Does selenium status affect biomarkers of inflammation in patients with coronary artery disease?
In a 2026 Norwegian study, researchers examined and compared epicardial adipose tissue biopsies from two groups of heart disease patients [Opstad 2026]:
- Coronary artery disease patients undergoing coronary artery bypass grafting (n = 52)
- Heart valve disease patients receiving valve replacement (n = 22)
- The heart valve disease patients had lower vulnerability to elevated inflammation levels. As such, they served as a control group to the group of coronary artery disease patients.
The research team obtained the epicardial adipose tissue biopsies during open-chest heart surgery. They measured selenium concentrations in the blood circulation and in the epicardial adipose tissue of the heart disease patients.
Epicardium and epicardial adipose tissue
Note: What is the epicardium?
The Cleveland Clinic explains that the epicardium is the outer layer of the heart muscle and the inner layer of the pericardium that surrounds the heart. A layer of fat (= adipose tissue) separates the epicardium from the heart muscle. The epicardium protects the heart and helps the heart function [Cleveland Clinic staff 2025].
Selenium concentrations and levels of inflammation
Do lower selenium concentrations indicate higher levels of inflammation?
The results of the Norwegian study showed the following associations [Opstad 2026]:
- Selenium concentrations were lower in patients with coronary artery disease than in the control heart valve patients.
- In the patients with coronary artery disease, serum selenium concentrations correlated inversely with levels of the central inflammation biomarkers IL-6 and hs-CRP.
- Higher selenium concentrations, i.e., selenium levels above the median linked to lower epicardial adipose tissue expression of CASP1 and NLRP3 and to reduced IL-6 levels.
Note: What are CASP1 and NLPR3?
CASP1 is an enzyme that triggers inflammation and fights infections. NLPR3 also triggers inflammation and releases pro-inflammatory cytokines.
Selenium and Selenoproteins in Epicardial Adipose Tissue
The Norwegian researchers’ analysis of publicly available RNA sequencing data showed the presence of the following antioxidant selenoproteins in patients’ epicardial adipose tissue [Opstad 2026]:
- GPX1
- GPX3
- GPX4
- SELENOP
Thus, the lower selenium concentrations in patients with coronary artery disease suggests the following conclusions [Opstad 2026]:
- Selenium status in coronary artery disease is linked to elevated systemic inflammation and to elevated epicardial adipose tissue inflammation.
- There seems to be a role for selenoprotein-dependent antioxidant mechanisms in regulating cardiac adipose tissue inflammation.
Selenium supplementation and inflammation levels
Analysis of data from the KiSel-10 randomized controlled trial suggests that long-term supplementation with selenium plus Coenzyme Q10 in an elderly population with low selenium status is associated with a broad reduction in biomarkers linked to chronic low-grade inflammation [Alehagen 2015; Alehagen 2019; Alehagen 2022]:
- Lower hs-CRP
- Lower soluble P-selectin
Lower sTNFR1 and sTNFR2 - Lower osteopontin and osteoprotegerin
Conclusion: Selenium and Inflammation in Heart Disease
Patients with coronary artery disease had lower serum selenium concentrations and lower epicardial selenium levels.
The lower serum selenium concentrations were associated with increased systemic inflammation and elevated inflammation in epicardial adipose tissue.
Thus, lower selenium intakes and lower selenium status may impair selenoprotein-dependent antioxidant defense.
Elevated inflammation in tissue near the heart muscle and the coronary arteries may contribute to adverse cardiac remodeling and atherosclerosis progression [Opstad 2026].
Sources
Alehagen U et al. Levels of sP-selectin and hs-CRP decrease with dietary intervention with selenium and coenzyme Q10 combined: a secondary analysis of a randomized clinical trial. PLoS One. 2015;10(9):e0137680.
Alehagen U et al. Decrease in inflammatory biomarker concentration by intervention with selenium and coenzyme Q10: a sub-analysis of osteopontin, osteoprotergerin, TNFr1, TNFr2 and TWEAK. J Inflamm (Lond). 2019 Mar 18;16:5.
Alehagen U et al. Improved cardiovascular health by supplementation with selenium and coenzyme Q10: applying structural equation modelling (SEM) to clinical outcomes and biomarkers to explore underlying mechanisms in a prospective randomized double-blind placebo-controlled intervention project in Sweden. Eur J Nutr. 2022;61:3135-3148.
Cleveland Clinic staff. Epicardium. Updated 6 Nov 2025. Retrieved from https://my.clevelandclinic.org/health/body/epicardium.
Opstad TB et al. Selenium status is associated with inflammation in epicardial adipose tissue in elderly patients with coronary artery disease. Antioxidants. 2026;15(6):687.
The information presented in this review article is not medical advice. Readers should not use it as medical advice.