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21 August 2007 | Volume 147 Issue 4
Background: Findings from animal models suggest that selenium supplementation improves glucose metabolism.
Objective: To examine the effect of long-term selenium supplementation on the incidence of type 2 diabetes.
Design: Secondary analysis of a randomized, double-blind, placebo-controlled trial.
Setting: Areas of Low selenium consumption of the eastern United States.
Patients: 1202 persons seen in dermatology clinics who did not have type 2 diabetes at baseline.
Intervention: Oral administration of selenium, 200 µg/d, or placebo.
Measurements: Incidence of type 2 diabetes.
Results: During an average follow-up of 7.7 years (SD, 2.7), type 2 diabetes developed in 58 selenium recipients and 39 placebo recipients (incidence, 12.6 cases per 1000 person-years vs. 8.4 cases per 1000 person-years, respectively; hazard ratio, 1.55 [95% CI, 1.03 to 2.33]). The lack of benefit of selenium supplementation on the incidence of type 2 diabetes persisted in analyses stratified by age, sex, body mass index, and smoking status. An exposure–response gradient was found across tertiles of baseline plasma selenium level, with a statistically significantly increased risk for type 2 diabetes in the highest tertile of baseline plasma selenium level (hazard ratio, 2.70 [CI, 1.30 to 5.61]).
Limitations: Diabetes was a secondary outcome in the parent trial. Diagnoses of diabetes were self-reported but were validated in most participants. The sample was mostly older and white.
Conclusions: Selenium supplementation does not seem to prevent type 2 diabetes, and it may increase risk for the disease.
Editors' Notes
Context
Contribution
Cautions
Implication
—The Editors
Author and Article Information
From the State University of New York at Buffalo and Cancer Prevention and Population Sciences, Roswell Park Cancer Institute, Buffalo, New York; Clinical Sciences Research Institute, Warwick Medical School, Coventry, United Kingdom; and U.S. Department of Agriculture Human Nutrition Research Center, Grand Forks, North Dakota.
Potential Financial Conflicts of Interest: None disclosed.
Requests for Single Reprints: Saverio Stranges, MD, PhD, Clinical Sciences Research Institute, Warwick Medical School, University Hospital Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, United Kingdom; e-mail, s.stranges{at}warwick.ac.uk.
Current Author Addresses: Dr. Stranges, Cappuccio, and Ceriello: Clinical Sciences Research Institute, Warwick Medical School, University Hospital Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, United Kingdom.
Drs. Marshall and Reid and Mr. Natarajan: Roswell Park Cancer Institute, Carlton House Building, Elm and Carlton Streets, Buffalo, NY 14263.
Drs. Donahue and Trevisan: Department of Social and Preventive Medicine, State University of New York at Buffalo, South Campus, 3435 Main Street, Farber Hall, Buffalo, NY 14214.
Dr. Combs: Human Nutrition Research Center, U.S. Department of Agriculture, 2420 Second Avenue North, Stop 9034, Grand Forks, ND 58202.
Author Contributions: Analysis and interpretation of the data: S. Stranges, R. Natarajan, R.P. Donahue, M. Trevisan, G.F. Combs, F.P. Cappuccio.
Drafting of the article: S. Stranges, R.P. Donahue, M. Trevisan.
Critical revision of the article for important intellectual content: S. Stranges, R.P. Donahue, M. Trevisan, G.F. Combs, F.P. Cappuccio.
Final approval of the article: S. Stranges, M. Trevisan, F.P. Cappuccio.
Statistical expertise: R. Natarajan, M. Trevisan.
Administrative, technical, or logistic support: G.F. Combs, F.P. Cappuccio.
Collection and assembly of data: G.F. Combs. ARTICLE
Effects of Long-Term Selenium Supplementation on the Incidence of Type 2 Diabetes
A Randomized Trial
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