Serum Levels of Selenium Inversely Associated with the Severity of Liver Cirrhosis

by | Nov 8, 2022 | 2022, Liver Health, Minerals, Selenium

Written by Taylor Woosley, Staff Writer. Data from the 2017-2018 NHANES datasets of 5641 subjects show that, after fully multivariate adjustments, participants in the highest serum selenium quartile (>2.60 µg/L) had lower LSM values (p< 0.005) compared with participants in the lowest quartile. 

liver scanCirrhosis is one of the leading causes of death in clinics among all digestive diseases1. Liver cirrhosis refers to scarring of liver tissue caused by long-term damage that prevents the liver from functioning properly2. The development of cirrhosis is associated with viruses, alcohol consumption, and non-alcoholic steatohepatitis (NASH)3. Patients with decompensated cirrhosis develop multiple complications; the most common being ascites and gastroesophageal variceal bleedings, with a high risk of mortality4.

Selenium (Se), a micronutrient that is essential for the proper functioning of all organisms, has been researched for its antioxidant capabilities5. It plays a crucial role in redox homeostasis and provides defense against oxidative stress and inflammation6. Se deficiency induces a systematic redox imbalance and inflammation in the blood and causes pathological changes in the liver7.

Shih et al. conducted a cross-sectional observational study using data from The National Health and Nutrition Examination Survey (NHANES), an annual survey focused on health information and statistics of the US population. Data analyzed was from the 2017-2018 NHANES datasets. Information regarding demographic information, educational level, medical history, and personal history were obtained during interviews by trained examiners. Further information including physical examinations and a liver ultrasound transient elastography were conducted in the Mobile Examination Center (MEC). Inductively coupled plasmadynamic reaction cell mass spectrometry (ICP-DRC-MS) was used to determine serum levels of selenium, lead, cadmium, and mercury.

A linear regression model was used to examine the associations between each trace element. Furthermore, a model for covariate adjustment (adjusted for age, sex, BMI, race/ethnicity, platelet count, alanine aminotransferase (ALT), serum creatinine, serum total bilirubin and urine albumin, smoking history, and use of dietary supplements) was established. The Fibrosis (Fib)-4 index was included in the adjusted model to provide a non-invasive scoring system for the disease activity of liver fibrosis. Serum selenium levels were divided into quartiles and a regression model adjusted for multiple covariates was analyzed to investigate the association between each quartile and severity of liver stiffness measurement (LSM).

The study included 5641 participants with a mean age of 44.88 ± 20.90. The mean serum selenium level was 2.41 ± 0.33 µg/L and the mean LSM value was 5.87 ± 5.02 kPa. Significant results of the study show a significant linear decrease in LSM values in male groups with increased serum selenium levels in the fully adjusted model, and the regression coefficient was -1.045 (95% CI: -1.746, -0.344; p = 0.003). Additionally, compared with participants in the lowest quartile, those in the highest serum selenium quartile (>2.60 µg/L) had lower LSM values, as the regression coefficient was -0.416 (95% CI: -0.829, -0.004; p < 0.05) after fully multivariate adjustments.

Study findings show that there is an inverse association between the serum level of selenium and the severity of liver cirrhosis. Furthermore, the subgroup analysis found that the inverse association was shown in individuals with older age. Further studies are needed to investigate the use of selenium to slow the progression of liver fibrosis and cirrhosis. Study limitations include the inability to establish the protective effect of selenium due to the cross-sectional nature of the study.

Source: Shih, Chi-Wei, Ying-Jen Chen, and Wei-Liang Chen. “Inverse Association between Serum Selenium Level and Severity of Liver Fibrosis: A Cross-Sectional Study.” Nutrients 14, no. 17 (2022): 3625.

© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/).

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Posted November 8, 2022.

Taylor Woosley studied biology at Purdue University before becoming a 2016 graduate of Columbia College Chicago with a major in Writing. She currently resides in Glen Ellyn, IL.

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