ResultsAverage selenium intake at b

Results
Average selenium intake at baseline was 55.7μg/day. After a median follow-up of 16 years, 253 women developed type 2 diabetes. At baseline, women who developed diabetes over follow-up were on average older, heavier, less educated, had higher dietary intakes of total and animal proteins, consumed less alcohol, and were more likely to be postmenopausal than women who did not develop diabetes. In addition, they had a higher mean dietary intake of selenium (60.9 vs. 56.8μg/d, P< 0.001) (Table 1). Red meat and fish were the two main sources of dietary selenium intake in this population (Table 2). Selenium intake was positively associated with BMI, with total and animal protein intake, and with the ratio of polyunsaturated to saturated fatty acid intake (Table 3). Conversely, intake of total carbohydrates, starch, sugars fibers and alcohol were all inversely associated with dietary selenium intake. The age, education, and menopausal status adjusted odds ratio for incident type2 diabetes comparing the highest to the lowest quintile of selenium intake was 2.64 (95% CI: 1.73, 4.01), with evidence of a progressive increase in risk across quintiles (P-trend < 0.001) (Table 4). The odds ratio estimates were not considerably altered after additional adjustment for BMI, smoking status, dietary variables and body weight change during follow-up (OR 2.39, 95% CI: 1.32, 4.32). When selenium was used as a continuous variable, the odds ratios associated with a 10μg/d increase in selenium intake were 1.29 (95% CI: 1.17, 1.41) in the reduced model, and 1.29 (95% CI: 1.10, 1.52) in the fully adjusted model. The linearity of the relationship between selenium intake and risk of diabetes was confirmed in spline regression models (not shown). There was no statistical evidence that BMI, menopausal status, smoking and alcohol intake modified the association of selenium intake with diabetes risk (data not shown).
Discussion
In this prospective study, dietary selenium intake showed a strong and graded association with the risk of type 2 diabetes in a large sample of Italian women. The association was independent of a number of potential confounding factors including socio-demographic, anthropometric, lifestyle and dietary variables. To our knowledge, this is one of the few epidemiological studies to examine the prospective relationship of dietary selenium intake with incident type 2 diabetes in Europe. Recent findings from observational studies and randomised clinical trials from the US, a selenium-replete population, indicate that high selenium status or selenium supplementation may be associated with an increased risk of type 2 diabetes [5-8]. Data from the Third National Health and Nutrition Examination Survey (NHANES III) [5] and from NHANES 2003-2004 [8]showedsignificantcross-sectional associations between high serum selenium levels and the prevalence of type 2 diabetes in representative samples of the US population. Furthermore, selenium supplementation (200 μg/d) in the Nutritional Prevention of Cancer (NPC) trial, conducted in the Eastern US, was associated with an increased risk of incident type 2 diabetes compared to placebo (hazard ratio, 1.55, 95% CI: 1.03, 2.33). Theincreaseinriskwaslargely limited to participants with high baseline selenium levels (hazard ratio of 2.70 in the highest tertile of serum selenium) [6]. Finally, the Selenium and Vitamin E Cancer Prevention Trial (SELECT), conducted among 35,000 North American men aged 50 and older, was prematurely stopped because of lack of efficacy of vitamin E and selenium supplementation (200μg/d) in cancer prevention and because of a small, though not statistically significant increase in the number of cases of adult onset diabetes in participants taking only selenium (relative risk compared to placebo 1.07, 99% CI: 0.94, 1.22) [7]. In disagreement with these studies, cross-sectional findings from the Health Professionals Follow-up Study showed

Hasil (Bahasa Indonesia) 1:

HasilSelenium rata-rata asupan pada awal adalah 55.7μg / hari. Setelah tindak lanjut rata-rata 16 tahun, perempuan 253 mengembangkan diabetes tipe 2. Pada dasar, wanita yang mengembangkan diabetes atas tindak lanjut rata-rata lebih tua, lebih berat, kurang berpendidikan, telah lebih tinggi diet asupan protein total dan hewan, dikonsumsi alkohol kurang dan lebih cenderung menjadi pascamenopause daripada wanita yang tidak mengembangkan diabetes. Selain itu, mereka memiliki asupan makanan yang lebih tinggi berarti selenium (60,9 vs 56.8μg / d, P < 0.001) (Tabel 1). Daging merah dan ikan adalah dua sumber utama dari asupan makanan selenium pada populasi (Tabel 2). Selenium asupan adalah positif dikaitkan dengan BMI, asupan protein total dan hewan, dan dengan rasio tak jenuh ganda untuk asupan asam lemak jenuh (Tabel 3). Sebaliknya, asupan karbohidrat total, Pati, serat gula dan alkohol dikaitkan semua terbalik dengan asupan makanan selenium. Usia, pendidikan, dan menopause status disesuaikan rasio peluang untuk type2 insiden diabetes membandingkan sekelompok terendah selenium asupan tertinggi adalah 2.64 (95% CI: 1,73, 4.01), dengan bukti peningkatan progresif risiko di seluruh quintiles (P-tren < 0.001) (Tabel 4). Rasio peluang perkiraan yang tidak jauh diubah setelah penyesuaian tambahan untuk BMI, status Rokok, Variabel Diet dan berat badan berubah selama tindak lanjut (2,39 atau, 95% CI: 1.32, 4.32). Ketika selenium digunakan sebagai variabel terus-menerus, rasio peluang yang terkait dengan 10μg/d kenaikan asupan selenium adalah 1,29 (95% CI: 1,17, 1.41) dalam model berkurang, dan 1,29 (95% CI: 1,10, 1.52) dalam model sepenuhnya disesuaikan. Linearitas dari hubungan antara asupan selenium dan risiko diabetes dikukuhkan dalam model regresi spline (tidak ditampilkan). Ada tidak ada bukti statistik bahwa BMI, asupan menopause status, rokok dan alkohol diubah Asosiasi asupan selenium dengan risiko diabetes (data tidak ditampilkan).DiskusiIn this prospective study, dietary selenium intake showed a strong and graded association with the risk of type 2 diabetes in a large sample of Italian women. The association was independent of a number of potential confounding factors including socio-demographic, anthropometric, lifestyle and dietary variables. To our knowledge, this is one of the few epidemiological studies to examine the prospective relationship of dietary selenium intake with incident type 2 diabetes in Europe. Recent findings from observational studies and randomised clinical trials from the US, a selenium-replete population, indicate that high selenium status or selenium supplementation may be associated with an increased risk of type 2 diabetes [5-8]. Data from the Third National Health and Nutrition Examination Survey (NHANES III) [5] and from NHANES 2003-2004 [8]showedsignificantcross-sectional associations between high serum selenium levels and the prevalence of type 2 diabetes in representative samples of the US population. Furthermore, selenium supplementation (200 μg/d) in the Nutritional Prevention of Cancer (NPC) trial, conducted in the Eastern US, was associated with an increased risk of incident type 2 diabetes compared to placebo (hazard ratio, 1.55, 95% CI: 1.03, 2.33). Theincreaseinriskwaslargely limited to participants with high baseline selenium levels (hazard ratio of 2.70 in the highest tertile of serum selenium) [6]. Finally, the Selenium and Vitamin E Cancer Prevention Trial (SELECT), conducted among 35,000 North American men aged 50 and older, was prematurely stopped because of lack of efficacy of vitamin E and selenium supplementation (200μg/d) in cancer prevention and because of a small, though not statistically significant increase in the number of cases of adult onset diabetes in participants taking only selenium (relative risk compared to placebo 1.07, 99% CI: 0.94, 1.22) [7]. In disagreement with these studies, cross-sectional findings from the Health Professionals Follow-up Study showed