Biofortified Maize Improves Selenium Status of Women and Children in a Rural Community in Malawi: Results of the Addressing Hidden Hunger With Agronomy Randomized Controlled Trial

Background: Selenium deficiency is widespread in the Malawi population. The selenium concentration in maize, the staple food crop of Malawi, can be increased by applying selenium-enriched fertilizers. It is unknown whether this strategy, called agronomic biofortification, is effective at alleviating selenium deficiency.Objectives: The aim of the Addressing Hidden Hunger with Agronomy (AHHA) trial was to determine whether consumption of maize flour, agronomically-biofortified with selenium, affected the serum selenium concentrations of women, and children in a rural community setting.Design: An individually-randomized, double-blind placebo-controlled trial was conducted in rural Malawi. Participants were randomly allocated in a 1:1 ratio to receive either intervention maize flour biofortified with selenium through application of selenium fertilizer, or control maize flour not biofortified with selenium. Participant households received enough flour to meet the typical consumption of all household members (330 g capita−1 day−1) for a period of 8 weeks. Baseline and endline serum selenium concentration (the primary outcome) was measured by inductively coupled plasma mass spectrometry (ICP-MS).Results: One woman of reproductive age (WRA) and one school-aged child (SAC) from each of 180 households were recruited and households were randomized to each group. The baseline demographic and socioeconomic status of participants were well-balanced between arms. No serious adverse events were reported. In the intervention arm, mean (standard deviation) serum selenium concentration increased over the intervention period from 57.6 (17.0) μg L−1 (n = 88) to 107.9 (16.4) μg L−1 (n = 88) among WRA and from 46.4 (14.8) μg L−1 (n = 86) to 97.1 (16.0) μg L−1 (n = 88) among SAC. There was no evidence of change in serum selenium concentration in the control groups.Conclusion: Consumption of maize flour biofortified through application of selenium-enriched fertilizer increased selenium status in this community providing strong proof of principle that agronomic biofortification could be an effective approach to address selenium deficiency in Malawi and similar settings.Clinical Trial Registration:http://www.isrctn.com/ISRCTN85899451, identifier: ISRCTN85899451.

A U-Shaped Relationship Between Selenium Concentrations and All-Cause or Cardiovascular Mortality in Patients With Hypertension

Background: Given the antioxidant activity of selenium, it has been reported benefits for blood pressure control and hypertension prevention, but few studies have investigated the association between serum selenium with mortality in hypertensive population.Methods: All participants with hypertension aged ≥18 years at baseline were recruited from the National Health and Nutritional Examination Surveys (NHANES) 2003–2004, and followed for mortality through December 31, 2015. Subjects were categorized by quartiles of serum selenium (Q1: ≤124 μg/L, Q2: 125–135 μg/L, Q3: 136–147 μg/L, Q4: ≥148 μg/L). Multivariate Cox regression were implemented to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Restricted cubic spline analysis and two-piecewise linear regression were used to evaluate the relationship of serum selenium with mortality. Survival curves were used to depict cause-specific mortalities.Results: A total of 929 participants (52.53% were male) were eligible for the current study with the average age of 63.10 ± 12.59 years. There were 307 deaths occurred including 56 cardiovascular death events during the mean follow-up time of 121.05 ± 40.85 months. A U-shaped association was observed between serum selenium and all-cause or cardiovascular mortality. In fully adjusted model, comparisons among quartiles revealed that risks of all-cause [HR (95%CI), 0.57 (0.39–0.81)] and cardiovascular death [HR (95%CI), 0.33 (0.13–0.86)] were lower in Q3. The nadir mortality of all-cause and cardiovascular was occurred at the serum selenium level of 136 μg/L and 130 μg/L, respectively.Conclusion: Serum selenium concentration showed a U-shaped association with all-cause and cardiovascular mortality.

The association between serum selenium concentration and prognosis in patients with heart failure in a Chinese population

Whether Selenium (Se) deficiency relates with adverse prognosis in Chinese patients with heart failure (HF) is still unknown. This study aimed to investigate the association of serum Se level and the outcomes of patients with HF in a Chinese population. Patients with HF and serum Se examination were retrospectively included. Baseline information were collected at patient’s first admission. The primary and secondary outcomes were all-cause mortality and rehospitalization for HF during follow-up, respectively. The study participants were divided into quartiles according to their serum Se concentrations. The Cox proportional hazard models were adopted to estimate the association of serum Se levels with observed outcomes. A total of 411 patients with HF with a mean age of 62.5 years were included. The mean serum level of Se was 68.3 ± 27.7 µg/L. There was nonsignificant difference of baseline characterizes between the four quartile groups. In comparison with patients in the highest quartile, those with the lowest quartile (17.40–44.35 µg/L) were associated with increased risk of all-cause mortality [adjusted hazard ratios (95% CI) 2.32 (1.43–3.77); Ptrend = 0.001]. Our study suggested that a lower serum Se level was significantly associated with increased risk of all-cause mortality in patients with HF.

Association Between Serum Selenium and Serum C-Reactive Protein Concentrations in Persons Infected With Human Immunodeficiency Virus Infection

Objectives Chronic inflammation and selenium deficiency are common in persons infected with the human immunodeficiency virus (HIV). Both C-reactive protein, a pro-inflammatory biomarker, and selenium deficiency have been associated with accelerated disease progression and poorer survival among persons infected with HIV-infection. However, research on the role of serum selenium levels in inflammation is limited. We assessed the association between serum selenium levels and C-reactive protein (CRP) concentrations in a cohort of persons infected with HIV. Methods A cross-sectional survey was conducted among 233 HIV-infected persons (124 men and 109 women) aged 18–60 years who were residing in Kathmandu, Nepal. Regular serum CRP and selenium concentrations were measured by the latex agglutination turbidimetric and the atomic absorption method, respectively. Relationships were assessed using multiple linear regression analysis to adjust for potential confounding factors including sociodemographic, smoking, body mass index, chronic diseases, CD4+ T-cell count, and anti-retroviral therapy. Results The geometric means of serum selenium and CRP concentrations were 9.65 µg/dL and 1.43 mg/L, respectively. Mean serum CRP concentration was significantly decreased with increasing serum selenium concentration across selenium tertiles (P for trend = 0.019), with mean serum CRP concentration in the highest tertile of serum selenium concentration was 40.8% lower than that in the lowest tertile. We found a significant inverse relation between log selenium and log CRP concentrations (beta for 1 unit change in log selenium; β = −1.01, p = 0.06). Conclusions Serum selenium levels may be inversely associated with serum CRP concentrations in persons infected with HIV. Further prospective study to confirm the role of serum selenium levels in inflammation among persons infected with HIV is warranted. Funding Sources University of Massachusetts Amherst.

The association of serum selenium with serum lipids in US adults

High selenium concentrations were associated with cardiovascular diseases, type 2 diabetes, and central nervous disorders. The author examined the relation of serum selenium concentration with serum lipids levels with the use of the National Health and Nutrition Examination Survey (NHANES) 2017-2018. 759 adults aged more than 20 years old from NHANES 2017-2018 were examined in the analysis. Serum selenium was measured by mass spectrometry. Triglyceride, HDL cholesterol, and total cholesterol were measured through enzymatical methods. LDL cholesterol was calculated then. Comparing Q4 to Q1 of serum selenium, the multivariable adjusted average differences (95% CI) in triglyceride, HDL cholesterol, LDL cholesterol, and total cholesterol were 21.3 mg/dL (9.1, 33.4 mg/dL), 2.3 mg/dL (-0.6, 5.2 mg/dL), 6.3 mg/dL (-1.3, 13.9 mg/dL), 12.8 (95% CI: 4.2, 21.5 mg/dL), respectively. Hence, The increasing serum selenium concentration is associated with increasing triglyceride, total cholesterol, HDL cholesterol, and LDL cholesterol among US adults.

Injectable organic and inorganic selenium in dairy cows – Effects on milk, blood and somatic cell count levels

Mastitis is the most costly disease of dairy cows. A pro-active approach includes insuring adequate levels of selective trace minerals. The aim of this study was to determine the effect of two different commercially available, injectable selenium products, (sodium) Na-selenite (inorganic) and (selenium) Se-methionine (organic), on milk composition and on serum and milk selenium concentrations in high-yielding Holstein cows on total mix ration. Sixty multiparous cows were randomly selected into three groups of 20, one control group and two groups supplemented with injectable trace minerals. Blood and milk samples were collected over a period of 60 days. No specific change was indicated in milk yield, lactose, milk urea nitrogen (MUN) and milk pH levels compared with baseline values. The Se-methionine supplemented group showed a numerical increase in total milk protein percentage. In the group injected with Se-methionine, a negative correlation was present for the initial 72 hours between serum selenium concentration and somatic cell count (SCC) and a highly significant (p 0.001) increase in milk selenium concentration for the initial 24 hours. Serum selenium concentration of Se-methionine-supplemented cows was however not significantly changed. Injection of Na-selenite led to a 60-day initial increase in serum selenium concentration above baseline levels and a significant milk selenium concentration on day 1 but to a negative correlation between serum selenium concentration and SCC. Differences in serum and milk selenium concentrations followed with the use of organic and inorganic selenium injectables. Injectable Na-selenite, as selenium, can be of important value for cattle farmers if supplemented on strategically physiological periods to improve production, reproduction and immunity.