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. 2009 Sep;117(9):1409-13.
doi: 10.1289/ehp.0900704. Epub 2009 May 15.

Serum selenium concentrations and diabetes in U.S. adults: National Health and Nutrition Examination Survey (NHANES) 2003-2004

Martin Laclaustra  1 , Ana Navas-Acien, Saverio Stranges, Jose M Ordovas, Eliseo Guallar
Affiliations

Serum selenium concentrations and diabetes in U.S. adults: National Health and Nutrition Examination Survey (NHANES) 2003-2004

Martin Laclaustra et al. Environ Health Perspect. 2009 Sep.

Abstract

Background: Increasing evidence suggests that high selenium levels are associated with diabetes and other cardiometabolic risk factors.

Objectives: We evaluated the association of serum selenium concentrations with fasting plasma glucose, glycosylated hemoglobin levels, and diabetes in the most recently available representative sample of the U.S. population.

Methods: We used a cross-sectional analysis of 917 adults > or = 40 years of age who had a fasting morning blood sample in the National Health and Nutrition Examination Survey 2003-2004. We evaluated the association of serum selenium, measured by inductively coupled plasma-dynamic reaction cell-mass spectrometry, and diabetes, defined as a self-report of current use of hypoglycemic agents or insulin or as fasting plasma glucose > or = 126 mg/dL.

Results: Mean serum selenium was 137.1 microg/L. The multivariable adjusted odds ratio [95% confidence interval (CI)] for diabetes comparing the highest quartile of serum selenium (> or = 147 microg/L) with the lowest (< 124 microg/L) was 7.64 (3.34-17.46). The corresponding average differences (95% CI) in fasting plasma glucose and glycosylated hemoglobin were 9.5 mg/dL (3.4-15.6 mg/dL) and 0.30% (0.14-0.46%), respectively. In spline regression models, the prevalence of diabetes as well as glucose and glycosylated hemoglobin levels increased with increasing selenium concentrations up to 160 microg/L.

Conclusions: In U.S. adults, high serum selenium concentrations were associated with higher prevalence of diabetes and higher fasting plasma glucose and glycosylated hemoglobin levels. Given high selenium intake in the U.S. population, further research is needed to determine the role of excess selenium levels in the development or the progression of diabetes.

Keywords: NHANES; National Health and Nutrition Examination Survey; diabetes; glycosylated hemoglobin; selenium.

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Figures

Figure 1
Figure 1
Adjusted ORs (curves) and 95% CIs (gray shading) for diabetes (A) and adjusted differences (and 95% CI) in fasting glucose (B) and glycosylated hemoglobin (C) by serum selenium concentration. Serum selenium was modeled as restricted quadratic splines with nodes at the 5th, 50th, and 95th percentiles. The multivariable linear regression models were adjusted for sex, age, race, education, BMI, smoking, cotinine, postmenopausal status, and use of vitamin and mineral supplements (model 3). The odds for diabetes and the values of the continuous variables at the 20th percentile (122 μg/L) of the serum selenium distribution were used as reference. The histogram shows the distribution of selenium concentrations in the study population.
Figure 2
Figure 2
Adjusted ORs (95% CIs) for diabetes comparing the 80th percentile (150 μg/L) with the 20th percentile (122 μg/L) of the serum selenium distribution. Serum selenium was modeled as restricted quadratic splines with nodes at the 5th, 50th, and 95th percentiles. Multivariable logistic regression models were adjusted for sex, age, race, education, BMI, smoking, cotinine, postmenopausal status, and use of vitamin and mineral supplements (model 3). The size of the square indicates the number of participants in each stratum. p-Values correspond to tests for interaction between selenium splines and selected participant characteristics.
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