Inverse Association Between Baseline Plasma Selenium Concentrations and Risks of Renal Function Decline in Hypertensive Adults

Recent advancements in the application of multi-elemental profiling and ionomics in cardiovascular diseases

BACKGROUND

Trace elements and minerals are crucial for human growth and health, whose imbalance is associated with a variety of diseases. Recently, multi-elemental profiling and ionomics have been rapidly developed and widely used to study the distribution, variation, and interactions of various elements in diverse physiological and pathological conditions. By utilizing high-throughput elemental analytical techniques and bioinformatics approaches, researchers can uncover the relationship between the metabolism and balance of different elements and numerous human diseases.

METHODS

The presented work reviews recent advances in multi-elemental and ionomic profiling of human biological samples for several major types of cardiovascular diseases.

RESULTS

Research indicates distinct and dynamic patterns of ion contents in these diseases. Accumulation of copper and environmental toxic metals as well as deficiencies in zinc and selenium appear to be the most significant risk factors for the majority of cardiovascular diseases, suggesting that an imbalance in these elements may play a role in the development of these illnesses. Furthermore, each type of cardiovascular disease exhibits a relatively unique distribution of ions in biofluid and hair samples from patients, potentially serving as indicators for the specific disease.

CONCLUSION

Multi-elemental profiling and ionomics not only enhance our understanding of the association between elemental dyshomeostasis and the development of cardiovascular diseases but also facilitate the discovery of novel diagnostic and prognostic markers for these conditions.

Role of selenium in the pathophysiology of cardiorenal anaemia syndrome

Chronic kidney disease (CKD) and cardiovascular disease (CVD) have multiple bidirectional mechanisms, and anaemia is one of the critical factors that are associated with the progression of the two disorders [referred to as cardiorenal anaemia syndrome (CRAS)]. Several lines of evidence indicate that CRAS confers a worse prognosis, suggesting the need to clarify the underlying pathophysiology. Among the micronutrients (trace elements) that are essential to humans, inadequate iron status has previously been implicated in the pathogenesis of CRAS; however, the roles of other trace elements remain unclear. Selenium critically regulates the function of selenoproteins, in which selenocysteine is present at the active centres. The human genome encodes 25 selenoproteins, and accumulating data indicate that they regulate diverse physiological processes, including cellular redox homeostasis, calcium flux, thyroid hormone activity and haematopoiesis, all of which directly or indirectly influence cardiac function. The essential role of selenium in human health is underscored by the fact that its deficiency results in multiple disorders, among which are cardiomyopathy and abnormal erythrocyte morphology. Studies have shown that selenium deficiency is not uncommon in CKD patients with poor nutritional status, suggesting that it may be an under-recognized cause of anaemia and cardiovascular disorders in these patients. In this review, we discuss the role of selenium in the pathophysiology of CKD, particularly in the context of the interconnection among CKD, cardiac dysfunction and anaemia. Given that selenium deficiency is associated with treatment-resistant anaemia and an increased risk of CVD, its role as a key modulator of CRAS merits future investigation.

Association of composite dietary antioxidant index with mortality risk among adults with chronic kidney disease in NHANES

At present, the relationship between the intake of antioxidants in food and the mortality rate of patients with chronic kidney disease (CKD), especially the association with the mortality rate of specific causes, is not clear. This study included 6379 adult CKD patients from the National Health and Nutrition Examination Survey (2001-2018). Use the Cox proportional hazards model, restricted cubic spline (RCS) model, and stratified and sensitivity analysis to evaluate the relationship between the Composite Dietary Antioxidant Index (CDAI) and mortality in patients with chronic kidney disease. During the follow-up period, 2381 all-cause deaths were recorded, including 719 deaths from cardiovascular disease, 132 deaths from cerebrovascular disease, and 430 deaths from cancer. We found that compared to the lowest quartile of CDAI, the weighted multivariate hazard ratio of participants in the highest quartile was 0.83 (95% confidence interval: 0.72, 0.96) for all-cause mortality, Cardiovascular mortality was 0.91 (95% confidence interval: 0.70, 1.18), Cerebrovascular death was 0.51 (95% confidence interval: 0.24, 1.07), Death due to cancer was 0.64 (95% confidence interval: 0.45, 0.92). RCS analysis shows a non-linear relationship between CDAI and all-cause mortality and cancer mortality. At the same time, there is no non-linear relationship between CDAI and cardiovascular mortality and cerebrovascular mortality. Stratified analysis shows that race and BMI are influencing factors for CDAI-CKD mortality. Sensitivity analysis confirmed the robustness of the results. Our research findings emphasize the potential advantages of an antioxidant diet in reducing the risk of mortality in CKD patients.

Preoperative serum selenium predicts acute kidney injury after adult cardiac surgery

BACKGROUND

The relationship between serum selenium (Se) and acute kidney injury after adult cardiac surgery (CSA-AKI) remains controversial. This study aimed to investigate the association of preoperative Se level with incident CSA-AKI.

METHOD AND RESULTS

A retrospective cohort study was conducted on patients who underwent cardiac surgery. The primary outcome was incident CSA-AKI. Multivariable logistic regression models and natural cubic splines were used to estimate the association of Se levels and primary outcome. A total of 453 patient with a mean age of 62.97 years were included. Among all patients, 159 (35.1%) incident cases of CSA-AKI were identified. The level of preoperative Se concentration in patients with CSA-AKI was significant lower than that in patients without CSA-AKI. The higher preoperative Se level was significantly associated with decreased risk of CSA-AKI (adjusted OR 0.91, 95% CI: 0.87-0.99). Dose-response relationship curve revealed a nearly L-shape correlation between serum Se selenium levels and incident CSA-AKI.

CONCLUSION

Our study suggested that a higher level of serum Se was significantly associated with lower risk of CSA-AKI. Further prospective studies are needed to clarify the causal relationship between serum Se level and incident CSA-AKI.

Higher serum selenium concentration is associated with lower risk of all-cause and cardiovascular mortality among individuals with chronic kidney disease: A population-based cohort study of NHANES

Background

Selenium is an essential nutrient and trace element required for human health and plays an important role in antioxidative and anti-inflammatory processes. However, the long-term impact of selenium levels on the health of patients with chronic kidney disease remains unclear.

Method

Participants in this study were 3,063 CKD adults from the Third National Health and Nutrition Examination Survey (NHANES 1999–2000, 2003–2004, and 2011–2018). The mortality status and the cause of death of the study participants were obtained from the National Death Index records. For all-cause and cardiovascular disease (CVD) mortality, the models employed to estimate hazard ratios (HRs) and 95% CI were Cox proportional hazard models and competing risk models, respectively.

Result

During the follow-up period, 884 deaths occurred, including 336 heart-disease-associated deaths. The median (IQR) concentration of serum selenium was 181.7 (156.1, 201.5) μg/L. After full adjustment, serum selenium levels were associated with a decreased risk of mortality in patients with CKD, including all-cause and CVD mortality (P < 0.001). The multivariate-adjusted HRs (95%CI) were 0.684 (0.549–0.852) for all-cause mortality (Ptrend < 0.001) and 0.513 (0.356–0.739) for CVD mortality (Ptrend < 0.001) when selenium concentrations were compared according to the extreme quartiles. Selenium levels are inversely associated with an increased risk of all-cause mortality and CVD mortality. Similar results were observed in subgroup and sensitivity analyses.

Conclusion

Higher serum selenium concentration was independently associated with a decreased risk of all-cause and CVD mortality in patients with CKD.

Excess selenium intake is associated with microalbuminuria in female but not in male among adults with obesity: Results from NHANES 2009-2018

INTRODUCTION

Selenium is a critical trace element with antioxidant activities that has been related to the preservation of kidney function. Few studies, however, have looked at the effects of excess selenium on kidneys. The purpose of the present study was performed to investigate the relationship between dietary selenium intake and the prevalence of microalbuminuria in American adults with obesity.

METHODS

A total of 8,547 participants with obesity in the National Health and Nutrition Examination Survey (NHANES) with the age of 19 years or older were included in the present study. Multivariable regression and subgroup analyses were performed to examine the association between dietary selenium and microalbuminuria in the two genders, separately. A selenium intake above the median was defined as high selenium intake.

RESULTS

Dietary selenium intake was significantly higher in men compared to women (139.49 μg/day vs. 101.06 μg/day; P < 0.0001). Among female participants, the prevalence of microalbuminuria was significantly higher in participants with a high selenium intake compared with those without a high selenium intake (13.82 vs. 9.96%; P = 0.008), whereas this difference did not exist in male participants (10.79 vs. 11.97%; P = 0.40). Dietary selenium is not significantly correlated with microalbuminuria (P = 0.68) in the male population, whereas each 1 μg/day of increase in selenium consumption was independently associated with a 6h higher risk of microalbuminuria (OR = 1.006; 95% CI, 1.001-1.011, P = 0.01) in females.

CONCLUSION

According to our research, excessive selenium consumption is positively correlated with microalbuminuria in females with obesity, but not in males with obesity.