Serum Selenium and Incident Cardiovascular Disease in the PREvención con DIeta MEDiterránea (PREDIMED) Trial: Nested Case-Control Study
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Cardiovascular diseaseSerum seleniumOlder populationsPREDIMEDMediterranean diet
Gutiérrez-Bedmar, M... [et al.]. Serum Selenium and Incident Cardiovascular Disease in the PREvención con DIeta MEDiterránea (PREDIMED) Trial: Nested Case-Control Study. J. Clin. Med. 2022, 11, 6664. [https://doi.org/10.3390/jcm11226664]
Sponsorshipofficial funding agency for biomedical research of the Spanish government, Instituto de Salud Carlos III (ISCIII) RTIC G03/140; RTIC RD 06/0045 "PREDIMED" JR14/00008; Spanish government, Instituto de Salud Carlos III (ISCIII), through Centro de Investigacion Biomedica en Red de Fisiopatologia de la Obesidad y Nutricion (CIBERobn); Centro Nacional de Investigaciones Cardiovasculares CNIC 06/2007; Fondo de Investigacion Sanitaria-Fondo Europeo de Desarrollo Regional (Proyecto de Investigacion) PI04-2239 PI05/2584 CP06/00100 PI07/0240 PI07/1138 PI07/0954 PI 07/0473 PI10/01407 PI10/02658 PI11/01647 P11/02505 PI13/00462; Ministry of Science and Innovation, Spain (MICINN) (AGL)-2009-13906-C02 AGL2010-22319-C03 AGL2013-49083C3-1-R; Ministerio de Economia y Competitividad-Fondos FEDER-Instituto de Salud Carlos III UNGR15-CE-3380 Fundacion Mapfre 2010; Junta de Andalucia PI0105/2007; Public Health Division of the Department of Health of the Autonomous Government of Catalonia; Center for Forestry Research & Experimentation (CIEF) GVACOMP 06109 GVACOMP2010-181 GVACOMP2011-151 PROMETEO 21/2021; Conselleria de Sanitat y Atencion Primaria CS2010-AP-111 CS2011-AP-042; Regional Government of Navarra P27/2011; Centre Catala de la Nutricio de l'Institut d'Estudis Catalans
Background: Selenium is an essential trace mineral with potential interest for cardiovascular disease (CVD) prevention owing to its antioxidant properties. Epidemiological data on selenium status and CVD remain inconsistent. The objective of this study was to ascertain whether low serum selenium (SSe) concentrations are related to an increased risk of a first CVD event in a population at high cardiovascular risk. Methods: We undertook a case-control study nested within the “PREvención con DIeta MEDiterránea” (PREDIMED) trial. A total of 207 participants diagnosed with CVD (myocardial infarction, stroke, or cardiovascular death) during the follow-up period (2003–2010) were matched by sex, age, and intervention group to 436 controls by incidence density sampling. Median time between serum sample collection and subsequent CVD event occurrence was 0.94 years. SSe levels were determined using inductively coupled plasma mass spectrometry analysis. Covariates were assessed through validated questionnaires, in-person interviews, and medical record reviews. Conditional logistic regression was used to calculate multivariable-adjusted odds ratios (ORs). Results: Among women, the mean SSe concentration was lower in cases than in controls (98.5 g/L vs. 103.8 g/L; p = 0.016). In controls, SSe levels were directly associated with percentage of total energy intake from proteins and fish intake (p for linear trend < 0.001 and 0.049, respectively), whereas SSe concentrations were inversely associated with age, body mass index, and percentage of total energy intake from carbohydrates (p for linear trend < 0.001, 0.008 and 0.016 respectively). In the total group, we observed an inverse dose–response gradient between SSe levels and risk of CVD in the fully-adjusted model (highest vs. lowest quartile: OR = 0.47, 95% CI: 0.27–0.81; ptrend = 0.003). Conclusions: Among elderly individuals at high cardiovascular risk, high SSe concentrations within population reference values are associated with lower first CVD incidence.