title: Selenium intake and cardiovascular risk: what is new?
abstract: OBJECTIVE
  Selenium is an essential element with a narrow safety margin. Adequate selenium intake is needed to maximize the activity of glutathione peroxidases and other selenoproteins. This review discusses recent experimental and epidemiologic contributions on the role of selenium for the prevention of atherosclerotic cardiovascular disease.
  
  
  RESULTS
  Few randomized trials have evaluated the efficacy of selenium supplementation on cardiovascular endpoints. Most trials, conducted in selenium-replete populations, found no evidence of cardiovascular protection. A meta-analysis of 13 prospective cohort studies found a moderate inverse relationship between plasma/serum selenium and coronary heart disease. The interpretation of these data is complicated, however, by potential residual confounding and publication bias. In contrast, recent data from trials of selenium-containing supplements and from epidemiologic studies suggest that chronically increased selenium intake in selenium-replete populations can induce diabetes and maybe also hypercholesterolemia.
  
  
  CONCLUSIONS
  Current evidence is insufficient to support a protective role for selenium in cardiovascular prevention. Large high-quality randomized controlled trials and observational studies are needed across populations with different levels of selenium intake. Furthermore, subjects living in regions with high selenium intake should be aware that selenium supplements may increase their risk of diabetes and hypercholesterolemia.
authors.affiliation: Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland 21205, USA. anavas@jhsph.edu
authors.forename: Ana
authors.initials: A
authors.lastname: Navas-Acien
authors.forename: Joachim
authors.initials: J
authors.lastname: Bleys
authors.forename: Eliseo
authors.initials: E
authors.lastname: Guallar
mesh_terms: D000818:Animals; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control*; D015986:Confounding Factors, Epidemiologic; D019587:Dietary Supplements; D006801:Humans; D015201:Meta-Analysis as Topic; D012307:Risk Factors; D018036:Selenium Compounds / Q000097:blood / Q000494:pharmacology*
chemical_list: D018036:Selenium Compounds