High Serum Selenium Levels Linked to Increased Diabetes Risk

Contrary to expectation, high serum selenium levels are positively associated with the prevalence of diabetes, according to findings published in the April issue of Diabetes Care. "Oxidative stress reduces insulin secretion and increases insulin resistance in some experimental models and thus play a causal role in the pathogenesis of diabetes," write Dr. Joachim Bleys and colleagues from Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland. "Because of its antioxidant properties, selenium might thus prevent the development of diabetes."

To test their hypothesis that selenium levels would be inversely associated with diabetes prevalence, the researchers conducted a cross-sectional analysis of data from 8876 subjects (at least 20 years of age) who participated in the Third National Health and Nutrition Examination Survey.

The team defined diabetes as a fasting plasma glucose of at least 126 mg/dL, a self-report of a physician diagnosis of diabetes, or current use of insulin or oral hypoglycemic medication. Atomic absorption spectrometry was used to measure serum selenium.

The results ran counter to what was anticipated. After adjustment for age, sex, race, and body mass index, serum selenium levels were 126.8 ng/mL and 124.7 ng/mL in diabetic and non-diabetic subjects, respectively (adjusted difference 2.1 ng/mL; p = 0.02).

The multivariate-adjusted odds ratio for diabetes for the highest versus the lowest quintile of serum selenium was 1.57.
The authors call for prospective studies with diabetes incidence as the outcome in order to establish a causal role of selenium on the risk of diabetes.

"Until the findings of these studies are available, selenium intake, including selenium supplementation, should not be recommended for diabetes prevention in populations with adequate selenium status," Dr. Bleys and colleagues advise. "Furthermore, diabetic patients should avoid selenium supplementation until randomized controlled trials show objective benefits on mortality or morbidity end points."

Diabetes Care 2007;30:829-834.

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