figure 2)
Selenium status was associated with fasting glucose; this association was no longer significant when the model was further adjusted for smoking status, physical activity, metabolic syndrome and BMI
Summary
Selenium is an essential micronutrient to human life, as it is required for the synthesis of the 21st amino acid selenocysteine, the defining feature of 25 selenoproteins identified in humans. Inadequate selenium intake, which affects one in seven people in the world [3], has been associated with increased risk of cancer [4], neurodegenerative diseases [5,6,7] and thyroid dysfunction [8, 9]. Recent studies have indicated that high selenium consumption is associated with an increased risk of chronic diseases such as diabetes [10] and non-alcoholic fatty liver disease [11], and all-cause mortality [12] These studies corroborate the hypothesis that the metabolic outcomes of selenium in the human body follow a U-shaped curve [13, 14], meaning that selenium intake within the correct range is critical for human well-being, with either too high or too low being prejudicial
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