TY  - BOOK
AU  - Umans, Jason G
TI  - High level of selenium exposure in the Strong Heart Study: a cause for incident cardiovascular disease?
SN  - 1523-0864
PY  - 2022///
KW  - IN PROCESS -- NOT YET INDEXED
KW  - MedStar Health Research Institute
KW  - Journal Article
N2  - Increasing evidence suggests that high selenium (Se) exposure is associated with adverse health effects. However, limited evidence exists on the association of Se exposure with cardiovascular disease (CVD), especially in communities affected by high naturally occurring Se in environmental media. We evaluated the prospective association between urinary Se levels and CVD incidence and mortality for 2,727 American Indian adults who participated in the Strong Heart Study, with urinary Se levels measured at baseline (1989-1991) and CVD outcomes ascertained through 2017. The median (interquartile range) of urinary Se was 49.0 (36.7, 67.4) microg/g creatinine. The multivariable adjusted hazard ratios (95%CI) of incident CVD, coronary heart disease, and stroke comparing the 75th vs. 25th percentile of urinary Se distributions were 1.11 (1.01, 1.22), 1.05 (0.94, 1.17), and 1.08 (0.88, 1.33), respectively. In flexible dose-response models, increased risk for CVD incidence was only observed when urinary Se level exceeded 60 microg/g creatinine. For CVD mortality, a non-statistically significant U-shaped relationship was found across urinary Se levels. There was no evidence of effect modification by other urinary metal/metalloid levels. Our observation leads to the hypothesis that elevated Se exposure is a risk factor for CVD, especially in Se-replete populations
UR  - https://dx.doi.org/10.1089/ars.2022.0029
ER  -