[Association between plasma selenium and the risk of impaired glucose regulation].

Objective: To investigate the association between plasma selenium exposure and the risk of impaired glucose regulation (IGR). Methods: A case-control study was conducted to select IGR patients who were admitted to the outpatient clinic of the Department of Endocrinology to perform oral glucose tolerance test(OGTT) at the Tongji Hospital affiliated to the Tongji Medical College from September 2004 to 2016 as a case group. Participants with normal glucose tolerance recruited from an unselected group of population undergoing routine health examinations in the same hospital were selected as a control group. The control group was matched according to the age (±5 years old) and sex of the case group. The inclusion criteria for subjects recruited were as follows: age ≥30 years, body mass index (BMI) <40 kg/m(2), no history of a diagnosis of IGR or type 2 diabetes, and no history of receiving pharmacological treatment for hyperlipidemia or hypertension. Patients with any clinically systemic disease such as neurological or endocrine disease, acute illness, chronic inflammatory disease or infectious disease were excluded from the study. A total of 1 957 subjects, 897 in the case group and 1 060 in the control group, were included. Questionnaires were used to collect information of all subjects, and peripheral venous blood was collected after fasting and OGTT, respectively. Plasma selenium, fasting blood glucose, blood lipid (total cholesterol, triglycerides, high density lipoprotein cholesterol, and low density lipoprotein cholesterol) and 2 h OGTT plasma glucose concentration were detected, respectively. The subjects were divided into low, medium and high concentration groups according to the tertiles of plasma selenium concentration in the control group. The multivariate unconditional logistic regression analysis was performed to analyze the association between plasma selenium exposure and IGR. Results: The age (mean±SD) of the case and control group was (53.71±11.38) and (53.95±12.17) years old. The plasma selenium concentration [M (P(25), P(75))] in the case group was 92.81(77.07, 107.05) μg/L, which was significantly higher than the control group [88.73 (77.13, 100.88) μg/L] (P<0.05). The results of multivariate unconditional logistic regression analysis showed that after adjusting for age, sex, BMI, family history of diabetes and hypertension, the risk of IGR was higher in the high-concentration group and the low-concentration group compared with the middle-concentration group, the values of OR (95%CI) were 1.22 (95%CI: 0.94-1.59) and 1.81 (95%CI: 1.42-2.30), respectively. Conclusion: The study suggested a U-shaped association between plasma selenium and IGR.目的： 探讨血浆硒与糖尿病前期（IGR）患病风险之间的关联。 方法： 采用病例对照研究方法，选择2004年12月至2016年11月在华中科技大学同济医学院附属同济医院内分泌科进行口服糖耐量试验（OGTT）的门诊IGR患者作为病例组，在该医院进行健康体检且糖耐量正常的人群作为对照组，按病例组的年龄（±5岁）和性别进行匹配。纳入标准为年龄≥30岁、体重指数<40 kg/m(2)、无IGR或2型糖尿病疾病史、无高血脂或高血压药物治疗史；排除标准为有神经、内分泌等系统性疾病，近期患有急性疾病、慢性炎症、感染性疾病者。最终共纳入1 957例研究对象，病例组和对照组分别为897例和1 060名。采用问卷调查方法收集基本信息，采集空腹静脉血和OGTT后的静脉血，分别检测血浆硒、空腹血糖、血脂四项（总胆固醇、甘油三酯，高密度脂蛋白胆固醇、低密度脂蛋白胆固醇）和OGTT 2 h血糖浓度。根据对照组血浆硒浓度的三分位数，将研究对象分为低、中、高浓度组。采用多因素非条件logistic回归分析血浆硒与IGR的关联。 结果： 病例组和对照组的年龄分别为（53.71±11.38）、（53.95±12.17）岁，病例组的血浆硒浓度M（P(25)，P(75)）为92.81（77.07，107.05）μg/L，高于对照组[88.73（77.13~100.88）μg/L]（P<0.05）。多因素非条件logistic回归模型结果显示，调整了年龄、性别、体重指数、糖尿病家族史和高血压患病情况后，与血浆硒中浓度组对象相比，低浓度组和高浓度组对象IGR患病风险OR（95%CI）值分别为1.22（0.94~1.59）、1.81（1.42~2.30）。 结论： 血浆硒可能与IGR患病风险之间存在"U型"关联。.