Interaction effect between blood selenium levels and stroke history on all-cause mortality: a retrospective cohort study of NHANES

 Is your competent? doctor currently preparing protocols on selenium based on these two recent research articles? NO? So your don't have a functioning stroke doctor?

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Interaction effect between blood selenium levels and stroke history on all-cause mortality: a retrospective cohort study of NHANES

Yanli LiLanqun LiuZufu YangJimin Xu^*

• Department of Traditional Chinese Medicine, Beijing Boai Hospital, China Rehabilitation Research Center, School of Rehabilitation Medicine, Capital Medical University, Beijing, China

Aim: The study aimed to investigate the interaction effect between blood selenium levels and stroke history on all-cause mortality.

Methods: In this retrospective cohort study, participant data were obtained from the National Health and Nutrition Examination Survey (NHANES) 2011–2018. The covariates were screened via the backward selection method in weighted univariate and multivariate Cox regression models. Weighted univariate and multivariate Cox regression models were conducted to investigate the association of blood selenium and stroke history with all-cause mortality. The results were expressed as hazard ratios (HRs) and 95% confidence intervals (CIs). The synergy index (SI) was used to assess the assistive interaction. The association was further explored in different gender groups.

Results: Totally, 8,989 participants were included, of whom 861 (9.57%) died. Participants with blood selenium ≥192.96 ug/L were associated with lower odds of all-cause mortality (HR = 0.70, 95% CI: 0.58–0.84), whereas those with a stroke history were associated with a higher risk of all-cause mortality (HR = 1.57, 95% CI: 1.15–2.16). Compared to participants with blood selenium ≥192.96 ug/L and non-stroke history, participants with both blood selenium < 192.96 ug/L and stroke history had a higher all–cause mortality risk (HR = 2.31, 95% CI: 1.62–3.29; SI = 0.713, 95% CI: 0.533–0.952). All participants with blood selenium < 192.96 ug/L and stroke history were related to higher all–cause mortality risk (HR = 1.61, 95% CI: 1.21–2.13). In males, the interaction effect of blood selenium and stroke history on all–cause mortality (HR = 2.27, 95% CI: 1.50–3.46; SI = 0.651, 95% CI: 0.430–0.986) increased twice.

Conclusion: Blood selenium and stroke history have an interaction effect on all-cause mortality. Increasing selenium-rich food or supplement intake, especially for individuals with a stroke history, may improve poor prognosis.(Well, then, do the research that creates a protocol for selenium!)

Introduction

Stroke, a neurological emergency, is the second leading cause of death and a major contributor to disability worldwide (1). Stroke affects 13.7 million people and causes 5.5 million deaths (2). Stroke is also responsible for about 140,000 deaths in the U.S. every year, which is about one out of every 20 deaths in the country (3). Stroke history is an independent risk factor for poor prognosis in ischemic stroke patients (4). Oxidative stress and inflammation play significant roles in the pathogenesis of stroke (5–7).

Selenium, an essential trace element, plays a critical role in various physiologic processes, including oxidative stress, thyroid hormone metabolism, and immune function (8, 9). Lower circulating selenium levels have been linked to an elevated risk of cardiovascular disease, increased risk of ischemic stroke, and all-cause mortality (10). In patients with heart failure, blood selenium was independently associated with a 50% higher mortality rate (11). A lower concentration of selenium could increase the risk of ischemic stroke (12). And Wang et al. reported that plasma selenium was inversely associated with the risk of a first ischemic stroke (13). Zhao et al. (14) also found a negative relationship between blood selenium levels and stroke. In addition, the modifying effect of selenium was observed in metabolic disease, cardiovascular disease (CVD), and neurologic symptoms (15–17). We hypothesize that blood selenium level and stroke history may have an interaction with the long-term prognosis of participants.

Thus, this study aimed to investigate the interaction effect of blood selenium and stroke on all-cause mortality. The findings of this study will contribute to existing knowledge on the role of blood selenium in stroke prognosis and provide guidelines for the development of targeted interventions to improve outcomes for individuals with stroke histories.

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