Adequate serum selenium levels are critical for the proper functioning of certain selenoproteins that are involved in a variety of biological pathways, including thyroid hormone metabolism and redox pathways. Previous studies have also shown that extremely low levels of selenium are associated with the development of Keshan disease, an endemic form of cardiomyopathy, that was reversed with selenium supplementation.

Why This Study Matters

While previous work has suggested that selenium deficiency is related to increased mortality and accelerated HF progression, prospective studies of the general population linking selenium levels to new-onset HF are lacking. This study aimed to fill the gap by exploring the link between serum selenium levels and mortality as well as onset of HF using a well-characterized, adult cohort.

Study Design

Investigators utilized the Prevention of REnal and Vascular End-stage Disease (PREVEND), a large, prospective, general population cohort based in the Netherlands. Selenium levels were measured in 5973 subjects. The average participant age was 53.6 years and females comprised 52% of subjects. The primary outcome of this study was a composite endpoint of all-cause mortality and new-onset HF. The median follow-up period was 8.4 years.

Results and Conclusions

In non-smoking participants, selenium levels greater than 110 µg/L were significantly associated with reduced risk of death and new-onset HF, with a more pronounced effect observed in male subjects.

These participants had serum selenium levels close to 123 µg/L which is the reported level of selenium needed for optimal selenoprotein function. For comparison, the normal concentration of serum selenium in adults is 70 to 150 µg/L.

Researchers observed no positive associations for smoking subjects, consistent with previous studies that showed smokers had lower serum selenium levels.

Selenium levels were also positively correlated with higher total cholesterol and glucose concentrations as well as female gender. They were negatively correlated with smoking, higher body mass index, increased C-reactive protein levels, and iron deficiency.