Low plasma selenium status is significantly associated with heart disease risk and with elevated blood bio-markers of chronic inflammation. A 2021 cross-sectional study of elderly individuals in central Italy has revealed that individuals with a plasma selenium status lower than 60 mcg/L are especially at risk of heart disease [Giacconi 2021].
Moreover, in the peripheral blood mononuclear cells of elderly individuals diagnosed with heart disease, the researchers found that low plasma selenium status was significantly associated with enhanced gene expression of inflammatory cytokines and chemokines and with a downregulation of sirtuins SIRT-1, SIRT-5, SIRT-6, and SIRT-7 [Giacconi 2021].
Note: The peripheral blood mononuclear cells are lymphocytes (e.g., T cells, B cells, NK cells) and monocytes as distinguished from such blood cells as erythrocytes, granulocytes, and platelets.
Note: Cytokines and chemokines are immune system proteins. Some have a pro-inflammatory effect, and some have an anti-inflammatory effect.
Note: Sirtuins are enzymes that enzymes that regulate resistance to stress and regulate aging processes in cells. Moreover, research shows that SIRT-1, SIRT-6 and SIRT-7 act as key regulators in the protection from the risk of atherosclerosis [Giacconi 2021].
Low Selenium Status and elevated chronic Inflammation
Selenium is an essential trace element. The body cannot synthesize it; it must come from the diet.
Selenium plays an important role in immune system functions. It counteracts chronic inflammation by regulating inflammatory gene expression.
Accordingly, reduced selenium intakes and reduced selenium status can lead to increased expression of pro-inflammatory cytokines and chemokines and to increased oxidative stress, thereby contributing to the development and progression of heart disease [Giacconi 2021].
The Italian researchers reported that they consistently found evidence of increased levels of inflammatory markers in both the heart disease patients and in the healthy elderly subjects who had lower levels of plasma selenium [Giacconi 2021].
The study participants consisted of 606 heart disease patients and 858 healthy control subjects born in Marche Region of Italy. The heart disease patients had a mean age of 73 years plus/minus 9 years. The healthy control participants also had a mean age 73 years plus/minus 9 years [Giaconni].
Selenium Supplementation and Reduced Levels of Blood Bio-Markers for Inflammation
In the KiSel-10 clinical trial of the combined supplementation of elderly Swedish citizens with selenium and Coenzyme Q10, Professor Alehagen and the team of researchers observed significantly reduced circulating bio-markers of chronic inflammation [Alehagen 2015a; Alehagen 2019].
The beneficial heart health effects of daily supplementation with 200 mcg of selenium and 2 x 100 mg of Coenzyme Q10 for 48 months in the KiSel-10 Study persisted during 12 years of follow-up [Alehagen 2018]. The researchers attributed the reduced cardiovascular mortality and the improved heart function seen on echocardiograms to reduced oxidative stress, reduced inflammation, reduced fibrosis, and reduced extent of endothelial dysfunction [Alehagen 2015a; Alehagen 2015b; Alehagen 2018; Alehagen 2020].
Other randomized, double-blind, placebo-controlled trials with selenium supplementation have shown beneficial effects on cardio-metabolic risk [Raygan 2018] and reduction of oxidative stress and inflammation in coronary heart disease patients [Ju 2017].
Conclusion: Selenium and Risk of Chronic Inflammation and Heart Disease
The Italian researchers conclude that an adequate selenium status is necessary to prevent the development and progression of heart disease. Their findings show that individuals with plasma selenium levels below 60 mcg/L were 1.9 times more likely to suffer from heart disease, compared to individuals with adequate selenium levels [Giacconi 2021].
In the central Italy study, selenium deficiency was independently associated with heart disease and with elevated blood bio-markers of inflammation. Selenium deficiency was seen to affect the expression of cytokines, chemokines, and sirtuins in the peripheral blood mononuclear cells [Giacconi 2021].
In the study of elderly community living Swedish citizens, Alehagen et al [2016] showed that a low mean serum selenium status of 67.1 mcg/L was significantly associated with increased risk of all-cause death and heart disease death. The association held true after adjustment for such potential confounding variables as male gender, smoking, ischemic heart disease, diabetes, chronic obstructive pulmonary disease and impaired heart function.
Low selenium intakes do not provide sufficient selenium to achieve the physiological saturation level for several selenoprotein enzymes. Consequently, modest selenium supplementation may be necessary to improve the health of the populations in selenium-poor regions of the world [Alehagen 2016].
Sources
Alehagen U, Lindahl TL, Aaseth J, Svensson E. 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. 2015a;10:e0137680.
Alehagen U, Aaseth J, Johansson P. Less increase of copeptin and MR-proADM due to intervention with selenium and coenzyme Q10 combined: Results from a 4-year prospective randomized double-blind placebo-controlled trial among elderly Swedish citizens. Biofactors. 2015b;41:443-52.
Alehagen U, Johansson P, Björnstedt M, Rosén A. Relatively high mortality risk in elderly Swedish subjects with low selenium status. Eur J Clin Nutr. 2016;70:91-6.
Alehagen U, Alexander J, Aaseth J. Supplementation with selenium and coenzyme Q10 reduces cardiovascular mortality in elderly with low selenium status: a secondary analysis of a randomised clinical trial. PLoS One. 2016;11:e0157541.
Alehagen U, Aaseth J, Alexander J, Johansson P. Still reduced cardiovascular mortality 12 years after supplementation with selenium and coenzyme Q10 for four years: A validation of previous 10-year follow-up results of a prospective randomized controlled trial. PLoS One. 2018;13:e0193120 .
Alehagen U, Alexander J, Aaseth J, Larsson A. Decrease in inflammatory biomarker concentration by intervention with selenium and coenzyme Q10: a subanalysis of osteopontin, osteoprotergerin, TNFr1, TNFr2 and TWEAK. J Inflamm (Lond). 2019;16:5.
Alehagen U, Alexander J, Aaseth J, Larsson A. Significant decrease of von Willebrand factor and plasminogen activator inhibitor-1 by providing supplementation with selenium and Coenzyme Q10 to an elderly population. European Journal of Nutrition. 2020;59:3581-3590.
Giacconi R, Chiodi L, Boccoli G, Costarelli L, Piacenza F, Provinciali M, Malavolta M. Reduced levels of plasma selenium are associated with increased inflammation and cardiovascular disease in an Italian elderly population. Exp Gerontol. 2021 Mar;145:111219.
Ju W, Li X, Li Z, Wu GR, Fu XF, Yang XM, Zhang XQ, Gao XB. The effect of selenium supplementation on coronary heart disease: A systematic review and meta-analysis of randomized controlled trials. J Trace Elem Med Biol. 2017 Dec;44:8-16.
Raygan F, Behnejad M, Ostadmohammadi V, Bahmani F, Mansournia MA, Karamali F, Asemi Z. Selenium supplementation lowers insulin resistance and markers of cardio-metabolic risk in patients with congestive heart failure: a randomised, double-blind, placebo-controlled trial. Br J Nutr. 2018 Jul;120(1):33-40.
The information presented in this review article is not intended as medical advice and should not be used as such.
30 December 2021