Effect of selenium on markers of risk of pre-eclampsia in UK pregnant women: a randomised, controlled pilot trial.
Pre-eclampsia is a serious hypertensive condition of pregnancy associated with high maternal and fetal morbidity and mortality. Se intake or status has been linked to the occurrence of pre-eclampsia by our own work and that of others. We hypothesised that a small increase in the Se intake of UK pregnant women of inadequate Se status would protect against the risk of pre-eclampsia, as assessed by biomarkers of pre-eclampsia. In a double-blind, placebo-controlled, pilot trial, we randomised 230 primiparous pregnant women to Se (60 μg/d, as Se-enriched yeast) or placebo treatment from 12 to 14 weeks of gestation until delivery. Whole-blood Se concentration was measured at baseline and 35 weeks, and plasma selenoprotein P (SEPP1) concentration at 35 weeks. The primary outcome measure of the present study was serum soluble vascular endothelial growth factor receptor-1 (sFlt-1), an anti-angiogenic factor linked with the risk of pre-eclampsia. Other serum/plasma components related to the risk of pre-eclampsia were also measured. Between 12 and 35 weeks, whole-blood Se concentration increased significantly in the Se-treated group but decreased significantly in the placebo group. At 35 weeks, significantly higher concentrations of whole-blood Se and plasma SEPP1 were observed in the Se-treated group than in the placebo group. In line with our hypothesis, the concentration of sFlt-1 was significantly lower at 35 weeks in the Se-treated group than in the placebo group in participants in the lowest quartile of Se status at baseline (P= 0·039). None of the secondary outcome measures was significantly affected by treatment. The present finding that Se supplementation has the potential to reduce the risk of pre-eclampsia in pregnant women of low Se status needs to be validated in an adequately powered trial.
Department of Nutritional Sciences,School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey,GuildfordGU2 7XH,UK.
Margaret P
MP
Rayman
Nuffield Department of Obstetrics and Gynaecology, University of Oxford,OxfordOX3 9DU,UK.
Elizabeth
E
Searle
Anu Research Centre, Department of Obstetrics and Gynaecology, Cork University Maternity Hospital,Wilton, Cork,Republic of Ireland.
Lynne
L
Kelly
Surrey Clinical Research Centre (CRC), Faculty of Health and Medical Sciences, University of Surrey,GuildfordGU2 7XP,UK.
Sigurd
S
Johnsen
Department of Nutritional Sciences,School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey,GuildfordGU2 7XH,UK.
Katherine
K
Bodman-Smith
Department of Nutritional Sciences,School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey,GuildfordGU2 7XH,UK.
Sarah C
SC
Bath
Department of Nutritional Sciences,School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey,GuildfordGU2 7XH,UK.
Jinyuan
J
Mao
Nuffield Department of Obstetrics and Gynaecology, University of Oxford,OxfordOX3 9DU,UK.
Christopher W G
CW
Redman
D000328:Adult; D015415:Biomarkers / Q000032:analysis / Q000097:blood; D019587:Dietary Supplements; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D015994:Incidence; D009262:Nails / Q000737:chemistry; D009752:Nutritional Status; D010865:Pilot Projects; D011225:Pre-Eclampsia / Q000097:blood / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D012306:Risk; D012643:Selenium / Q000032:analysis / Q000097:blood / Q000172:deficiency / Q000627:therapeutic use*; D051149:Selenoprotein P / Q000097:blood*; D006113:United Kingdom / Q000453:epidemiology; D040281:Vascular Endothelial Growth Factor Receptor-1 / Q000097:blood*; D015002:Yeast, Dried / Q000737:chemistry / Q000627:therapeutic use*
D015415:Biomarkers; D051149:Selenoprotein P; C501162:FLT1 protein, human; D040281:Vascular Endothelial Growth Factor Receptor-1; D012643:Selenium