Association between Intake and Serum Selenium Levels and Risk Factors of Cardiovascular Disease (Narrative Review)

Authors

1 Students Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran<br/>Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran<br/>

2 Department of Modern Sciences and Technologies, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

3 Brighton & Sussex Medical School, Division of Medical Education, Falmer, Brighton, Sussex BN1 9PH, UK

4 Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran<br/>Cardiovascular Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mas

Abstract

Background: Selenium (Se) is a necessary elementand is a potent antioxidant adjusting the activity of some enzymes such as glutathione peroxidase (GPx). Selenium metabolism is associated with the biology of heart and its functions, and selenium deficiency is related to cardiovascular pathology. Several studies indicate a relationship between selenium and cardiovascular disease.
Objectives: The aim of this study was the investigation of the role of selenium in cardiovascular disease.
Methods: We searched the ISI, PubMed, Scopus, and Google Scholar databases for studies that evaluated the association between selenium levels and cardiovascular health and cardiovascular disease. At first, the studies containing the words "selenium ", "cardiovascular disease", "selenium supplementation", "levels of selenium" and "hypertension" were selected.
We searched papers using ‘selenium_, ‘selenium supplementation_, ‘selenium deficiency_and, ‘Se_in combination with ‘cardiovascular disease_, ‘hypertension_’, ‘heart disease_’, ‘heart failure_’ as keywords. Results: 17 articles (6 randomized clinical trials and 11 observational studies) were eligible to be included in the current review. Some clinical trials showed that selenium supplementation could decrease the risk factors of cardiovascular disease include lipid profiles and inflammatory markers. Observational studies showed that low selenium concentrations are a risk factor of cardiovascular disease however, this is not definitive. But the presence of normal levels of selenium in the body for antioxidant defense is essential.
Conclusion: More clinical trial studies with larger sample size are needed to confirm that selenium is effective in preventing and treatment of cardiovascular disease.

Keywords


  1. Mendis S, Puska P, Norrving B. Global atlas on cardiovascular disease prevention and control. Geneva: World Health Organization; 2011.
  2. Gatto  L,  Marco  V,  Contarini  M,  Prati  F.  Atherosclerosis  to predict cardiac events: where and how to look for it. J Cardiovasc Med (Hagerstown). 2017;18(Suppl 1):e154-6. doi: 10.2459/JCM.0000000000000465. [PubMed: 27875346].
  3. Stadtman TC. Selenoproteins--tracing the role of a trace element in protein function. PLoS Biol. 2005;3(12):e421. doi: 10.1371/journal.pbio.0030421. [PubMed: 16336050].
  4. Combs GF. Selenium in global food systems. Br J Nutr. 2001;85(5):517-47. doi: 10.1079/bjn2000280. [PubMed: 11348568].
  5.  Mehdi  Y,  Hornick JL,  Istasse  L,  Dufrasne  I.  Selenium  in  the environment, metabolism and involvement in body functions. Molecules. 2013;18(3):3292-311. doi: 10.3390/molecules 18033292. [PubMed: 23486107].
  6.  Neve J. Selenium as a risk factor for cardiovascular diseases. J Cardiovasc Risk. 1996;3(1):42-7. [PubMed: 8783029].
  7. Hercberg S, Galan P, Preziosi P, Bertrais S, Mennen L, Malvy D, et al. The SU. VI. MAX study: a randomized, placebo-controlled trial of the health effects of antioxidant vitamins and minerals. Arch Intern Med. 2004;164(21):2335-42. doi: 10.1001/archinte.164.21.2335. [PubMed: 15557412].
  8. Muth O, Oldfield J, Remmert L, Schubert JR. Effects of selenium and vitamin E on white muscle disease. Science. 1958;128(3331):1090. doi: 10.1126/science.128.3331.1090. [PubMed: 13592294].
  9. Brown  KM,  Arthur  JR.  Selenium,  selenoproteins  and  human health: a review. Public Health Nutr. 2001;4(2B):593-9. [PubMed: 11683552].
  10. Roemmich JN, Lambiase MJ, Balantekin KN, Feda DM, Dorn J. Stress, behavior, and biology: risk factors for cardiovascular diseases in youth. Exerc Sport Sci Rev. 2014;42(4):145-52. doi: 10.1249/JES.0000000000000027. [PubMed: 25061998].
  11. Vasconcellos F, Seabra A, Katzmarzyk PT, Kraemer-Aguiar LG, Bouskela E, Farinatti P. Physical activity in overweight and obese adolescents: systematic reviewof the effectsonphysical fitness components and cardiovascular risk factors. Sports Med. 2014;44(8):1139-52. doi: 10.1007/s40279-014-0193-7. [PubMed: 24743931].
  12. Ji F, Ning F, Duan H, Kaprio J, Zhang D, Zhang D, et al. Genetic and environmental influences on cardiovascular disease risk factors: a study of Chinese twin children and adolescents. Twin Res Hum Genet. 2014;17(2):72-9. doi: 10.1017/thg.2014.5. [PubMed: 24576535].
  13. D’Addato S, Palmisano S, Borghi C. How important are triglycerides as risk factors? J Cardiovasc Med. 2017;18(Suppl 1):e7-12.   doi:   10.2459/JCM.0000000000000438.   [PubMed: 27763943].
  14. Shils  ME,  Shike  M.  Modern  nutrition  in  health  and  disease. Philadelphia: Lippincott Williams & Wilkins; 2006.
  15. Benstoem C, Goetzenich A, Kraemer S, Borosch S, Manzanares W, Hardy G, et al. Selenium and its supplementation in cardiovascular disease--what do we know? Nutrients. 2015;7(5):3094-118. doi: 10.3390/nu7053094. [PubMed: 25923656].
  16. Maulik N, Das DK. Emerging potential of thioredoxin and thioredoxin interacting proteins in various disease conditions. Biochim Biophys Acta. 2008;1780(11):1368-82. doi: 10.1016/ j.bbagen.2007.12.008. [PubMed: 18206121].
  17. Lu C, Qiu F, Zhou H, Peng Y, Hao W, Xu J, et al. Identification and characterization of selenoprotein K: an antioxidant in cardiomyocytes. FEBS Lett. 2006;580(22):5189-97. doi: 10.1016/j.febslet.2006.08.065. [PubMed:16962588].
  18. Flores-Mateo G, Navas-Acien A, Pastor-Barriuso R, Guallar E. Selenium and coronary heart disease: a meta-analysis. Am J Clin Nutr. 2006;84(4):762-73. doi: 10.1093/ajcn/84.4.762. [PubMed: 17023702].
  19. Loscalzo J. Keshan disease, selenium deficiency, and the selenoproteome. N Engl J Med. 2014;370(18):1756-60. doi: 10.1056/NEJMcibr1402199. [PubMed: 24785212].
  20. Omrani H, Golmohamadi S, Pasdar Y, Jasemi K, Almasi A. Effect of selenium supplementation on lipid profile in hemodialysis patients. J Renal Inj Prev. 2016;5(4):179-82. doi: 10.15171/ jrip.2016.38. [PubMed: 27689119].
  21. Boskabadi H, Maamouri G, Rezagholizade Omran F, Mafinejad S, Tara F, Rayman MP, et al. Effect of prenatal selenium supplementation on cord blood selenium and lipid profile. Pediatr Neonatol. 2012;53(6):334-9. doi: 10.1016/j.pedneo. 2012.08.008. [PubMed: 23276436].
  22. Stranges S, Marshall JR, Trevisan M, Natarajan R, Donahue RP, Combs GF, et al. Effects of selenium supplementation on cardiovascular disease incidence and mortality: secondary analyses in a randomized clinical trial. Am J Epidemiol. 2006;163(8):694-9. doi: 10.1093/aje/kwj097. [PubMed: 16495471].
  23. Rees K, Hartley L, Day C, Flowers N, Clarke A, Stranges S. Selenium supplementation for the primary prevention of cardiovascular disease. Cochrane Database Syst Rev. 2013;1:CD009671. doi: 10.1002/14651858.CD009671.pub2. [PubMed: 23440843].
  24. Joseph J, Loscalzo J. Selenistasis: epistatic effects of selenium on cardiovascular phenotype. Nutrients. 2013;5(2):340-58. doi: 10.3390/nu5020340. [PubMed: 23434902].
  25. Satia JA, King IB, Morris JS, Stratton K, White E. Toenail and plasma levels as biomarkers of selenium exposure. Ann Epidemiol. 2006;16(1):53-8. doi: 10.1016/j.annepidem.2005. 02.011. [PubMed: 15961316].
  26. Longnecker MP, Stram DO, Taylor PR, Levander OA, Howe M, Veillon C, et al. Use of selenium concentration in whole blood, serum, toenails, or urine as a surrogate measure of selenium intake. Epidemiology. 1996;7(4):384-90. doi: 10.1097/ 00001648-199607000-00008. [PubMed: 8793364].
  27. Salonen J, Alfthan G, Huttunen J, Pikkarainen J, Puska P. Association between cardiovascular death and myocardial infarction and serum selenium in a matched-pair longitudinal study. Lancet. 1982;2(8291):175-9. doi: 10.1016/s0140- 6736(82)91028-5. [PubMed: 6123886].
  28. Parizadeh SM, Moohebati M, Ghafoori F, Ghayour-Mobarhan M, Kazemi-Bajestani  SM,  Tavallaie  S,  et  al.  Serum  selenium  and glutathione peroxidase concentrations in Iranian patients with angiography-defined coronary artery disease. Angiology. 2009;60(2):186-91. doi: 10.1177/0003319708319780. [PubMed: 18586758].
  29. Parizadeh SM, Moohebati M, Ghafoori F, Ghayour-Mobarhan M, Kazemi-Bajestani  SM,  Tavallaie  S,  et  al.  Serum  selenium  and glutathione peroxidase concentrations in Iranian patients with angiography-defined coronary artery disease. Angiology. 2009;60(2):186-91. doi: 10.1177/0003319708319780. [PubMed: 18586758].
  30. González-Estecha    M,    Palazón-Bru    I,    Bodas-Pinedo    A, Trasobares  E,  Palazón-Bru  A,  Fuentes  M,  et al.  Relationship between serum selenium, sociodemographic variables, other trace elements and lipid profile in an adult Spanish population. J Trace Elem Med Biol. 2017;43:93-105. doi: 10.1016/j. jtemb.2016.12.002. [PubMed: 28073603].
  31. Stranges S, Navas-Acien A, Rayman MP, Guallar E. Selenium status and cardiometabolic health: state of the evidence. Nutr Metab Cardiovasc Dis. 2010;20(10):754-60. doi: 10.1016/j. numecd.2010.10.001. [PubMed: 21094028].
  32. Ghayour-Mobarhan  M,  Taylor  A,  Lanham-New  S,  Lamb  DJ, Nezhad MA, Kazemi-Bajestani SM, et al. Serum selenium and glutathione peroxidase in patients with obesity and metabolic syndrome. Pak J Nutr. 2008;7(1):112-7.
  33. Laclaustra M, Navas-Acien A, Stranges S, Ordovas JM, Guallar E. Serum selenium concentrations and hypertension in the US population. Circ Cardiovasc Qual Outcomes. 2009;2(4): 369- 76.    doi:    10.1161/CIRCOUTCOMES.108.831552.    [PubMed: 20031863].
  34. Nawrot TS, Staessen JA, Roels HA, Den Hond E, Thijs L, Fagard RH, et al. Blood pressure and blood selenium: a cross-sectional and longitudinal population study. Eur Heart J. 2007; 28(5):628-33. doi: 10.1093/eurheartj/ehl479. [PubMed: 17242009].
  35. Beck MA,  Kolbeck  PC,  Rohr  LH,  Shi Q,  Morris  VC,  Levander OA. Benign human enterovirus becomes virulent in selenium‐deficient mice. J Med Virol. 1994;43(2):166-70. doi: 10.1002/jmv.1890430213. [PubMed: 8083665].
  36. Beck MA. Increased virulence of coxsackievirus B3 in mice due to vitamin E or selenium deficiency. J Nutr. 1997;127(5):966S- 70S. doi: 10.1093/jn/127.5.966S. [PubMed: 9164275].
  37. Stranges S, Sieri S, Vinceti M, Grioni S, Guallar E, Laclaustra M, et al. A prospective study of dietary selenium intake and risk of type 2 diabetes. BMC Public Health. 2010;10:564. doi: 10.1186/1471-2458-10-564. [PubMed: 20858268].
  38. Laclaustra M, Stranges S, Navas-Acien A, Ordovas JM, Guallar E. Serum selenium and serum lipids in US adults: National Health and  Nutrition  Examination  Survey  (NHANES)  2003–2004. Atherosclerosis. 2010;210(2):643-8. doi: 10.1016/j.atheros clerosis.2010.01.005. [PubMed: 20102763].
  39. Alamdari DH, Ghayour-Mobarhan M, Tavallaie S, Parizadeh MR, Moohebati M, Ghafoori F, et al. Prooxidant–antioxidant balance as a new risk factor in patients with angiographically defined coronary artery disease. Clin Biochem. 2008;41(6):375-80. doi: 10.1016/j.clinbiochem.2007.12.008. [PubMed: 18191639].
  40. Landmesser U, Harrison DG. Oxidant stress as a marker for cardiovascular events: Ox marks the spot. Circulation. 2001;104(22):2638-40. [PubMed: 11723010].
  41. Motamed  S,  Ebrahimi  M,  Safarian  M,  Ghayour-Mobarhan  M, Mouhebati M, Azarpazhouh M, et al. Micronutrient intake and the presence of the metabolic syndrome. N Am J Med Sci. 2013;5(6):377-85. doi: 10.4103/1947-2714.114171. [PubMed: 23923113].
  42. Rayman  MP.  The  importance  of  selenium  to  human  health. Lancet. 2000;356(9225):233-41. doi: 10.1016/S0140- 6736(00)02490-9. [PubMed: 10963212].
  43. Alehagen U, Aaseth J. Selenium and coenzyme Q10 interrelationship in cardiovascular diseases–A clinician's point of view. J Trace Elem Med Biol. 2015;31:157-62. doi: 10.1016/j.jtemb.2014.11.006. [PubMed:25511910].
  44. Asemi  Z,  Jamilian  M,  Mesdaghinia  E,  Esmaillzadeh  A.  Effects of selenium supplementation on glucose homeostasis, inflammation, and oxidative stress in gestational diabetes: Randomized, double-blind, placebo-controlled trial. Nutrition. 2015;31(10):1235-42. doi: 10.1016/j.nut.2015.04.014. [PubMed:26250486].
  45. Bahmani F, Kia M, Soleimani A, Mohammadi AA, Asemi Z. The effects of selenium supplementation on biomarkers of inflammation and oxidative stress in patients with diabetic nephropathy: a randomised, double-blind, placebo-controlled trial. Br J Nutr. 2016;116(7):1222-8. doi: 10.1017/S0007 114516003251. [PubMed: 27647263].
  46. Lymbury RS, Marino MJ, Perkins AV. Effect of dietary selenium on the progression of heart failure in the ageing spontaneously hypertensive rat. Mol Nutr Food Res. 2010;54(10):1436-44. doi: 10.1002/mnfr.201000012. [PubMed: 20486210].
  47. Traulsen H, Steinbrenner H, Buchczyk DP, Klotz LO, Sies H. Selenoprotein P protects low-density lipoprotein against oxidation. Free Radic Res. 2004;38(2):123-8. doi: 10.1080/ 10715760320001634852. [PubMed: 15104205].
  48. Omrani  HR,  Rahimi  M,  Nikseresht  K.  The  effect  of  selenium supplementation on acute phase reactants and thyroid function tests in hemodialysis patients. Nephrourol Mon. 2015;7(2):e24781. doi: 10.5812/numonthly.24781. [PubMed: 25883912].
  49. Alehagen U, Johansson P, Björnstedt M, Rosén A, Dahlström U. Cardiovascular mortality and N-terminal-proBNP reduced after combined selenium and coenzyme Q10 supplementation: a 5-year prospective randomized double-blind placebo- controlled trial among elderly Swedish citizens. Int J Cardiol. 2013;167(5):1860-6. doi: 10.1016/j.ijcard.2012.04.156. [PubMed: 22626835].
  50. Mao J, Bath SC, Vanderlelie JJ, Perkins AV, Redman CW, Rayman MP. No effect of modest selenium supplementation on insulin resistance in UK pregnant women, as assessed by plasma adiponectin concentration. Br J Nutr. 2016;115(1):32- 8. doi: 10.1017/S0007114515004067. [PubMed: 26481811].