title: Relatively high mortality risk in elderly Swedish subjects with low selenium status.
abstract: OBJECTIVE
  The daily dietary intake of selenium (Se), an essential trace element, is still low in Sweden in spite of decades of nutritional information campaigns and the effect of this on the public health is presently not well known. The objective of this study was to determine the serum Se levels in an elderly Swedish population and to analyze whether a low Se status had any influence on mortality.
  
  
  METHODS
  Six-hundred sixty-eight (n=668) elderly participants were invited from a municipality and evaluated in an observational study. Individuals were followed for 6.8 years and Se levels were re-evaluated in 98 individuals after 48 months. Clinical examination of all individuals included functional classification, echocardiography, electrocardiogram and serum Se measurement. All mortality was registered and endpoints of mortality were assessed by Kaplan-Meier plots, and Cox proportional hazard ratios adjusted for potential confounding factors were calculated.
  
  
  RESULTS
  The mean serum Se level of the study population (n=668) was 67.1 μg/l, corresponding to relatively low Se intake. After adjustment for male gender, smoking, ischemic heart disease, diabetes, chronic obstructive pulmonary disease and impaired heart function, persons with serum Se in the lowest quartile had 43% (95% confidence interval (CI): 1.02-2.00) and 56% (95% CI: 1.03-2.36) increased risk for all-cause and cardiovascular mortality, respectively. The result was not driven by inflammatory effects on Se concentration in serum.
  
  
  CONCLUSIONS
  The mean serum Se concentration in an elderly Swedish population was 67.1 μg/l, which is below the physiological saturation level for several selenoprotein enzymes. This result may suggest the value of modest Se supplementation in order to improve the health of the Swedish population.
authors.affiliation: Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Heart Center, Linköping University, Linköping, Sweden.
authors.forename: U
authors.initials: U
authors.lastname: Alehagen
authors.affiliation: Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Heart Center, Linköping University, Linköping, Sweden.
authors.forename: P
authors.initials: P
authors.lastname: Johansson
authors.affiliation: Division of Pathology F42, Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden.
authors.forename: M
authors.initials: M
authors.lastname: Björnstedt
authors.affiliation: Division of Cell Biology, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Rosén
authors.affiliation: Division of Cell Biology, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
authors.forename: C
authors.initials: C
authors.lastname: Post
authors.affiliation: Research Department, Innlandet Hospital Trust and Hedmark University College, Norway.
authors.forename: J
authors.initials: J
authors.lastname: Aaseth
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000097:blood / Q000401:mortality*; D002423:Cause of Death; D003677:Deficiency Diseases / Q000097:blood / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D009752:Nutritional Status; D016016:Proportional Hazards Models; D012306:Risk; D012643:Selenium / Q000097:blood*; D013548:Sweden / Q000453:epidemiology; D014131:Trace Elements / Q000097:blood*
chemical_list: D014131:Trace Elements; D012643:Selenium